A Signature of Maternal Anti-Fetal Rejection in Spontaneous Preterm Birth: Chronic Chorioamnionitis, Anti-Human Leukocyte Antigen Antibodies, and C4d

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dc.contributor.authorLee, JoonHo
dc.contributor.authorRomero, Roberto
dc.contributor.authorXu, Yi
dc.contributor.authorKim, Jung Sun
dc.contributor.authorTopping, Vanessa
dc.contributor.authorYoo, Wonsuk
dc.contributor.authorPedro Kusanovic, Juan
dc.contributor.authorChaiworapongsa, Tinnakorn
dc.contributor.authorHassan, Sonia S.
dc.contributor.authorYoon, Bo Hyun
dc.contributor.authorKim, Chong Jai
dc.date.accessioned2024-01-10T12:04:19Z
dc.date.available2024-01-10T12:04:19Z
dc.date.issued2011
dc.description.abstractBackground: Chronic chorioamnionitis is found in more than one-third of spontaneous preterm births. Chronic chorioamnionitis and villitis of unknown etiology represent maternal anti-fetal cellular rejection. Antibody-mediated rejection is another type of transplantation rejection. We investigated whether there was evidence for antibody-mediated rejection against the fetus in spontaneous preterm birth.
dc.description.abstractMethods and Findings: This cross-sectional study included women with (1) normal pregnancy and term delivery (n = 140) and (2) spontaneous preterm delivery (n = 140). We analyzed maternal and fetal sera for panel-reactive anti-HLA class I and class II antibodies, and determined C4d deposition on umbilical vein endothelium by immunohistochemistry. Maternal anti-HLA class I seropositivity in spontaneous preterm births was higher than in normal term births (48.6% vs. 32.1%, p = 0.005). Chronic chorioamnionitis was associated with a higher maternal anti-HLA class I seropositivity (p<0.01), significant in preterm and term birth. Villitis of unknown etiology was associated with increased maternal and fetal anti-HLA class I and II seropositivity (p<0.05, for each). Fetal anti-HLA seropositivity was closely related to maternal anti-HLA seropositivity in both groups (p<0.01, for each). C4d deposition on umbilical vein endothelium was more frequent in preterm labor than term labor (77.1% vs. 11.4%, p<0.001). Logistic regression analysis revealed that chronic chorioamnionitis (OR = 6.10, 95% CI 1.29-28.83), maternal anti-HLA class I seropositivity (OR = 5.90, 95% CI 1.60-21.83), and C4d deposition on umbilical vein endothelium (OR = 36.19, 95% CI 11.42-114.66) were associated with preterm labor and delivery.
dc.description.abstractConclusions: A major subset of spontaneous preterm births has a signature of maternal anti-fetal cellular and antibody-mediated rejections with links to fetal graft-versus-host disease and alloimmune reactions.
dc.description.funderPerinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT
dc.format.extent9 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1371/journal.pone.0016806
dc.identifier.issn1932-6203
dc.identifier.pubmedidMEDLINE:21326865
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0016806
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/75763
dc.identifier.wosidWOS:000287037000022
dc.information.autorucMedicina;Kusanovic J;S/I;1008900
dc.issue.numero2
dc.language.isoen
dc.nota.accesoSin adjunto
dc.publisherPUBLIC LIBRARY SCIENCE
dc.revistaPLOS ONE
dc.rightsregistro bibliográfico
dc.subjectNEONATAL ALLOIMMUNE THROMBOCYTOPENIA
dc.subjectCLINICAL-SIGNIFICANCE
dc.subjectALLOGRAFT-REJECTION
dc.subjectRECURRENT ABORTION
dc.subjectMEDIATED REJECTION
dc.subjectHUMORAL IMMUNITY
dc.subjectUNKNOWN ETIOLOGY
dc.subjectHLA ANTIBODIES
dc.subjectPREGNANCY
dc.subjectMECHANISMS
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleA Signature of Maternal Anti-Fetal Rejection in Spontaneous Preterm Birth: Chronic Chorioamnionitis, Anti-Human Leukocyte Antigen Antibodies, and C4d
dc.typeartículo
dc.volumen6
sipa.codpersvinculados1008900
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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