Ureaplasma parvum alters the immune tolerogenic state in placental tissue and could cause miscarriage

Abstract

Objective: To study the inflammatory profile and genes involved in the response to bacterial infections in women who developed spontaneous abortion in the presence of Ureaplasma parvum.

Design: Cross-sectional study.

Setting: A maternal and child referral center.

Patient(s): Eighty-nine women with spontaneous abortion and 20 women with normal vaginal delivery (control group) were studied.

Intervention(s): Samples of biopsied placental tissue were collected for Mollicutes detection.

Main outcome measure(s): The samples were subjected to histologic analysis, immunohistochemical evaluation for macrophages and lymphocytes, cytokine quantification, and quantitative polymerase chain reaction array to evaluate the expression of 84 genes related to the innate and adaptive immune responses.

Result(s): The presence of U. parvum in the abortion group was positively associated with the influx of polymorphonuclear cells in the placental tissue and increased concentrations of interleukin-6 and interleukin-12p70. U. parvum caused downregulation of genes involved in the immune response, such as attraction of immune cells, activation of an inflammatory response, T-helper cell 17 response activation, and activation of the complement system at the beginning and end of pregnancy.

Conclusion: The direct action of U. parvum on placental tissue altered the gestational tolerogenic state, reducing the immune response against pathogens and activating the extrinsic apoptotic pathway, causing spontaneous abortion.

Keywords: Mollicutes; Mycoplasmas; Spontaneous abortion; Ureaplasma parvum; gene expression.