title: Amniotic fluid soluble Toll-like receptor 2 in pregnancies complicated by preterm prelabor rupture of membranes.
abstract: OBJECTIVE
  To determine amniotic fluid soluble Toll-like receptor 2 (sTLR2) levels in PPROM according to the presence of microbial invasion of the amniotic cavity (MIAC), histological chorioamnionitis (HCA), and both these conditions. To test the cutoff level of 222.7 ng/mL, as proposed in our previous study, in order to distinguish women with both MIAC and HCA.
  
  
  METHODS
  169 women with a gestational age between 24+0 and 36+6 weeks were included in a prospective cohort study. Amniocenteses were performed, and sTLR2 in the amniotic fluid were determined using ELISA.
  
  
  RESULTS
  Women with MIAC had higher sTLR2 levels (median 113.2 ng/mL) than those without MIAC (median 47.1 ng/mL; p < 0.0001). Women with HCA did not have a higher sTLR2 level (median 52.6 ng/mL) compared with women without HCA (median 47.1 ng/mL; p = 0.23). Women with both MIAC and HCA had higher sTLR2 levels (median: 311.3 ng/mL) than other women (17.5 ng/mL; p < 0.0001). The cutoff level 222.7 ng/mL had a sensitivity of 63%, a specificity of 98%, and a likelihood ratio of 40.3 for the prediction of both MIAC and HCA.
  
  
  CONCLUSIONS
  Amniotic fluid sTLR2 is a promising predictor of both MIAC and HCA with high specificity in PPROM.
authors.affiliation: Department of Clinical Immunology and Allergy, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic.
authors.forename: Ctirad
authors.initials: C
authors.lastname: Andrys
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Marcela
authors.initials: M
authors.lastname: Drahosova
authors.forename: Ivana
authors.initials: I
authors.lastname: Musilova
authors.forename: Lenka
authors.initials: L
authors.lastname: Pliskova
authors.forename: Helena
authors.initials: H
authors.lastname: Hornychova
authors.forename: Martin
authors.initials: M
authors.lastname: Prochazka
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000650:Amnion / Q000382:microbiology; D000653:Amniotic Fluid / Q000737:chemistry* / Q000382:microbiology; D002821:Chorioamnionitis / Q000175:diagnosis / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism* / Q000382:microbiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis; D012995:Solubility; D051195:Toll-Like Receptor 2 / Q000032:analysis*
chemical_list: C495342:TLR2 protein, human; D051195:Toll-Like Receptor 2