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Reproductive Sciences
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*High Risk Pregnancy
*Infections and Pregnancy
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Article

Pretreatment With Toll-like Receptor 4 Antagonist Inhibits Lipopolysaccharide-Induced Preterm Uterine Contractility, Cytokines, and Prostaglandins in Rhesus Monkeys

Kristina M. Adams Waldorf, MD*, David Persing, MD, PhD, Miles J. Novy, MD, Drew W. Sadowsky, MD, PhD, and Michael G. Gravett, MD

* To whom correspondence should be addressed. E-mail: adamsk{at}u.washington.edu.


   Abstract
Intrauterine infection, which occurs in most early preterm births, triggers an immune response culminating in preterm labor. The authors hypothesize that blockade of lipopolysaccharide (LPS)–induced immune responses by a toll-like receptor 4 antagonist (TLR4A) would prevent elevations in amniotic fluid (AF) cytokines, prostaglandins, and uterine contractility. Chronically catheterized rhesus monkeys at 128 to 147 days’ gestation received intra-amniotic infusions of either (1) saline (n = 6), (2) LPS (0.15-10 µg; n = 4), or (3) TLR4A pretreatment with LPS (10 µg) 1 hour later (n = 4). AF cytokines, prostaglandins, and uterine contractility were compared using 1-way ANOVA with Bonferroni adjusted pairwise comparisons. Compared with saline controls, LPS induced significant elevations in AF interleukin-8 (IL-8), tumor necrosis factor (TNF)–{alpha}, PGE2, PGF2{alpha}, and uterine contractility ( P < .05). In contrast, TLR4A pretreatment inhibited LPS-induced uterine activity and was associated with significantly lower AF IL-8, TNF-{alpha}, PGE2, and PGF2{alpha} versus LPS alone (P < .05). Toll-like receptor antagonists, together with antibiotics, may delay or prevent infection-associated preterm birth.

First published on January 9, 2008, doi:10.1177/1933719107310992

Reproductive Sciences 2008;15:121.

A more recent version of this article appeared on February 1, 2008


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