title: Possible early prediction of preterm birth by determination of novel proinflammatory factors in midtrimester amniotic fluid.
abstract: Interferon-gamma-inducible T cell-alpha chemoattractant (ITAC) is a chemokine, directing activated T lymphocytes toward sites of inflammation. ADAM-8 (A disintegrin and metalloprotease-8) is a glycoprotein expressed in cells promoting inflammation. Elastase, a protease targeting at the degradation of intra- or extracellular proteins, is inhibited by secretory leukocyte proteinase inhibitor (SLPI), which protects against microbial invasion. Adhesion molecules (soluble intercellular adhesion molecule--sICAM-1 and soluble vascular cell adhesion molecule-sVCAM--1) serve as markers of inflammation or tissue damage. We hypothesized that elevated midtrimester amniotic fluid concentrations of above substances, and decreased levels of SLPI could possibly be useful predictors of asymptomatic intra-amniotic inflammation and/or infection, eventually resulting in preterm labor and delivery. The study involved 312 women undergoing midtrimester amniocentesis. Thirteen cases, progressing to preterm delivery (<37 weeks), were matched with 21 controls (delivering >37 weeks) for age, parity, and gestational age at amniocentesis. Amniotic fluid levels of the above substances were measured by enzyme-linked immunosorbent assay (ELISA). Only amniotic fluid ITAC and ADAM-8 levels were significantly higher (P=0.005 and P < 0.02, respectively) in women delivering at <37 weeks than at >37 weeks. SLPI concentrations significantly increased in women going into labor without ruptured membranes irrespective of pre- or term delivery (P < 0.007, P < 0.001, respectively) and correlated with elastase (r=0.508, P < 0.002). In conclusion, elevated midtrimester amniotic fluid levels of ITAC and ADAM-8 could predict occult infections/inflammations, possibly resulting in preterm birth.
authors.affiliation: Second Department of Obstetrics and Gynecology, University of Athens, 19, Soultani Str., GR-10682 Athens, Greece. malamitsi@aias.gr
authors.forename: Ariadne
authors.initials: A
authors.lastname: Malamitsi-Puchner
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vrachnis
authors.forename: Evi
authors.initials: E
authors.lastname: Samoli
authors.forename: Stavroula
authors.initials: S
authors.lastname: Baka
authors.forename: Zoe
authors.initials: Z
authors.lastname: Iliodromiti
authors.forename: Karl-Philipp
authors.initials: KP
authors.lastname: Puchner
authors.forename: Pantelis
authors.initials: P
authors.lastname: Malligianis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Hassiakos
mesh_terms: D051722:ADAM Proteins; D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D001565:Benzoates / Q000378:metabolism*; D001713:Biphenyl Compounds / Q000378:metabolism*; D016022:Case-Control Studies; D054371:Chemokine CXCL11; D019743:Chemokines, CXC / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008565:Membrane Proteins; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis
chemical_list: D001565:Benzoates; D001713:Biphenyl Compounds; C515202:CXCL11 protein, human; D054371:Chemokine CXCL11; D019743:Chemokines, CXC; D008565:Membrane Proteins; D051722:ADAM Proteins; C068490:ADAM8 protein, human