title: Current concepts in maternal-fetal immunology: Recognition and response to microbial pathogens by decidual stromal cells.
abstract: Chorioamnionitis is an acute inflammation of the gestational (extraplacental) membranes, most commonly caused by ascending microbial infection. It is associated with adverse neonatal outcomes including preterm birth, neonatal sepsis, and cerebral palsy. The decidua is the outermost layer of the gestational membranes and is likely an important initial site of contact with microbes during ascending infection. However, little is known about how decidual stromal cells (DSCs) respond to microbial threat. Defining the contributions of individual cell types to the complex medley of inflammatory signals during chorioamnionitis could lead to improved interventions aimed at halting this disease. We review available published data supporting the role for DSCs in responding to microbial infection, with a special focus on their expression of pattern recognition receptors and evidence of their responsiveness to pathogen sensing. While DSCs likely play an important role in sensing and responding to infection during the pathogenesis of chorioamnionitis, important knowledge gaps and areas for future research are highlighted.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Anjali P
authors.initials: AP
authors.lastname: Anders
authors.affiliation: Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, TN, USA.|Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Gaddy
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Doster
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.|Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Aronoff
mesh_terms: D002821:Chorioamnionitis / Q000276:immunology* / Q000628:therapy; D003656:Decidua / Q000166:cytology*; D005260:Female; D054884:Host-Pathogen Interactions; D006801:Humans; D007113:Immunity, Innate; D007112:Immunity, Maternally-Acquired; D007239:Infections / Q000276:immunology*; D008431:Maternal-Fetal Exchange / Q000276:immunology; D058990:Molecular Targeted Therapy; D053474:Nod1 Signaling Adaptor Protein / Q000378:metabolism; D053473:Nod2 Signaling Adaptor Protein / Q000378:metabolism; D011247:Pregnancy; D051192:Receptors, Pattern Recognition / Q000378:metabolism; D017154:Stromal Cells / Q000276:immunology*
chemical_list: C119067:NOD1 protein, human; C429018:NOD2 protein, human; D053474:Nod1 Signaling Adaptor Protein; D053473:Nod2 Signaling Adaptor Protein; D051192:Receptors, Pattern Recognition
keywords: chorioamnionitis; decidual stromal cells; infection; microbes; pathogen recognition