The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection

Nardhy Gomez-Lopez, Roberto Romero, Yaozhu Leng, Yi Xu, Rebecca Slutsky, Dustyn Levenson, Percy Pacora, Eunjung Jung, Bogdan Panaitescu, Chaur Dong Hsu

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Monocytes, after neutrophils, are the most abundant white blood cells found in the amniotic cavity of women with intra-amniotic inflammation/infection. However, the origin of such cells has not been fully investigated. Herein, we determined (1) the origin of amniotic fluid monocytes/macrophages from women with intra-amniotic inflammation/infection, (2) the relationship between the origin of amniotic fluid monocytes/macrophages and preterm or term delivery and (3) the localization of monocytes/macrophages in the placental tissues. Amniotic fluid samples (n = 16) were collected from women with suspected intra-amniotic inflammation or infection. Amniotic fluid monocytes/macrophages were purified by fluorescence-activated cell sorting, and DNA fingerprinting was performed. Blinded placental histopathological evaluations were conducted. Immunohistochemistry was performed to detect CD14+ monocytes/macrophages in the placental tissues. DNA fingerprinting revealed that (1) 56.25% (9/16) of amniotic fluid samples had mostly fetal monocytes/macrophages, (2) 37.5% (6/16) had predominantly maternal monocytes/macrophages and (3) one sample (6.25% [1/16]) had a mixture of fetal and maternal monocytes/macrophages. (4) Most samples with predominantly fetal monocytes/macrophages were from women who delivered early preterm neonates (77.8% [7/9]), whereas all samples with mostly maternal monocytes/macrophages or a mixture of both were from women who delivered term or late preterm neonates (100% [7/7]). (5) Most of the women included in this study presented acute maternal and fetal inflammatory responses in the placenta (85.7% [12/14]). (6) Women who had mostly fetal monocytes/macrophages in amniotic fluid had abundant CD14+ cells in the umbilical cord and chorionic plate, whereas women with mostly maternal amniotic fluid monocytes/macrophages had abundant CD14+ cells in the chorioamniotic membranes. Amniotic fluid monocytes/macrophages can be of either fetal or maternal origin, or a mixture of both, in women with intra-amniotic inflammation or infection. These immune cells could be derived from the fetal and maternal vasculature of the placenta.

Original languageEnglish (US)
Pages (from-to)822-840
Number of pages19
JournalJournal of Perinatal Medicine
Volume47
Issue number8
DOIs
StatePublished - Oct 1 2019
Externally publishedYes

Keywords

  • acute chorioamnionitis
  • clinical chorioamnionitis
  • fetal inflammatory response
  • funisitis
  • innate immune cells
  • interleukin-6
  • labor
  • microbial invasion of the amniotic cavity
  • pregnancy
  • preterm labor
  • term labor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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