Objective

To study the inflammatory profile and genes involved in the response to bacterial infections in women who developed spontaneous abortion in the presence of Ureaplasma parvum.

Design

Cross-sectional study.

Setting

A maternal and child referral center.

Patient(s)

Eighty-nine women with spontaneous abortion and 20 women with normal vaginal delivery (control group) were studied.

Intervention(s)

Samples of biopsied placental tissue were collected for Mollicutes detection.

Main Outcome Measure(s)

The samples were subjected to histologic analysis, immunohistochemical evaluation for macrophages and lymphocytes, cytokine quantification, and quantitative polymerase chain reaction array to evaluate the expression of 84 genes related to the innate and adaptive immune responses.

Result(s)

The presence of U. parvum in the abortion group was positively associated with the influx of polymorphonuclear cells in the placental tissue and increased concentrations of interleukin-6 and interleukin-12p70. U. parvum caused downregulation of genes involved in the immune response, such as attraction of immune cells, activation of an inflammatory response, T-helper cell 17 response activation, and activation of the complement system at the beginning and end of pregnancy.

Conclusion

The direct action of U. parvum on placental tissue altered the gestational tolerogenic state, reducing the immune response against pathogens and activating the extrinsic apoptotic pathway, causing spontaneous abortion.

中文翻译：

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小脲原体改变胎盘组织的免疫耐受状态并可能导致流产

客观的

研究在存在小脲原体的情况下发生自然流产的女性的炎症特征和与细菌感染反应相关的基因。

设计

横断面研究。

环境

母婴转诊中心。

耐心）

研究了 89 名自然流产妇女和 20 名正常阴道分娩的妇女（对照组）。

干预措施

收集活检胎盘组织的样本用于 Mollicutes 检测。

主要观察指标）

对样本进行组织学分析、巨噬细胞和淋巴细胞的免疫组织化学评估、细胞因子定量和定量聚合酶链反应阵列，以评估与先天性和适应性免疫反应相关的 84 个基因的表达。

结果）

U. parvum在流产组中的存在与胎盘组织中多形核细胞的流入和白细胞介素 6 和白细胞介素 12p70 的浓度增加呈正相关。U. parvum导致参与免疫反应的基因下调，例如免疫细胞的吸引、炎症反应的激活、T 辅助细胞 17 反应的激活以及妊娠开始和结束时补体系统的激活。

结论

U. parvum对胎盘组织的直接作用改变了妊娠耐受状态，降低了对病原体的免疫反应并激活了外源性凋亡途径，导致自然流产。