Intrauterine infection,immune system and premature birth |
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Authors: | Fernanda Rodrigues Helmo Eduardo Arthur Rodovalho Alves Renata Alves de Andrade Moreira Viviane Oliveira Severino Laura Penna Rocha Maria Luíza Gonçalves dos Reis Monteiro |
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Institution: | 1. Department of General Pathology, Institute of Biological and Natural Sciences, Federal University of Triangulo Mineiro, Minas Gerais, Brazil;2. Department of Immunology, Oncology Research Institute (IPON), Federal University of Triangulo Mineiro, Minas Gerais, Brazil |
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Abstract: | Preterm birth accounts for nearly one million deaths among children under five years of age, and although its etiopathogenesis is not fully elucidated, ascending intrauterine infection and fetal inflammatory response seem to be the main triggers. The intense inflammatory response mediated by IL-1β, TNF-α, PAF, IFN-γ and IL-6, PGE2 and MMP-1 and MMP-9 causes fetal membrane damage and rupture, increased uterine contractions and biochemical and structural changes in the cervix. Furthermore, preterm neonates have deficient innate and adaptive immune responses characterized by reduced levels of IgG, opsonization and phagocytosis, as well as increased activation of Th1 cells in relation to Th2 cells. Therefore, this triad is favors the occurrence of neonatal complications, such as respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia. Due to serious maternal and child health complications of intrauterine infection, several studies have tried to identify biomarkers for the early diagnosis of this entity. This literature review aims to discuss the main scientific findings regarding the association between ascending intrauterine infection, immune system and preterm birth. |
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Keywords: | Prematurity ascending intrauterine infection inflammation inflammatory response immune system |
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