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Intra-amniotic Inflammation in Women with Preterm Labor with Intact Membranes - Clinical and Experimental Aspects
Stráník, Jaroslav ; Kacerovská Musilová, Ivana (advisor) ; Šimetka, Ondřej (referee) ; Čečková, Martina (referee)
Preterm labor with intact membranes (PTL) is responsible for approximately 40% of all preterm deliveries. PTL is frequently complicated by intra-amniotic inflammation (IAI), characterized by the elevation of inflammatory mediators in the amniotic fluid. Based on the presence or absence of microbial invasion of the amniotic cavity (MIAC), two different clinical phenotypes of IAI are distinguished: i) intra-amniotic infection, when microorganisms are present in the amniotic fluid, and ii) sterile IAI, when there are no microorganisms in the amniotic fluid. The clinical severity of both phenotypes of IAI is underlined by their association with adverse neonatal outcomes. In addition to the presence or absence of MIAC, there are also differences between the phenotypes of IAI in terms of their intra-amniotic inflammatory status characteristics. The clinical part of this thesis has addressed these differences in women with PTL. The first specific aim of this clinical study was to determine the concentration of interleukin (IL)-6 in the cervical fluid of women with PTL complicated by intra-amniotic infection and sterile IAI. The second specific aim was to determine the concentration of IgGFc-binding protein (FcgammaBP) in the amniotic and cervical fluids of women with PTL complicated by intra-amniotic...
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Changes of Immune Parameters Induced by Intraamnial Inflammation
Souček, Ondřej ; Andrýs, Ctirad (advisor) ; Lokaj, Jindřich (referee) ; Šimetka, Ondřej (referee)
Changes of immune parameters induced by intraamnial inflammation Abstract Intraamniotic infection plays an important role in the etiology of preterm birth and can lead to a serious threat to fetal health. The diagnostic approach is based on direct microbiological detection of an infectious agent or indirect detection by determining various biomarkers, which concentration increases during intraamniotic infection. Due to the nature of the infection, these parameters are determined from amniotic fluid, which makes this diagnosis difficult for both the doctor and the mother and routinely unavailable. The dissertation comments the published results of a scientific team whose aim was to identify suitable markers of infection, determine their concentration in amniotic fluid and test their diagnostic potential in cervical fluid, ie biological material that can be collected non- invasively. Amniotic and cervical fluid samples were taken from women with singleton pregnancies with preterm labor and that were complicated by intraamniotic inflammation and infection in part of the cohort. It was found that among the tested molecules there is a statistically higher concentration of calreticulin, cathepsin G, CD11b, FcgammaBP and MIP1α in amniotic fluid during intraamniotic infection. Significantly higher levels of...
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