Perfiles de citocinas en tejido placentario de mujeres con resultados adversos del embarazo asociadas a infección intra-amniótica

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dc.contributor.advisorLafaurie Villamil, Gloria Ines
dc.contributor.advisorde Avila Quiroga, Juliette
dc.contributor.authorGomez Peña, Luz Amparo
dc.date.accessioned2023-03-03T18:32:32Z
dc.date.available2023-03-03T18:32:32Z
dc.date.issued2017
dc.description.abstractLas infecciones intra-amnióticas son una de las principales causas que desencadenan eventos adversos en el embarazo y pueden estar asociadas a infecciones crónicas como la enfermedad periodontal. Se han descrito dos mecanismos asociados con la degradación de la decidua; uno por una vía directa a través de los factores de virulencia de los microorganismos y otro indirecto asociado a la activación de citocinas en respuesta a antígenos presentes en la decidua. Establecer la asociación de la expresión de citocinas representativas de LTh1, LTh17, célula NK, macrófago y los perfiles microbianos aislados de infecciones intra-amnióticas con la presencia de BPN, RPM, PPT y/o signos clínicos de infección intra-amniótica. Se realizó un estudio observacional de corte transversal, en donde se examinaron un total de 210 mujeres durante el parto. Se seleccionaron 40 mujeres embarazadas, que se dividieron en cinco grupos:1) mujeres que no presentaron ningún resultado de evento adverso o infección intra-amniótica (n = 17), 2) mujeres sin infección intra-amniótica pero con presencia de algún evento adverso (n = 9), 3) mujeres con infección intra-amniótica por P. gingivalis y algún resultado de evento adverso (n = 5), 4) mujeres con infección intra-amniótica por P. gingivalis sin resultado de evento adverso (n = 4) y 5) mujeres con infección intra-amniótica relacionadas con microorganismos de importancia médica (n = 5). A todas las pacientes se les realizó un examen clínico obstétrico, toma de muestras de placenta y sangre de cordon umbilical con un diagnóstico periodontal en el momento del parto. Se determinó el perfil microbiológico por PCR anidada para microorganismos de origen oral y uro-genital en tejido placentario y la concentración de citocinas asociadas a perfiles de LT-ayudador por citometría de flujo. Los métodos estadísticos incluyeron análisis bivariado por Chi2, análisis de componentes principales entre los patrones de respuesta de las citocinas durante el parto, Kruskal-Wallis para la comparación entre mediana de concentraciones de citocinas y ANOVA de una via post-hoc Dummet para comparar la relación de citocinas/ IFNγ; entre los grupos. El 60% de las mujeres en el grupo de infección intra-amniótica por P. gingivalis tenían periodontitis según criterios CDC, y también P. gingivalis en la placa subgingival (p <0,05). Todos los grupos mostraron un perfil Th1 predominante que se caracterizó por la sobreexpresión de IFNγ y su asociación con la activación de la célula Natural Killer por IL-15 y Granzima B (p <0,005). Se observó una reducción significativa de las citocinas IL-10 e IL17F entre los grupos, mostrando reducciones significativas en el grupo de P. gingivalis con presencia de evento adverso (p <0,005). Además, este grupo mostró algunas variaciones sobre el patrón Th1, que exhiben una influencia significativa de las citocinas de macrófagos MCP-1, TNFα, IL-21 (p <0.05). El grupo control no mostró ninguna diferencia con infección intra-amniótica relacionada a microorganismos de importancia médica. La infección placentaria con P. gingivalis en mujeres embarazadas altera significativamente las concentraciones de citocinas que están directamente relacionadas con el embarazo. La presencia de esta bacteria puede activar directamente al MCP-1 sin ser inducido por altas concentraciones de citocinas del perfil Th1 como el IFNγ; posiblemente por exposición a patrones moleculares derivados del patógeno por vía hematógena generando eventos adversos en el embarazo.spa
dc.description.abstractenglishThe intra-amniotic infections are main causes of adverse outcomes on the pregnancy, and some of these infections can be related with periodontal disease. It has been described two ways associated with the decidua damage. One of this correspond with a direct effect of microorganisms or its virulence factors; the other way refers to activation of mechanisms of response against decidual bacterial antigens and it is recognized as an indirect way. The aim of this study was to establish the association between the expression of cytokines patterns from LTh1, LTh7, NK cell and macrophage cell lines and the placental microbiota profiles with adverse outcomes as LBW, PMR, PTB and other clinical signals of intraamniotic infection. It was performed a cross sectional study where it was evaluated 210 pregnant women during delivery. Forty pregnant women were included in this study, which were divided in five groups: 1) women which didn’t have any adverse outcome or intraamniotic infection (n=17); 2) women which without intraamniotic infection but had some adverse outcome (n=9); 3) women with P. gingivalis intraamniotic infection and some adverse outcome (n=5); 4) women with P. gingivalis intra-amniotic infection without adverse outcome (n=4) and 5) women with intra-amniotic infection related with medical relevance microorganisms (n=5). Which received a obstetric and periodontal evaluation and It was taken samples of placenta and umbilical blood, also subgingival plaque in the moment of them deliveries. It was determined the microbiological profile in placenta and gingival plaque using nested PCR. All included women were distributed in five groups according the microbiota profile and adverse outcome condition and it was measured the levels of IL1β, IL6, TNF-α, MCP-1α, IL15, Granzyme B, IL17A, IL17F, IL21, IL21, IL12p70 and IFN-γ, in placental samples using a multiplex flow cytometry assay. The statistical analysis did include a bivariate evaluation by chi square test, a principal components group by group test, and comparisons by Kruskal Wallis test, U Mann Whitney test or one way ANOVA with Dunnett correction. All analysis were made using IBM-SPSS V23 for Windows and R software. 60% of women in P. gingivalis intraamniotic group had periodontitis by CDC criteria, which also had P. gingivalis in periodontal plaque (p<0.05). All patients showed a predominant Th1 profile which it was characterized by the IFNγ over-expression and its association with NK linage activation by IL-15 and Granzyme B (p <0.005). It was observed a significant reduction of IL-10 and IL17F cytokines among groups (p<0.05), showing significant reductions in P. gingivalis group (p< 0,005). Also, P. gingivalis group showed some variations about the Th1 pattern, which exhibit a significant influence of the macrophage cytokines MCP1, TNFα, IL-21 (p<0.05). Control group did not show any difference with intra-amniotic infection related with medical relevance microorganisms group. The evidence has been showing the relationship between periodontitis with adverse outcomes of pregnancy, however this is the first study that shows how P. gingivalis intraamniotic infection can induce a significant reduction of regulatory cytokines as well as increased levels of MPC-1 a cytokine associated with macrophage activation, explaining its possible relationship with adverse outcomes in pregnancy.eng
dc.description.degreelevelMaestríaspa
dc.description.degreenameMagíster en Ciencias Odontológicasspa
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/10100
dc.language.isospa
dc.publisher.facultyFacultad de Odontologíaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programMaestría en Ciencias Odontológicasspa
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dc.rights.accessrightsinfo:eu-repo/semantics/closedAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_14cb
dc.rights.localAcceso cerradospa
dc.subjectParto pre-términospa
dc.subjectInfecciones intra-amnióticasspa
dc.subjectCélulas NKspa
dc.subjectLinfocitos T colaboradoresspa
dc.subjectMacrófagosspa
dc.subject.keywordsPreterm birthspa
dc.subject.keywordsIntra-amniotic infectionspa
dc.subject.keywordsTh lymphocytespa
dc.subject.keywordsMacrophagespa
dc.subject.keywordsPorphyromonas gingivalisspa
dc.subject.nlmWU 100
dc.titlePerfiles de citocinas en tejido placentario de mujeres con resultados adversos del embarazo asociadas a infección intra-amnióticaspa
dc.title.translatedCytokine profiles in placental tissue of women with adverse pregnancy outcomes associated with intra-amniotic infectionspa
dc.type.coarhttps://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/bachelorThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Maestríaspa

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Maestría en Ciencias Odontológicas