title: Clinical chorioamnionitis at term: the amniotic fluid fatty acyl lipidome.
abstract: Clinical chorioamnionitis at term (TCC) is the most common obstetrical infliction diagnosed in labor and delivery units worldwide and is associated with a substantial increase in maternal and neonatal morbidity and mortality. This obstetrical complication is a heterogeneous condition, as only half of patients have detectable microorganisms in the amniotic cavity. Because bioactive lipids play a key role in the initiation and resolution of an inflammatory response, we aimed to characterize the amniotic fluid lipidome in patients with TCC. We studied the amniotic fluid of patients in the following groups: 1) spontaneous labor at term without clinical chorioamnionitis (TLB) and 2) spontaneous labor at term with clinical chorioamnionitis (TCC). The TCC group was subdivided into a) those with microbial invasion of the amniotic cavity (TCC-MIAC) and b) those without microbial invasion of the amniotic cavity (TCC-noMIAC). The amniotic fluid concentration of proinflammatory lipid mediators did not differ between patients in TLB with TCC. In contrast, concentration of lipids with anti-inflammatory/proresolution properties was significantly lower in all patients with TCC than in those with TLB. These results suggest that while proinflammatory lipid mediators are involved in infection-driven intra-amniotic inflammation, a relative deficiency of anti-inflammatory/proresolution lipid mediator biosynthesis is a characteristic of TCC.
authors.affiliation: Bioactive Lipids Research Program, Department of Pathology, Wayne State University School of Medicine, Detroit, MI; Lipidomics Core Facility, Wayne State University School of Medicine, Detroit, MI. Electronic address: maddipati@wayne.edu.
authors.forename: Krishna Rao
authors.initials: KR
authors.lastname: Maddipati
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI.
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Piya
authors.initials: P
authors.lastname: Chaemsaithong
authors.affiliation: Bioactive Lipids Research Program, Department of Pathology, Wayne State University School of Medicine, Detroit, MI; Lipidomics Core Facility, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Sen-Lin
authors.initials: SL
authors.lastname: Zhou
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI.
authors.forename: Zhonghui
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI; Department of Computer Science, Wayne State University, Detroit, MI.
authors.forename: Adi L
authors.initials: AL
authors.lastname: Tarca
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Department of Obstetrics and Gynecology, Sótero del Río Hospital, Santiago, Chile; Division of Obstetrics and Gynecology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.affiliation: Division of Obstetrics and Gynecology, Pontificia Universidad Católica de Chile, Santiago, Chile; Center for Perinatal Diagnosis (CEDIP), Research and Academic Innovations, Hospital Clínico La Florida, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez
authors.affiliation: Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Nikolina
authors.initials: N
authors.lastname: Docheva
authors.affiliation: Bioactive Lipids Research Program, Department of Pathology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Honn
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D002821:Chorioamnionitis / Q000378:metabolism* / Q000473:pathology; D003430:Cross-Sectional Studies; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D055442:Metabolome; D011247:Pregnancy
chemical_list: D005227:Fatty Acids
keywords: eicosanoids; epoxy fatty acids; epoxygenase; infection; inflammation; intra-amniotic inflammation; lipidomics; lipoxygenase; omega-3 fatty acids; parturition