Teixeira Oliveira CN, Oliveira MTS, Martins Oliveira HB, Coelho Silva LS, Santos Júnior MN, Almeida CF, Amorim AT, Oliveira MV, Timenetsky J, Campos GB, Marques LM. Ureaplasma parvum alters the immune tolerogenic state in placental tissue and could cause miscarriage.
Fertil Steril 2021:S0015-0282(21)00488-X. [PMID:
34325918 DOI:
10.1016/j.fertnstert.2021.05.108]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/22/2022]
Abstract
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.
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