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• W1963966730 abstract "ObjectiveIC may result from dysfunctional cervical ripening via activation of either the innate or adaptive immune pathways. Unaddressed is the fundamental issue of whether one pathway triggers the other, or whether their activation occurs along independent but intersecting lines. The object of this study was to investigate that question.Study designIC was diagnosed in women (n = 25) with cervical dilation > 2cm, intact bulging membranes between 15-24w, and no detectable uterine activity. Each woman had an amniocentesis to aid cerclage placement. 36 women between 16-24w served as controls (amniocentesis for karyotype). All controls delivered normal infants > 37w. Innate immune pathway activation was identified in the amniotic fluid samples by presence or absence of 4 proteins of the MR score (defensins/calgranulins) using mass spectrometry SELDI. Adaptive pathway activation was identified by an elevated IL-6 (> 11.4 pg/mL) (ELISA).ResultsThere were significant differences in the prevalence of abnormality rates between the two tests (p = 0.05).12 (48%) women had either an abnormal MR Score, an elevated IL-6 or both. The IL-6 alone was abnormal in 20% (n = 5), and the MR Score alone abnormal in 8% (n = 2). No control had either an abnormal MR Score or an elevated IL-6 level.ConclusionInflammation is present in about half the women who present for rescue cerclage. However, the relevant inciting inflammatory pathway may be either innate or adaptive. The results of this study breaks new ground in our understanding of preterm birth associated with the clinical diagnosis of IC, and likely extends into idiopathic preterm labor associated with inflammation. ObjectiveIC may result from dysfunctional cervical ripening via activation of either the innate or adaptive immune pathways. Unaddressed is the fundamental issue of whether one pathway triggers the other, or whether their activation occurs along independent but intersecting lines. The object of this study was to investigate that question. IC may result from dysfunctional cervical ripening via activation of either the innate or adaptive immune pathways. Unaddressed is the fundamental issue of whether one pathway triggers the other, or whether their activation occurs along independent but intersecting lines. The object of this study was to investigate that question. Study designIC was diagnosed in women (n = 25) with cervical dilation > 2cm, intact bulging membranes between 15-24w, and no detectable uterine activity. Each woman had an amniocentesis to aid cerclage placement. 36 women between 16-24w served as controls (amniocentesis for karyotype). All controls delivered normal infants > 37w. Innate immune pathway activation was identified in the amniotic fluid samples by presence or absence of 4 proteins of the MR score (defensins/calgranulins) using mass spectrometry SELDI. Adaptive pathway activation was identified by an elevated IL-6 (> 11.4 pg/mL) (ELISA). IC was diagnosed in women (n = 25) with cervical dilation > 2cm, intact bulging membranes between 15-24w, and no detectable uterine activity. Each woman had an amniocentesis to aid cerclage placement. 36 women between 16-24w served as controls (amniocentesis for karyotype). All controls delivered normal infants > 37w. Innate immune pathway activation was identified in the amniotic fluid samples by presence or absence of 4 proteins of the MR score (defensins/calgranulins) using mass spectrometry SELDI. Adaptive pathway activation was identified by an elevated IL-6 (> 11.4 pg/mL) (ELISA). ResultsThere were significant differences in the prevalence of abnormality rates between the two tests (p = 0.05).12 (48%) women had either an abnormal MR Score, an elevated IL-6 or both. The IL-6 alone was abnormal in 20% (n = 5), and the MR Score alone abnormal in 8% (n = 2). No control had either an abnormal MR Score or an elevated IL-6 level. There were significant differences in the prevalence of abnormality rates between the two tests (p = 0.05).12 (48%) women had either an abnormal MR Score, an elevated IL-6 or both. The IL-6 alone was abnormal in 20% (n = 5), and the MR Score alone abnormal in 8% (n = 2). No control had either an abnormal MR Score or an elevated IL-6 level. ConclusionInflammation is present in about half the women who present for rescue cerclage. However, the relevant inciting inflammatory pathway may be either innate or adaptive. The results of this study breaks new ground in our understanding of preterm birth associated with the clinical diagnosis of IC, and likely extends into idiopathic preterm labor associated with inflammation. Inflammation is present in about half the women who present for rescue cerclage. However, the relevant inciting inflammatory pathway may be either innate or adaptive. The results of this study breaks new ground in our understanding of preterm birth associated with the clinical diagnosis of IC, and likely extends into idiopathic preterm labor associated with inflammation." @default.
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• W1963966730 title "Both innate and adaptive immunity may independently cause dysfunctional cervical ripening manifesting as incompetent cervix (IC)" @default.
• W1963966730 doi "https://doi.org/10.1016/j.ajog.2005.10.801" @default.
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