Cervical cerclage placement decreases local levels of proinflammatory cytokines in patients with cervical insufficiency

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dc.citation.issue4
dc.citation.volume217
dc.contributor.authorMonsanto, Stephany P.
dc.contributor.authorDaher, Silvia [UNIFESP]
dc.contributor.authorOno, Erika [UNIFESP]
dc.contributor.authorTezotto Pendeloski, Karen Priscilla [UNIFESP]
dc.contributor.authorTraina, Evelyn [UNIFESP]
dc.contributor.authorMattar, Rosiane [UNIFESP]
dc.contributor.authorTayade, Chandrakant
dc.coverageNew York
dc.date.accessioned2020-08-04T13:40:07Z
dc.date.available2020-08-04T13:40:07Z
dc.date.issued2017
dc.description.abstractBACKGROUND: Cervical insufficiency is characterized by premature, progressive dilation and shortening of the cervix during pregnancy. If left unattended, this can lead to the prolapse and rupture of the amniotic membrane, which usually results in midtrimester pregnancy loss or preterm birth. Previous studies have shown that proinflammatory cytokines such as interleukin-1 beta, interleukin-6, interleukin-8, and tumor necrosis factor alpha are up-regulated in normal parturition but are also associated with preterm birth. Studies evaluating such markers in patients with cervical insufficiency have evaluated only their diagnostic potential. Even fewer studies have studied them within the context of cerclage surgery. OBJECTIVES(S): The objective of the study was to evaluate the impact of local and systemic inflammatory markers on the pathogenesis of cervical insufficiency and the effect of cerclage surgery on the local immune microenvironment of women with cervical insufficiency. STUDY DESIGN: We recruited 28 pregnant women (12- 20 weeks' gestation) diagnosed with insufficiency and referred for cerclage surgery and 19 gestational age-matched normal pregnant women as controls. Serum and cervicovaginal fluid samples were collected before and after cerclage surgery and during a routine checkup for normal women and analyzed using a targeted 13-plex proinflammatory cytokine assay. RESULTS: Before surgery, patients with cervical insufficiency had higher levels of interleukin-1b, interleukin-6, interleukin-12, monocyte chemoattractant protein-1 and tumor necrosis factor alpha in cervicovaginal fluid compared to controls, but after surgery, these differences disappeared. No differences were found in serum of insufficiency versus control women. In patients with insufficiency, the levels of interleukin-1b, interleukin-6, interleukin-8, monocyte chemoattractant protein-1, and interferon gamma in cervicovaginal fluid declined significantly after cerclage compared with before intervention, but these changes were not detected in serum. CONCLUSION: Compared with normal women, patients with cervical insufficiency have elevated levels of proinflammatory cytokines in cervicovaginal fluid but not in serum, suggesting a dysregulation of the local immune environment. Cerclage intervention led to a significant decline in these proinflammatory cytokines, suggesting that cerclage may help reduce local inflammation in cervical insufficiency.en
dc.description.affiliationQueens Univ, Dept Biomed & Mol Sci, Kingston, ON, Canada
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Obstet, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Obstet, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCanadian Institutes of Health Research
dc.description.sponsorshipMITACS Globalink
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1016/j.ajog.2017.06.024
dc.identifier.citationAmerican Journal Of Obstetrics And Gynecology. New York, v. 217, n. 4, p. -, 2017.
dc.identifier.doi10.1016/j.ajog.2017.06.024
dc.identifier.issn0002-9378
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57304
dc.identifier.wosWOS:000411434300023
dc.language.isoeng
dc.publisherMosby-Elsevier
dc.relation.ispartofAmerican Journal Of Obstetrics And Gynecology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectcervical fluiden
dc.subjectcervical incompetenceen
dc.subjectcervical stitchen
dc.subjectcervicovaginal fluiden
dc.subjectcervixen
dc.subjectchemokinesen
dc.subjectcytokinesen
dc.subjectinflammatoryen
dc.subjectinterferon gammaen
dc.subjectinterleukin-1en
dc.subjectinterleukin-6en
dc.subjectinterleukin-8en
dc.subjectinterleukin-12en
dc.subjectMcDonald's cerclageen
dc.subjectmonocyte chemoattractant protein-1en
dc.subjectpregnancy outcomeen
dc.subjecttumor necrosis factor alphaen
dc.titleCervical cerclage placement decreases local levels of proinflammatory cytokines in patients with cervical insufficiencyen
dc.typeinfo:eu-repo/semantics/article
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