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Maternal regulation of inflammatory cues is required for induction of preterm birth
Monica Cappelletti, … , Tamara Tilburgs, Senad Divanovic
Monica Cappelletti, … , Tamara Tilburgs, Senad Divanovic
Published November 19, 2020
Citation Information: JCI Insight. 2020;5(22):e138812. https://doi.org/10.1172/jci.insight.138812.
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Research Article Inflammation

Maternal regulation of inflammatory cues is required for induction of preterm birth

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Abstract

Infection-driven inflammation in pregnancy is a major cause of spontaneous preterm birth (PTB). Both systemic infection and bacterial ascension through the vagina/cervix to the amniotic cavity are strongly associated with PTB. However, the contribution of maternal or fetal inflammatory responses in the context of systemic or localized models of infection-driven PTB is not well defined. Here, using intraperitoneal or intraamniotic LPS challenge, we examined the necessity and sufficiency of maternal and fetal Toll-like receptor (TLR) 4 signaling in induction of inflammatory vigor and PTB. Both systemic and local LPS challenge promoted induction of inflammatory pathways in uteroplacental tissues and induced PTB. Restriction of TLR4 expression to the maternal compartment was sufficient for induction of LPS-driven PTB in either systemic or intraamniotic challenge models. In contrast, restriction of TLR4 expression to the fetal compartment failed to induce LPS-driven PTB. Vav1-Cre–mediated genetic deletion of TLR4 suggested a critical role for maternal immune cells in inflammation-driven PTB. Further, passive transfer of WT in vitro–derived macrophages and dendritic cells to TLR4-null gravid females was sufficient to induce an inflammatory response and drive PTB. Cumulatively, these findings highlight the critical role for maternal regulation of inflammatory cues in induction of inflammation-driven parturition.

Authors

Monica Cappelletti, Jessica R. Doll, Traci E. Stankiewicz, Matthew J. Lawson, Vivien Sauer, Bingqiang Wen, Vladimir V. Kalinichenko, Xiaofei Sun, Tamara Tilburgs, Senad Divanovic

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Figure 1

Preterm birth is induced by both systemic and local route of challenge.

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Preterm birth is induced by both systemic and local route of challenge.
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(A) A schematic overview of the approach used to study PTB in gravid mice following LPS challenge. (B) Gravid WT mice (n = 4–12/condition) were injected i.p. with saline (US, unstimulated) or LPS (standard or ultrapure) at the indicated doses on day 16 of gestation, and the incidence of PTB was quantified. χ2 (2 × 3 matrix): standard LPS P = 0.0108; ultrapure LPS P < 0.0001. (C) Ultrasound image taken of an individual amniotic sac on day 16 of gestation. Contrast (green) was included in the i.a. injection, and all the injected fluid was retained within the amniotic sac. Saline or the concentration of ultrapure LPS used in challenge is provided below each bar and was administered as 2 doses in separate amniotic sacs for each uterine horn. Instance of PTB was quantified (n = 3–4/condition). χ2 (2 × 3 matrix) P = 0.0041. (D–G) Gravid WT mice (n = 3–8/condition) were challenged with ultrapure LPS by i.p. (75 μg) or i.a. (5 μg) injection, and mRNA expression in the decidua/myometrium was quantified at 6 and 12 hours postchallenge. Data represent fold change over nonstimulated ± SEM. (D) Cd68, Ccl2, and Ccl4 mRNA expression. (E) Ifnb, Isg15, and Irf7 mRNA expression. (F) Il6, Tnf, and Il1b mRNA expression. (G) Ptgs2 mRNA expression. (D–G) ANOVA followed by Tukey’s correction. *P < 0.05, **P < 0.01.

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