title: Exodus-1 (CCL20): evidence for the participation of this chemokine in spontaneous labor at term, preterm labor, and intrauterine infection.
abstract: OBJECTIVE
  CCL20, also known as MIP-3 alpha, is a chemokine that participates in chemotaxis of immature dendritic cells, effector/memory T-cells, and B-lymphocytes. The objectives of this study were to determine whether CCL20 can be detected in amniotic fluid (AF) and if AF concentration of this chemokine changes with advancing gestational age, parturition (term and preterm), and intra-amniotic infection/inflammation (IAI).
  
  
  METHODS
  A cross-sectional study was conducted including the following groups: (1) mid-trimester of pregnancy (n=65); (2) term not in labor (TNL; n=22); (3) term in labor (TIL; n=47); (4) spontaneous preterm labor (PTL) who delivered at term (n=57); (5) spontaneous PTL without IAI who delivered preterm (n=71); and (6) spontaneous PTL with IAI (n=38). AF CCL20 concentrations were determined using ELISA.
  
  
  RESULTS
  (1) The median AF CCL20 concentration in TNL was higher than that of mid-trimester patients; (2) Women in spontaneous labor at term had a higher median AF concentration of CCL20 than patients at term not in labor; (3) Patients with spontaneous PTL and IAI had a significantly higher median AF concentration of CCL20 than those without IAI who delivered preterm and those who delivered at term. Moreover, women with spontaneous PTL without IAI who delivered preterm had a significantly higher median AF concentration than those with PTL who subsequently delivered at term.
  
  
  CONCLUSIONS
  (1) CCL20 is a physiologic constituent of AF and its concentration increases as term approaches; (2) spontaneous labor (term and preterm) in the absence of IAI is associated with increased bioavailability of AF CCL20 suggesting that an increase in CCL20 is part of the common pathway of human parturition; (3) patients with IAI had dramatic elevations in the AF CCL20 concentrations suggesting that this chemokine participates in the host response to infection or other stimuli associated with intra-amniotic infection.
authors.affiliation: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Hamill
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Francesca
authors.initials: F
authors.lastname: Gotsch
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Sam
authors.initials: S
authors.lastname: Edwin
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
authors.forename: Nandor Gabor
authors.initials: NG
authors.lastname: Than
authors.forename: Pooja
authors.initials: P
authors.lastname: Mittal
authors.forename: Jimmy
authors.initials: J
authors.lastname: Espinoza
authors.forename: Lara A
authors.initials: LA
authors.lastname: Friel
authors.forename: Edi
authors.initials: E
authors.lastname: Vaisbuch
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D054418:Chemokine CCL20 / Q000378:metabolism*; D002821:Chorioamnionitis / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007752:Obstetric Labor, Premature / Q000503:physiopathology; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000378:metabolism*
chemical_list: C108355:CCL20 protein, human; D054418:Chemokine CCL20