RESUMO
Failure to predict and understand the causes of preterm birth, the leading cause of neonatal morbidity and mortality, have limited effective interventions and therapeutics. From a cohort of 2000 pregnant women, we performed a nested case control study on 107 well-phenotyped cases of spontaneous preterm birth (sPTB) and 432 women delivering at term. Using innovative Bayesian modeling of cervicovaginal microbiota, seven bacterial taxa were significantly associated with increased risk of sPTB, with a stronger effect in African American women. However, higher vaginal levels of ß-defensin-2 lowered the risk of sPTB associated with cervicovaginal microbiota in an ethnicity-dependent manner. Surprisingly, even in Lactobacillus spp. dominated cervicovaginal microbiota, low ß-defensin-2 was associated with increased risk of sPTB. These findings hold promise for diagnostics to accurately identify women at risk for sPTB early in pregnancy. Therapeutic strategies could include immune modulators and microbiome-based therapeutics to reduce this significant health burden.
Assuntos
Colo do Útero/microbiologia , Imunidade Inata , Microbiota/imunologia , Nascimento Prematuro/diagnóstico , Vagina/microbiologia , beta-Defensinas/genética , Adulto , Teorema de Bayes , Biomarcadores/metabolismo , População Negra , Estudos de Casos e Controles , Feminino , Expressão Gênica , Humanos , Recém-Nascido , Lactobacillus/classificação , Lactobacillus/imunologia , Lactobacillus/isolamento & purificação , Mobiluncus/classificação , Mobiluncus/imunologia , Mobiluncus/isolamento & purificação , Gravidez , Nascimento Prematuro/etnologia , Nascimento Prematuro/imunologia , Nascimento Prematuro/fisiopatologia , Prognóstico , Risco , População Branca , beta-Defensinas/imunologiaRESUMO
The antigenic profile of 30 vaginal isolates of Mobiluncus strains (22 M. curtisii and 8 M. mulieris) was determined by immunoblotting technique using mouse immune ascitic fluids containing polyclonal antibodies against the type strains M. curtisii subsp. holmesii (ATCC 35242) and M. mulieris (ATCC 35243). Two antigenic profiles were identified within M. curtisii isolates, whereas a certain variability was observed among M. mulieris strains where at least three antigens were constantly recognized. The detection of antigenic profiles of Mobiluncus strains by immunoblotting technique provided a simple method to identify Mobiluncus isolates at the species level.
Assuntos
Antígenos de Bactérias/análise , Western Blotting/métodos , Mobiluncus/imunologia , Animais , Anticorpos Antibacterianos , Variação Antigênica , Antígenos de Bactérias/química , Líquido Ascítico , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Peso Molecular , Vagina/microbiologiaRESUMO
While bacterial vaginosis (BV) is a polymicrobial syndrome, Mobiluncus spp. are the organisms most highly associated with this condition. It is possible that serum antibody to Mobiluncus spp. could be used as a serological marker for BV. Using immunofluorescence techniques, we studied the prevalence of antibody to M. curtisii among three cohorts-pregnant women, pediatric patients, and sexually inexperienced women. The prevalence of antibody in each of these three groups was 75, 6, and 0%, respectively. Of the three pediatric patients with antibody to Mobiluncus curtisii, two were neonates, and the only class of antibody detected was immunoglobulin G. Among the cohort of pregnant women, the presence of antibody could not be correlated with a clinical history of BV. Serum antibody to M. curtisii could be a useful serological marker for BV. The lack of correlation of antibody positivity to historical information regarding BV suggests that unrecognized or undiagnosed episodes of BV may be common.
