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1.
Clin Perinatol ; 51(2): 497-510, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705654

RESUMO

This review examines the complexities of preterm birth (PTB), emphasizes the pivotal role of inflammation in the pathogenesis of preterm labor, and assesses current available interventions. Antibiotics, progesterone analogs, mechanical approaches, nonsteroidal anti-inflammatory drugs, and nutritional supplementation demonstrate a limited efficacy. Tocolytic agents, targeting uterine activity and contractility, inadequately prevent PTB by neglecting to act on uteroplacental inflammation. Emerging therapies targeting toll-like receptors, chemokines, and interleukin receptors exhibit promise in mitigating inflammation and preventing PTB.


Assuntos
Nascimento Prematuro , Tocolíticos , Humanos , Gravidez , Feminino , Nascimento Prematuro/prevenção & controle , Tocolíticos/uso terapêutico , Recém-Nascido , Inflamação/tratamento farmacológico , Inflamação/prevenção & controle , Trabalho de Parto Prematuro/prevenção & controle
2.
Cytokine Growth Factor Rev ; 78: 50-63, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39048393

RESUMO

Preterm birth is a major public health concern, requiring a deeper understanding of its underlying inflammatory mechanisms and to develop effective therapeutic strategies. This review explores the complex interaction between inflammation and preterm labor, highlighting the pivotal role of the dysregulation of inflammation in triggering premature delivery. The immunological environment of pregnancy, characterized by a fragile balance of immune tolerance and resistance, is disrupted in preterm labor, leading to a pathological inflammatory response. Feto-maternal infections, among other pro-inflammatory stimuli, trigger the activation of toll-like receptors and the production of pro-inflammatory mediators, promoting uterine contractility and cervical ripening. Emerging anti-inflammatory therapeutics offer promising approaches for the prevention of preterm birth by targeting key inflammatory pathways. From TLR-4 antagonists to chemokine and interleukin receptor antagonists, these interventions aim to modulate the inflammatory environment and prevent adverse pregnancy outcomes. In conclusion, a comprehensive understanding of the inflammatory mechanisms leading to preterm labor is crucial for the development of targeted interventions in hope of reducing the incidence of preterm birth and improving neonatal health outcomes.


Assuntos
Anti-Inflamatórios , Inflamação , Trabalho de Parto Prematuro , Humanos , Gravidez , Feminino , Trabalho de Parto Prematuro/imunologia , Inflamação/imunologia , Anti-Inflamatórios/uso terapêutico , Nascimento Prematuro/imunologia , Nascimento Prematuro/prevenção & controle , Animais , Recém-Nascido
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