The local immunity of the genital system in pregnant women with a genital infection

In 101 healthy pregnant women and 132 pregnant women with genital infection (colpitis, endocervicitis, cervicitis) the characteristics of the anti-infectious protection of cervical mucus were studied. In pregnant women with inflammatory diseases of the vagina and cervix uteri disturbances in the local immunity of the sex system were detected. The study showed that in genital infections local immunodeficiency depended to a greater extent on the localization and spread of the process rather than on the etiological factor of the disease.     

The immunocorrective effect of laser reflexotherapy in experimental influenza infection

The influence of two schemes of laser acupuncture on some cell-mediated and humoral immunity characteristics of mice, as well as on their nonspecific antiviral resistance, in acute experimental influenza infection has been studied. The use of both schemes has been found to considerably decrease the severity of infection, enhancing the activity of lymphocytes of infected mice in the graft versus host reaction, the O2-producing activity of alveolar macrophages and modulating the ratio of antihemagglutinins and nonspecific antiviral inhibitors in the blood serum.     

The use of biological preparations for correction of microbial status in pregnant women

15 pregnant women with pregnancy lasting 28-32 weeks, whose medico-laboratory data (the positive result of the amino test, high pH value and the detection of "key" cells) suggested the presence of bacterial vaginosis, were placed under observation. The bacteriological study of vaginal microflora in all these women revealed pronounced disturbances simultaneously with the development of intestinal dysbacteriosis. The local application of the bacterial preparation "Zhlemik" containing freeze-dried live lactic acid bacteria of vaginal origin and the oral administration of lactic acid bifidumbacterin containing live bifidobacteria of intestinal origin permitted the successful restoration of vaginal and intestinal microbiocenosis. The capacity of biotherapeutic preparations for inducing non-specific immunostimulation led to a significant rise in the levels of IgA, IgM and IgG in vaginal secretions.     

Immune status and proinflammatury cytokines in pregnant women with acute cytomegalovirus infection

A total of 64 pregnant women aged 16-40 years with acute cytomegalovirus (CMV) infection were examined. CMV infection was diagnosed by the detection of anti- CMV IgM (by the enzyme immunoassay) or DNA by PCR in the blood. The immunophenotype of lymphocytes CD3+, CD4+, CD8+, CD16+, CD19+, IgG, IgM, IgA and the spontaneous production of TNFalpha and IL-8 in the blood were studied. In pregnant women with CMV infection the presence of the immunosuppression of cell-mediated immunity reactions, the hyperproduction of Fc-receptors of natural killers, B lymphocytes (CD19+), the hyperglobulinemia of serum IgM and IgG, as well as the increased synthesis of proinflammatory cytokines--TNFalpha and IL-8--were established.     

Seroepidemiology of Toxoplasma gondii infection in pregnant women in rural Durango, Mexico

The epidemiology of Toxoplasma gondii infection in pregnant women in rural Mexico is largely unknown. The seroepidemiology of T. gondii infection in 439 pregnant women from 9 communities in rural Durango State, Mexico was investigated. Using commercial enzyme-linked immunoassays, sera were tested for T. gondii IgG, IgM, and avidity antibodies. Prevalences of T. gondii IgG antibodies in the communities varied from 0% to 20%. Overall, 36 (8.2%) of the 439 women had IgG T. gondii antibodies. Ten (2.3%) women had also T. gondii IgM antibodies; IgG avidity was high in all IgM-positive women, suggesting chronic infection. None of the women, however, had delivered a known T. gondii-infected child. The seroprevalence was significantly higher (P < 0.05) in women from low socio-economic conditions (14%) than in those with higher socio-economic status (6.6%). Multivariate analysis showed that T. gondii infection was associated with soil floors at home (adjusted OR = 2.89; 95% CI: 1.12-7.49). This is the first epidemiological study of T. gondii infection in pregnant women in rural Mexico.     

Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis.

Microorganisms associated with bacterial vaginosis are commonly recovered from the amniotic fluid and chorion-amnion of patients who deliver prematurely. Bacteria closely related to those causing bacterial vaginosis may play a role in the initiation of uterine contractions, ripening of the cervix and weakening of the fetal membranes by stimulating prostaglandin synthesis. In the present investigation, cervical mucus was collected by brush from early pregnant women with and without bacterial vaginosis. The concentrations of PGE2, PGF2 alpha and 6-keto-PGF1 alpha were determined in the mucus samples by methyl oximation and then radioimmunoassay, utilizing antibodies raised against oximated prostaglandins. It was found that the concentration of PGE2 and PGF2 alpha was significantly higher in the mucus of women with bacterial vaginosis compared with healthy women. The concentration of 6-keto-PGF1 alpha was similar in both study groups. All patients had been instructed to abstain from sexual intercourse for 24 hours before sampling. However, it may be that women with high concentrations in their mucus may have had intercourse anyway. However, it is fairly well possible that the significant differences in the PGE2 and PGF2 alpha values are causally related to the higher rate of preterm labor in women with the commonplace infection of bacterial vaginosis.     

Disseminated toxoplasmosis in a Mediterranean pregnant Risso's dolphin (Grampus griseus) with transplacental fetal infection

Fatal disseminated toxoplasmosis was diagnosed in a Risso's dolphin (Grampus griseus) dam and its fetus on the basis of pathologic findings, immunohistochemistry, and structure of the parasite. The dolphin was stranded alive on the Spanish Mediterranean coast and died a few hours later. At necropsy the dam was in good condition. From the standpoint of pathology, however, it had generalized lymphadenomegaly and splenomegaly, enlargement of and multifocal hemorrhage in the adrenal glands, diffuse mucosal hemorrhage of the glandular and pyloric stomach, ulcerative glossitis and stomatitis, focal erosions and reddening of the laryngeal appendix, and severe paraotic sinusitis with intralesional nematodes Crassicauda grampicola. The dolphin was pregnant, most probably in the first gestational trimester. The most prominent microscopic lesions were multifocal granulomatous encephalomyelitis, diffuse subacute interstitial pneumonia, mild multifocal necrotizing hepatitis and nonsuppurative cholangiohepatitis, gastritis and adrenalitis, mild lymphoid depletion, medullary sinus and follicular histyocitosis, and systemic hemosiderosis. The fetus had foci of coagulative and lytic necrosis in the kidneys, the lung, and the heart. Most lesions were associated with tachyzoites and tissue cysts of Toxoplasma gondii. The diagnosis was confirmed immunohistochemically. This is the first report on toxoplasmosis in a Risso's dolphin (G. griseus) and on transplacental transmission to an early-stage fetus in any cetaceans.     

Epidemiological features of HIV infection among pregnant women in Makurdi, Benue State, Nigeria

Women in Benue State have for years had the highest HIV rate in the country, but because the sentinel surveys are anonymized and unlinked, not much is known about the socio-demographic, behavioural and other risk factors that predispose these women to the disease. The HIV/AIDS epidemic in Nigeria does not appear to be a single epidemic but rather multiple epidemics of varying magnitude and trends. This cross-sectional study was therefore carried out to identify the risk factors for HIV/AIDS among these women. A total of 404 consecutive consenting mothers enrolled at the booking clinic were followed up until delivery of their babies. They were interviewed using a semi-structured questionnaire and tested for HIV infection using an ELISA-based kit after obtaining informed consent. Mean age of the mothers was 26+/-6.1 years, 94.8% were married while 50.5% had at least secondary level education. Sixty-one (15.1%) mothers were HIV positive with mothers aged 15-24 years being responsible for 50.8% of all infection. Following bivariate analysis, being single, having a partner with low level of formal education, living in a rural location, being in a polygamous/multiple partner union, being a higher order polygamous wife, being married more than once and reporting a history of a sexually transmitted infection were significantly associated with HIV infection. Monogamous women who lived apart from their partners and women who had ever had blood transfusion were also more likely to be HIV positive. Following multivariate logistic regression, a young age of 15-24 years (multivariate OR=3.3, 95 % CI=1.2-8.4, p=0.02); ever had other STIs (OR=1.6, 95% CI 1.1-2.3, p=0.009); no formal maternal education (OR=0.6, 95% CI 0.4-0.9, p=0.021) and having one lifetime sexual partner (OR=0.4, 95% CI 0.3-0.5, p<0.00001) were significantly associated with HIV infection in the study population. Appropriate interventions must be directed at young people and should include STI control and abstinence education. Blood safety must be ensured as well as a general improvement in the level of formal and health education in this community.     

NACHT-LRR proteins (NLRs) in bacterial infection and immunity

Eukaryotes have evolved systems to detect bacterial intrusion. Recognition of bacteria relies on the sensing of pathogen associated molecular patterns (PAMPs) by host pattern recognition molecules (PRMs), which include various families of leucine-rich repeat (LRR) bearing proteins in plants and animals. Detection of microbes often occurs outside the cell. Recent findings now indicate that mammals have also evolved strategies to recognize bacteria inside the cell via members of the NACHT-LRR protein family (NLRs). Here, we review the biology of these mammalian NLRs and the emerging view of their important, role not solely as PRMs but as signalling platforms and regulators of immunity.     

Fatal hepatitis E viral infection in pregnant women in Ghana: a case series

ABSTRACT: BACKGROUND: Viral infections during pregnancy can pose serious threats to mother and fetus from the time of conception to the time of delivery. These lead to congenital defects, spontaneous abortion and even death. The definitive diagnosis and management of pregnancy-related viral infections may be challenging especially in less resourced countries. CASE PRESENTATION: We present clinical and laboratory responses to the diagnosis and management of three cases of fulminant hepatitis secondary to Hepatitis E viral infection in pregnancy.Case 1 was a 31-year-old Ghanaian woman who presented with a week's history of passing dark urine as well as yellowish discoloration of the eyes. She subsequently developed fulminant hepatitis secondary to Hepatitis E viral infection, spontaneously aborted at 24 weeks of gestation and later died.Case 2 was also a 31-year-old Ghanaian woman who was admitted with a four-day history of jaundice. She had low grade fever, but no history of abdominal pain, haematuria, pale stool or pruritus. She next developed fulminant hepatitis secondary to Hepatitis E viral infection. However, she did not miscarry but died at 28 weeks of gestation.Case 3 was a 17-year-old Ghanaian woman who was referred to the tertiary health facility on account of jaundice and anaemia. She had delivered a live male infant at maturity of 32 weeks but noticed she was jaundiced and had a presentation of active disease 3 days prior to delivery. The baby was icteric at birth and on evaluation, had elevated bilirubin (mixed type) with normal liver enzymes. Hepatitis E virus infection was confirmed in both mother and baby. However, the jaundice and the hepatomegaly resolved in mother and baby after 5 and 12 days respectively. CONCLUSION: To the best of our knowledge, these are the first documented cases of fatal fulminant hepatic failures resulting from HEV infection in Ghana.     

Seroprevalence of Toxoplasma gondii infection and risk factors associated with seropositivity of pregnant women in Korea

A total of 351 serum samples was examined for anti-T. gondii antibody titers; the overall seroprevalence was 3.7%. The Sabin-Feldman dye test (DT), latex agglutination test (LAT), and IgG enzyme-linked immunosorbent assay (IgG ELISA) indicated seroprevalences of 3.7%, 3.4%, and 4.0%, respectively. Compared with the DT, the sensitivities of the LAT and IgG ELISA were 84.6% and 100.0%, respectively, and the specificities of the LAT and IgG ELISA were both 99.7%. An increase in T. gondii seroprevalence with increasing age was detected, but the difference was not significant. The overall seroprevalence of T. gondii-antibody titers in pregnant Korean women was relatively low compared to those of Europeans and Americans. A multivariate analysis of risk factors showed that T. gondii infection was positively correlated with eating raw meat, but was not associated with the consumption of unwashed vegetables, drinking untreated water, a history of raising a cat, or blood transfusion. The consumption of raw or undercooked meat may, therefore, be the main route of T. gondii infection in Korea.     

三江地区妊娠妇女风疹病毒感染的血清学分析

目的调查2005年三江地区妊娠妇女风疹病毒感染情况。方法收集400例妊娠8～24周孕妇血清,采用酶联免疫吸附法（ELISA）检测风疹特异性IgM抗体,对IgM阳性患者进一步用PCR检测风疹病毒RNA,对该人群的风疹病毒感染率进行调查。结果检测400例孕妇风疹病毒IgM,阳性20例,阳性率为5．00％;检测IgM阳性者的风疹病毒RNA,结果阳性8例,占IgM阳性者的40．00％。结论用ELISA和PCR法进行妊娠早期风疹病毒感染的检测,对降低先天性风疹综合征患儿的出现具有重要意义。     

Comparative sero-epidemiologic observations of rubella infection in pregnant women and female university students

Sera from 58 pregnant women and 34 female university students were tested by a haemagglutination-inhibition (HI) method to determine the levels of immunity to rubella and to assess factors important in its epidemiology. Ages of women ranged from 15 to 35 years. Pregnant women were from the lower socio-economic groups, whilst students came from middle and upper income families. In both groups immunity to rubella increased with age. Students were more susceptible to the infection than pregnant women (21% compared with 3% respectively) - p less than 0.05 and the geometric mean titre was significantly higher in pregnant women than in students. Since women were of the same ages and essentially from the same geographical location, it is suggested that differences in susceptibility rates to rubella were due to differences in the socio-economic status of the two groups.     

The effect of bacterial infection on the biomechanical properties of biological mesh in a rat model

Background

The use of biologic mesh to repair abdominal wall defects in contaminated surgical fields is becoming the standard of practice. However, failure rates and infections of these materials persist clinically. The purpose of this study was to determine the mechanical properties of biologic mesh in response to a bacterial encounter.

Methods

A rat model of Staphylococcus aureus colonization and infection of subcutaneously implanted biologic mesh was used. Samples of biologic meshes (acellular human dermis (ADM) and porcine small intestine submucosa (SIS)) were inoculated with various concentrations of methicillin-resistant Staphylococcus aureus [10⁵, 10⁹ colony-forming units] or saline (control) prior to wound closure (n = 6 per group). After 10 or 20 days, meshes were explanted, and cultured for bacteria. Histological changes and bacterial recovery together with biomechanical properties were assessed. Data were compared using a 1-way ANOVA or a Mann-Whitney test, with p<0.05.

Results

The overall rate of staphylococcal mesh colonization was 81% and was comparable in the ADM and SIS groups. Initially (day 0) both biologic meshes had similar biomechanical properties. However after implantation, the SIS control material was significantly weaker than ADM at 20 days (p = 0.03), but their corresponding modulus of elasticity were similar at this time point (p>0.05). After inoculation with MRSA, a time, dose and material dependent decrease in the ultimate tensile strength and modulus of elasticity of SIS and ADM were noted compared to control values.

Conclusion

The biomechanical properties of biologic mesh significantly decline after colonization with MRSA. Surgeons selecting a repair material should be aware of its biomechanical fate relative to other biologic materials when placed in a contaminated environment.     

Role of HLA antigens in Rh (D) alloimmunized pregnant women from Mumbai, Maharashtra, India

Immunogenetic studies in various diseases provide potential genetic markers. We have studied the incidence of HLA A, B, C, DR and DQ loci antigen in Rh (D) antigen isoimmunized mothers compared to those nonimmunized isoimmunized Rh negative mothers. Seventy six mothers who were immunized to Rh (D) antigen due to pregnancy (responders) and fifty four mothers who did not develop Rh (D) isoimmunization despite positive pregnancies (nonresponders) were selected for the study. Standard methods of serological HLA typing, ABO and Rh (D) groups, and screening for Rh D antibodies were used. 392 unrelated individuals from the population were compared as controls. In addition 45 unrelated individuals from the same population were typed for HLA DRB and DQB gene using PCR-SSP kits. The genotype frequencies of HLA A2, A3, A28, B13, B17, B35, B52, B60, Cw2, Cw6, DR4, and DQ3 were significantly increased, while the frequencies of the HLA A11, A29, A31, B7, B37, B51, Cw1 and DR9 were decreased in the responder women when compared to the non-responder women. HLA A30 (19) split antigen was not identified in immunized women while HLA A23 (9) split antigen was not identified in non immunized women. HLA A3, B17, Cw2 and DR4 showed a significant relative risk among the immunized responder women. When compared with Rh immunized women (responders) reported from USA, England and Hungary the phenotype frequencies of HLA A11, A24, A28, B5, B17, B40, DR2 and DR5 were increased while HLA A23, B8, B18, and DR6 were decreased in the Indian Rh immunized women. Two locus haplotype frequency analysis observed among the responders women revealed that among the significant haplotypes expressed A2–B5, B7–Cw1, DR2–DQ1 were highly significant haplotypes in positive linkage, while A1–B5, and A1–B7 were in significant negative linkage disequilibrium. The haplotype frequencies were ≤one when these common hapoltypes were compared with control population. Thus in the present study it is evident that the inheritance of HLA A3, B17, Cw2 and DR4 increases the relative risk factor by 2.6 times among Indian Rh isoimmunized women. Further, it is evident that there are significant differences in the observed HLA antigen frequencies and two locus haplotypes in Rh isoimmunized women when compared to women from USA, UK and Hungary due to extreme HLA polymorphism in different populations of the world     

Metabolic activation of 2-aminofluorene, 2-acetylaminofluorene and N-hydroxy-acetylaminofluorene to bacterial mutagens with mussel (Mytilus galloprovincialis) and carp (Cyprinus carpio) subcellular preparations

1. The mode of activation of 2-aminofluorene (AF), 2-acetylaminofluorene (AAF) and N-hydroxy-acetylaminofluorene (OH-AAF) to Salmonella typhimurium TA 98 mutagens was investigated in subcellular fractions from the digestive gland of the mussel Mytilus galloprovincialis and from the liver of carp Cyprinus carpio. 2. In carp liver microsomes the activation of OH-AAF was due to very active deacetylase, in contrast to undetectable deacetylase-dependent activation in mussel microsomes. 3. AF and AAF are activated in mussel microsomes exclusively by a noninducible FAD-containing monooxygenase, whereas in carp microsomes in addition deacetylase and inducible cytochrome P-450 monooxygenase are involved. 4. N,O-Acetyltransferase, sulfotransferase and paraoxon sensitive cytosolic enzyme (PSCE) are involved in activation of OH-AAF, AF and AAF in both carp and mussel cytosols. 5. The metabolic activation of OH-AAF, AF and AAF to bacterial mutagens found in carp liver is similar to that described in livers of experimental mammalian species and strikingly different from the mode of activation found in mussel digestive gland.     

The association of plasma peroxiredoxin 3 with insulin in pregnant women

Peroxiredoxin 3 (PRX3) is predominantly located in mitochondria and plays a major role in scavenging hydrogen peroxide of mitochondria. In the present study, we detected plasma PRX3 in pregnant women receiving oral glucose tolerance test at 24–28 gestational weeks. Plasma PRX3 was significantly increased about 1?h later than insulin secretion. In vitro detection of PRX3 in mouse islet cells showed up-regulation by more than 2-fold at 1?h and reached its top at 2?h of glucose stimulation, and the PRX3 level in cultured mediums was concomitantly elevated in a glucose concentration-dependent manner. In addition, both fasting plasma insulin and PRX3 were significantly higher in the subjects of term pregnancy as compared to that at 24–28 gestational weeks, and there was a positive correlation between plasma PRX3 and insulin. Our results indicate that PRX3 plays an active role in the response to insulin release. The positive association of plasma PRX3 and insulin suggest PRX3 to be a potential indicator of high insulin resistance.