Browsing by Author "Jung, Eunjung"

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    Characterization of amniotic fluid sludge in preterm and term gestations
    (2022) Pedro Kusanovic, Juan; Jung, Eunjung; Romero, Roberto; Green, Pooja Mittal; Nhan-Chang, Chia-Ling; Vaisbuch, Edi; Erez, Offer; Kim, Chong Jai; Goncalves, Luis F.; Espinoza, Jimmy; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Diaz-Primera, Ramiro; Yeo, Lami; Suksai, Manaphat; Gotsch, Francesca; Hassan, Sonia S.
    Objective To describe the characteristics of amniotic fluid sludge obtained from patients in term and preterm gestations. Methods This cross-sectional study included patients with dense aggregates of particulate matter detected in amniotic fluid, observed with transvaginal sonography. All patients were in labor and had an impending delivery, either preterm or at term. Echogenic material contained within amniotic fluid was retrieved transvaginally by needle amniotomy under direct visualization. The amniotic fluid analysis consisted of a Gram stain, cultures for aerobic/anaerobic bacteria and genital mycoplasmas, and a white blood cell count. Results Twenty-five patients ranging from 18 to 41 weeks of gestation were included in the study. We observed the following: (1) the appearance of amniotic fluid was consistent with pus-like material, vernix, or meconium by naked eye examination; (2) samples collected before 33 weeks of gestation (n = 13) had a pus-like appearance; however, after this gestational age, most of the samples [83% (10/12)] appeared to be consistent with vernix; (3) amniotic fluid cultures were positive for microorganisms in 13 patients, of which 10 were preterm gestations before 33 weeks; (4) the most frequent microorganisms retrieved by culture were genital mycoplasmas (Ureaplasma urealyticum [46% (6/13)]), followed by Mycoplasma hominis [31% (4/13)] and Candida albicans [15% (2/13)]; and (5) patients with sonographic particulate matter in preterm gestations frequently presented acute histologic chorioamnionitis and funisitis, but these conditions were rare in patients at term. Conclusion The nature of amniotic fluid particulate material varies as a function of gestational age. The material obtained in preterm gestations is frequently related to an inflammatory process, while that obtained at term is often consistent with vernix and appears to represent a maturational process.
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    Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia implications for clinical care
    (2021) Romero, Roberto; Pacora, Percy; Kusanovic, Juan Pedro; Jung, Eunjung; Panaitescu, Bogdan; Maymon, Eli; Erez, Offer; Berman, Susan; Bryant, David R.; Gomez-Lopez, Nardhy; Theis, Kevin R.; Bhatti, Gaurav; Kim, Chong Jai; Yoon, Bo Hyun; Hassan, Sonia S.; Hsu, Chaur-Dong; Yeo, Lami; Diaz-Primera, Ramiro; Marin-Concha, Julio; Lannaman, Kia; Alhousseini, Ali; Gomez-Roberts, Hunter; Varrey, Aneesha; Garcia-Sanchez, Angel; Gervasi, Maria Teresa
    Objectives: Clinical chorioamnionitis at term is considered the most common infection-related diagnosis in labor and delivery units worldwide. The syndrome affects 5-12% of all term pregnancies and is a leading cause of maternal morbidity and mortality as well as neonatal death and sepsis. The objectives of this study were to determine the (1) amniotic fluid microbiology using cultivation and molecular microbiologic techniques; (2) diagnostic accuracy of the clinical criteria used to identify patients with intraamniotic infection; (3) relationship between acute inflammatory lesions of the placenta (maternal and fetal inflammatory responses) and amniotic fluid microbiology and inflammatory markers; and (4) frequency of neonatal bacteremia.
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    Defining a role for Interferon Epsilon in normal and complicated pregnancies
    (2022) Miller, Derek; Romero, Roberto; Kacerovsky, Marian; Musilova, Ivana; Galaz, Jose; Garcia-Flores, Valeria; Xu, Yi; Pusod, Errile; Demery-Poulos, Catherine; Gutierrez-Contreras, Pedro; Ning Liu, Tzu; Jung, Eunjung; Theis, Kevin R.; Coleman, Lanetta A.; Gomez-Lopez, Nardhy
    Interferon epsilon (IFNe) is a recently described cytokine that is constitutively expressed in the female repro-ductive tract. However, the role of this hormonally regulated cytokine during human pregnancy is poorly un-derstood. Moreover, whether IFNe participates in host immune response against bacteria-driven intra-amniotic infection or cervical human papillomavirus infection during pregnancy is unknown. Herein, using a unique set of human samples derived from multiple study cohorts, we aimed to uncover the role of IFNe in normal and complicated pregnancies. We showed that IFNe is expressed in the myometrium, cervix, and chorioamniotic membranes, and may therefore represent a constitutive element of host defense mechanisms in these tissues during pregnancy. The expression of IFNe in the myometrium and cervix appeared greater in late gestation than in mid-pregnancy, but did not seem to be impacted by labor. Notably, concentrations of IFNe in amniotic fluid, but not cervical fluid, were increased in a subset of women undergoing spontaneous preterm labor with intra-amniotic infection, indicating that IFNe could participate in anti-microbial responses in the amniotic cavity. However, stimulation with Ureaplasma parvum and/or lipopolysaccharide did not enhance IFNE expression by amnion epithelial or cervical cells in vitro, implicating alternative sources of this cytokine during intra-amniotic or cervical infection, respectively. Collectively, our results represent the first characterization of IFNe expression by human reproductive and gestational tissues during normal pregnancy and suggest a role for this cytokine in intra-amniotic infection leading to preterm birth.
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    Pregnancy-specific responses to COVID-19 revealed by high-throughput proteomics of human plasma
    (2023) Gomez-Lopez, Nardhy; Romero, Roberto; Escobar, Maria Fernanda; Carvajal, Javier Andres; Echavarria, Maria Paula; Albornoz, Ludwig L.; Nasner, Daniela; Miller, Derek; Gallo, Dahiana M.; Galaz, Jose; Arenas-Hernandez, Marcia; Bhatti, Gaurav; Done, Bogdan; Zambrano, Maria Andrea; Ramos, Isabella; Fernandez, Paula Andrea; Posada, Leandro; Chaiworapongsa, Tinnakorn; Jung, Eunjung; Garcia-Flores, Valeria; Suksai, Manaphat; Gotsch, Francesca; Bosco, Mariachiara; Than, Nandor Gabor; Tarca, Adi L.
    Gomez-Lopez et al. profile the plasma proteome of pregnant and non-pregnant COVID-19 patients and controls. Shared and pregnancy-specific proteomic changes are identified in COVID-19 patients compared to controls, with the proteome accurately identifying COVID-19 patients, even when asymptomatic.
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    The vaginal immunoproteome for the prediction of spontaneous preterm birth: A retrospective longitudinal study
    (2024) Shaffer, Zachary; Romero, Roberto; Tarca, Adi L.; Galaz, Jose; Arenas-Hernandez, Marcia; Gudicha, Dereje W.; Chaiworapongsa, Tinnakorn; Jung, Eunjung; Suksai, Manaphat; Theis, Kevin R.; Gomez-Lopez, Nardhy; Simon, Carlos
    Background: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. Most cases of preterm birth occur spontaneously and result from preterm labor with intact (spontaneous preterm labor [sPTL]) or ruptured (preterm prelabor rupture of membranes [PPROM]) membranes. The prediction of spontaneous preterm birth (sPTB) remains underpowered due to its syndromic nature and the dearth of independent analyses of the vaginal host immune response. Thus, we conducted the largest longitudinal investigation targeting vaginal immune mediators, referred to herein as the immunoproteome, in a population at high risk for sPTB. Methods: Vaginal swabs were collected across gestation from pregnant women who ultimately underwent term birth, sPTL, or PPROM. Cytokines, chemokines, growth factors, and antimicrobial peptides in the samples were quantified via specific and sensitive immunoassays. Predictive models were constructed from immune mediator concentrations. Results: Throughout uncomplicated gestation, the vaginal immunoproteome harbors a cytokine network with a homeostatic profile. Yet, the vaginal immunoproteome is skewed toward a pro-inflammatory state in pregnant women who ultimately experience sPTL and PPROM. Such an inflammatory profile includes increased monocyte chemoattractants, cytokines indicative of macrophage and T-cell activation, and reduced antimicrobial proteins/peptides. The vaginal immunoproteome has improved predictive value over maternal characteristics alone for identifying women at risk for early (<34 weeks) sPTB. Conclusions: The vaginal immunoproteome undergoes homeostatic changes throughout gestation and deviations from this shift are associated with sPTB. Furthermore, the vaginal immunoproteome can be leveraged as a potential biomarker for early sPTB, a subset of sPTB associated with extremely adverse neonatal outcomes.
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    The Vaginal Microbiota of Pregnant Women Varies with Gestational Age, Maternal Age, and Parity
    (2023) Romero, Roberto; Theis, Kevin R.; Gomez-Lopez, Nardhy; Winters, Andrew D.; Panzer, Jonathan J.; Lin, Huang; Galaz, Jose; Greenberg, Jonathan M.; Shaffer, Zachary; Kracht, David J.; Chaiworapongsa, Tinnakorn; Jung, Eunjung; Gotsch, Francesca; Ravel, Jacques; Peddada, Shyamal D.; Tarca, Adi L.
    There is debate regarding links between the vaginal microbiota and pregnancy complications, especially spontaneous preterm birth. Inconsistencies in results among studies are likely due to differences in sample sizes and cohort ethnicity.
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    Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology
    (2022) Romero, Roberto; Jung, Eunjung; Chaiworapongsa, Tinnakorn; Erez, Offer; Gudicha, Dereje W.; Kim, Yeon Mee; Kim, Jung-Sun; Kim, Bomi; Kusanovic, Juan Pedro; Gotsch, Francesca; Taran, Andreea B.; Yoon, Bo Hyun; Hassan, Sonia S.; Hsu, Chaur-Dong; Chaemsaithong, Piya; Gomez-Lopez, Nardhy; Yeo, Lami; Kim, Chong Jai; Tarca, Adi L.
    BACKGROUND: The major challenge for obstetrics is the prediction and prevention of the great obstetrical syndromes. We propose that defining obstetrical diseases by the combination of clinical presentation and disease mechanisms as inferred by placental pathology will aid in the discovery of biomarkers and add specificity to those already known.