长期暴露于羊膜内脂多糖会影响羊胎儿的大脑。

Ilias Nitsos, Sandra M Rees, Jhodie Duncan, Boris W Kramer, Richard Harding, John P Newnham, Timothy J M Moss
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引用次数: 96

摘要

目的:胎儿脑损伤与绒毛膜羊膜炎有关,通常没有明显的感染或胎儿妥协的迹象。我们的目的是确定长期暴露于由羊膜内输注脂多糖(LPS)引起的宫内炎症是否会影响胎儿大脑。方法:在妊娠第80天单胎母羊羊膜内植入渗透泵,注入大肠杆菌LPS (055:B5;N = 8)或生理盐水(N = 7)治疗28天。分娩(110天)时,评估脐动脉血和绒毛膜是否有炎症;测定羊水、胎、母血浆中细胞因子(白细胞介素[IL]-6、IL-8)的浓度。检测胎儿大脑半球大体解剖变化,免疫组化染色后估计激活的小胶质细胞/巨噬细胞、星形胶质细胞和少突胶质细胞的数量。结果:羊膜内注射LPS可引起羊膜绒毛膜炎、胎儿白细胞增多、激活的小胶质细胞/巨噬细胞在皮质下白质中中度至广泛浸润;剩下的两个胎儿受到的影响较小。在这些局灶性损伤区域,星形细胞过程衰减,轴突损伤,在广泛局灶性损伤区域,2',3'-环核苷酸3'-磷酸二酯酶(CNPase)免疫反应性少突胶质细胞数量减少。对照组胎儿皮质下白质有轻度(3/7)或未见活化的小胶质细胞/巨噬细胞浸润。总的来说,与对照组相比,lps暴露的胎儿白质中活化的小胶质细胞/巨噬细胞的浸润量显著增加。在无损伤区域,各组间少突胶质细胞和星形胶质细胞数量没有差异,脑白质体积和白质内血管密度也没有差异。LPS输注后羊水IL-6、IL-8及母体血浆IL-8浓度显著升高。结论:羊膜内LPS诱导的绒毛膜羊膜炎可伴有炎症细胞的增加和胎儿大脑皮层下白质的轴突破坏,但不会出现囊性病变。因此,对胎儿大脑的影响比在急性胎儿/宫内感染动物模型中报道的要轻。
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Chronic exposure to intra-amniotic lipopolysaccharide affects the ovine fetal brain.

Objective: Fetal brain injury is associated with chorioamnionitis, which is often present without signs of overt infection or fetal compromise. We aimed to determine if prolonged exposure to intrauterine inflammation caused by intra-amniotic infusion of lipopolysaccharide (LPS) would affect the fetal brain.

Methods: At 80 days of pregnancy ewes bearing singletons had osmotic pumps implanted intra-amniotically to infuse Escherichia coli LPS (055:B5; n = 8) or saline (n = 7) for 28 days. At delivery (110 days), umbilical arterial blood and chorioamnion were assessed for inflammation; cytokine concentrations (interleukin [IL]-6 and IL-8) in amniotic fluid and fetal and maternal plasma were measured. The fetal cerebral hemispheres were examined for gross anatomical changes and the number of activated microglia/macrophages, astrocytes, and oligodendrocytes estimated after immunohistochemical staining.

Results: Intra-amniotic administration of LPS caused chorioamnionitis, fetal leucocytosis, and a moderate to extensive infiltration of activated microglia/macrophages in the subcortical white matter in six of eight fetuses; the remaining two fetuses were less affected. Within these focal regions of damage there was an attenuation of astrocytic processes, axonal injury, and a reduction in the number of 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) immunoreactive oligodendrocytes in areas of extensive focal damage. In control fetuses there was mild (3/7) or no infiltration of activated microglia/macrophages in the subcortical white matter. Overall the infiltration of activated microglia/macrophages in the white matter was significantly greater in LPS-exposed fetuses compared to controls. In regions devoid of injury, the number of oligodendrocytes and astrocytes was not different between groups, nor was there a difference in the volume of cerebral white matter or density of blood vessels within the white matter. Amniotic fluid IL-6 and IL-8, and maternal plasma IL-8 concentrations were significantly increased by LPS infusion.

Conclusions: An increase in inflammatory cells and axonal disruption in the subcortical white matter of the fetal brain can accompany chorioamnionitis induced by intra-amniotic administration of LPS, but cystic lesions do not occur. Thus, the effect on the fetal brain is milder than that reported from animal models of acute fetal/intrauterine infection.

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