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Amniotic fluid soluble fas levels in intra-amniotic infection
1Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
Objective:
Membrane Fas can induce apoptosis in sensitive cells. It has been reported that soluble Fas (sFas) is elevated in septicemia. We examined amniotic fluid (AF) sFas levels in patients with and without intra-amniotic infection.
Methods:
Forty-two AF specimens were studied. Intra-amniotic infection was defined as the presence of a positive AF culture. Twenty-one specimens were from patients with intra-amniotic infection and 21 were from patients without intra-ammotic infection. Amniotic fluid sFas was determined by an enzyme immunoassay and normalized by AF creatinine levels. The Mann-Whitney U test, contingency table method, and Spearman's rank correlation test were used for statistical analyses. Data were expressed as median with ranges.
Results:
There were no significant differences in maternal age, gestational age, parity, and race between the groups. The median AF sFas was significantly higher with intra-amniotic infection than without it (5.07 U/mL, range 0.32-13. 25 compared with 1.95 U/mL, range 0.01-5.35; P =.004). After normalizing to AF creatinine, infected fluids also had significantly higher median sFas/creatinine than uninfected amniotic fluids (289.1 U/mg creatinine, range 16.6-920.5 compared with 126.8 U/mg creatinine, range 0.5-546.2; P =.01). Amniotic fluid sFas and sFas/creatinine were positively correlated with AF leukocytes and negatively correlated with AF glucose.
Conclusion:
Elevated AF sFas is associated with intra-amniotic infection. High production of AF sFas in intra-amniotic infection may play a role in the inhibition of apoptosis of AF leukocytes, leading to the persistence of inflammation.
Insights
Elevated soluble Fas (sFas) in amniotic fluid is linked to intra-amniotic infection. This finding may explain persistent inflammation by potentially inhibiting leukocyte apoptosis during infection.
Area of Science:
- Reproductive Medicine
- Immunology
- Infectious Diseases
Background:
- Soluble Fas (sFas) can induce apoptosis in susceptible cells.
- Elevated sFas levels have been observed in septicemia.
- The role of sFas in intra-amniotic infection is not well understood.
Purpose of the Study:
- To investigate the levels of amniotic fluid sFas in patients with and without intra-amniotic infection.
- To determine the association between amniotic fluid sFas and intra-amniotic infection.
Main Methods:
- Analyzed 42 amniotic fluid specimens (21 infected, 21 uninfected).
- Measured amniotic fluid sFas using enzyme immunoassay and normalized to creatinine.
- Employed Mann-Whitney U test, contingency tables, and Spearman's rank correlation for statistical analysis.
Main Results:
- Significantly higher median amniotic fluid sFas levels in infected versus uninfected groups (P =.004).
- Normalized sFas/creatinine levels were also significantly higher in infected amniotic fluid (P =.01).
- Amniotic fluid sFas correlated positively with leukocytes and negatively with glucose.
Conclusions:
- Elevated amniotic fluid sFas is associated with intra-amniotic infection.
- High sFas production may inhibit apoptosis of amniotic fluid leukocytes, contributing to inflammation persistence.
- Further research is warranted to elucidate the precise role of sFas in intra-amniotic infection pathogenesis.