Viral infection of the pregnant cervix predisposes to ascending bacterial infection

J Immunol. 2013 Jul 15;191(2):934-41. doi: 10.4049/jimmunol.1300661. Epub 2013 Jun 10.

Abstract

Preterm birth is the major cause of neonatal mortality and morbidity, and bacterial infections that ascend from the lower female reproductive tract are the most common route of uterine infection leading to preterm birth. The uterus and growing fetus are protected from ascending infection by the cervix, which controls and limits microbial access by the production of mucus, cytokines, and antimicrobial peptides. If this barrier is compromised, bacteria may enter the uterine cavity, leading to preterm birth. Using a mouse model, we demonstrate, to our knowledge for the first time, that viral infection of the cervix during pregnancy reduces the capacity of the female reproductive tract to prevent bacterial infection of the uterus. This is due to differences in susceptibility of the cervix to infection by virus during pregnancy and the associated changes in TLR and antimicrobial peptide expression and function. We suggest that preterm labor is a polymicrobial disease, which requires a multifactorial approach for its prevention and treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Animals
  • Bacterial Infections / immunology*
  • Bacterial Infections / microbiology
  • Cells, Cultured
  • Cervix Uteri / immunology*
  • Cervix Uteri / microbiology
  • Cervix Uteri / virology
  • Escherichia coli Infections / immunology
  • Escherichia coli Infections / microbiology
  • Female
  • Gonadal Steroid Hormones / physiology
  • Herpesviridae Infections / immunology*
  • Herpesviridae Infections / virology
  • Integrins / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Pregnancy
  • Premature Birth / etiology
  • Toll-Like Receptors / metabolism
  • Ureaplasma Infections / immunology
  • Ureaplasma Infections / microbiology
  • Uterine Cervical Diseases / immunology
  • Uterine Cervical Diseases / virology*
  • Uterine Diseases / immunology*
  • Uterine Diseases / microbiology
  • Uterine Diseases / virology

Substances

  • Gonadal Steroid Hormones
  • Integrins
  • Toll-Like Receptors