Immunomodulators plus antibiotics delay preterm delivery after experimental intraamniotic infection in a nonhuman primate model - 22/08/11
, Kristina M. Adams, MD a, c, Drew W. Sadowsky, PhD b, Alexandra R. Grosvenor, MD d, Steven S. Witkin, MD e, Michael K. Axthelm, DVM, PhD b, Miles J. Novy, MD b
Address correspondence to: Michael G. Gravett, MD, Department of Obstetrics and Gynecology, University of Washington, 1959 NE Pacific St, Box 356460, Seattle, WA 98195-6460Résumé |
Objective |
The purpose of this study was to determine whether treatment with ampicillin together with dexamethasone and indomethacin delays preterm birth that is induced by intraamniotic group B Streptococcus in a nonhuman primate model.
Study Design |
After contraction onset that was induced by group B Streptococcus (106 colony-forming units/mL), chronically instrumented rhesus macaques received either no treatment (controls; n = 6); ampicillin (n = 4); or ampicillin + dexamethasone + indomethacin (n = 5). Outcomes included the interval from contraction onset until delivery and concentrations of amniotic fluid inflammatory mediators.
Results |
Mean interval from contraction onset until delivery was 33 ± 8.7 hours in controls, 82 ± 28.0 hours with ampicillin (P = .18, vs controls), and 213 ± 50.8 hours with ampicillin + dexamethasone + indomethacin (P = .004, vs controls). Ampicillin eradicated group B Streptococcus; however, uterine activity, amniotic fluid cytokines, prostaglandins, and matrix metalloproteinase-9 remained elevated. Ampicillin + dexamethasone + indomethacin suppressed interleukin-1β, tumor necrosis factor-⍺, and prostaglandins E2 and F2⍺ but did not alter matrix metalloproteinase expression or chorioamnionitis.
Conclusion |
The combination of ampicillin + dexamethasone + indomethacin suppressed inflammation and significantly prolonged gestation.
Le texte complet de cet article est disponible en PDF.Key words : cytokine, intraamniotic infection, preterm labor, prostaglandins, rhesus macaque
Plan
| Reprints not available from the authors. |
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| Supported by National Institutes of Health grants AI42490, HD06159, HD18185, RR00163, and HD01264. |
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| Cite this article as: Gravett MG, Adams KM, Sadowsky DW, et al. Immunomodulators plus antibiotics delay preterm delivery after experimental intraamniotic infection in a nonhuman primate model. Am J Obstet Gynecol 2007;197:518.e1-518.e8. |
Vol 197 - N° 5
P. 518.e1-518.e8 - novembre 2007 Retour au numéro
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