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Endoglin in Amniotic Fluid as a Risk Factor for the Subsequent Development of Bronchopulmonary Dysplasia
Author(s) -
Kim Sun K.,
Romero Roberto,
Savasan Zeynep A.,
Xu Yi,
Dong Zhong,
Lee DeugChan,
Yeo Lami,
Hassan Sonia S.,
Chaiworapongsa Tinnakorn
Publication year - 2013
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12046
Subject(s) - medicine , bronchopulmonary dysplasia , prom , amniotic fluid , chorioamnionitis , endoglin , obstetrics , premature rupture of membranes , pregnancy , umbilical cord , placenta , gastroenterology , gestational age , fetus , immunology , genetics , stem cell , cd34 , biology
Objective Cross‐talk between inflammation and angiogenesis pathways has been recently reported. The objectives of this study were to: (i) examine whether amniotic fluid ( AF ) concentrations of soluble endoglin (sEng), a protein with anti‐angiogenic properties, change during pregnancy, parturition, or intra‐amniotic infection and/or inflammation ( IAI ); (ii) determine whether an increase in sEng in the AF of patients with preterm labor ( PTL ) and preterm prelabor rupture of membranes ( PROM ) is associated with adverse neonatal outcomes; and (iii) investigate potential sources of sEng in AF . Study design A cross‐sectional study was conducted to include patients in the following groups: (i) mid‐trimester ( n = 20); (ii) PTL with term delivery ( n = 95); (iii) PTL leading to preterm delivery with ( n = 40) and without IAI ( n = 46); (iv) preterm PROM with ( n = 37) and without IAI ( n = 37); (v) term in labor ( n = 48) and not in labor ( n = 44). AF concentrations of sEng were determined by enzyme‐linked immunosorbent assay. Chorioamniotic membranes, umbilical cord blood, and AF macrophages were examined for the expression of endoglin. Results (i) Patients with IAI had a higher median AF concentration of sEng than those without IAI ( P = 0.02 for PTL and 0.06 for preterm PROM ); (ii) AF concentrations of sE ng in the 3rd and 4th quartiles were associated with IAI ( OR 2.5 and 7.9, respectively); (iii) an AF sE ng concentration ≥779.5 pg/mL was associated with bronchopulmonary dysplasia (BPD) ( OR 7.9); (iv) endoglin was co‐localized with CD14+ macrophages in AF pellets of patients with IAI by immunofluorescence and flow cytometry; and (v) the concentration of sE ng in the supernatant was significantly increased after the treatment of macrophages with endotoxin or TNF ‐α. Conclusions Soluble endoglin participates in the host response against IAI . Activated macrophages may be a source of sEng concentrations in the AF of patients with IAI . An increase of sE ng in the AF is associated with BPD and adverse neonatal outcomes.