Extracellular granzyme A in amniotic fluid is elevated in the presence of sterile intra-amniotic inflammation in preterm prelabor rupture of membranes

Abstract

Introduction

To determine the levels of granzyme A in amniotic fluid in pregnancies complicated by preterm prelabor rupture of membranes (PPROM), based on the presence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI).

Methods of study

A total of 166 women with singleton pregnancies complicated by PPROM were included. Amniocentesis was performed at the time of admission and assessments of MIAC (using both cultivation and non-cultivation techniques) and IAI (interleukin-6 in amniotic fluid) were performed on all subjects. Based on the presence/absence of MIAC and IAI, the women were further divided into the following subgroups: intra-amniotic infection, sterile IAI, colonization, and absence of both MIAC and IAI. Amniotic fluid granzyme A levels were assessed using ELISA.

Results

Women with MIAC had lower levels of granzyme A in the amniotic fluid than women without this condition (with MIAC: median 15.9 pg/mL vs. without MIAC: median 19.9 pg/mL, p = .03). Women with sterile IAI had higher amniotic fluid granzyme A levels than women with intra-amniotic infection, colonization and women with the absence of either MIAC or IAI (intra-amniotic infection: median 15.6 pg/mL; sterile IAI: median 31.8 pg/mL; colonization: median 16.9 pg/mL; absence of both MIAC and IAI: median 18.8 pg/mL; p = .02).

Conclusions

The presence of sterile IAI was associated with elevated levels of granzyme A in amniotic fluid.

Keywords:

• Adaptive immunity
• intra-amniotic inflammation
• microbial invasion of the amniotic cavity
• preterm delivery
• protease
• T cells
• NK cells

Disclosure statement

The authors report that they have no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was supported by the project PERSONMED – Center for the Development of Personalized Medicine in Age-Related Diseases [Reg. Nr.CZ.02.1.01/0.0/0.0/17_048/0007441] and by Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic, project ‘‘PROGRES P40/10,” Faculty Hospital in Hradec Kralove (long-term organization development plan).