Chair highlights commentary written by the NIH Intramural Research Program - Overlooked Immune Cells Trigger Preterm Labor: New Insights Could Help Reduce Premature Births

A commentary was written by the NIH intramural Research Program. The work represents a collaboration between the Perinatology Research Branch of NICHD/NIH and Wayne State University

Overlooked Immune Cells Trigger Preterm Labor: New Insights Could Help Reduce Premature Births

"Any baby born less than 37 weeks after conception is considered premature, but not all premature births have the same root cause". In a new study, researchers from the Perinatology Research Branch and Wayne State University have detailed how a particular component of the immune system can trigger premature labor, which could help doctors prevent more preterm births.1"

"Most of the research has focused on investigating how the innate immune system can be somehow blocked so that preterm birth is stopped," explains PRB principal investigator and Wayne State University School of Medicine Associate Professor Nardhy Gomez-Lopez, Ph.D., the new study's senior author. "The fact that there are T cells in the placenta and nobody had studied them before intrigued me. I thought that if the T cells were there, they must be there for a reason."

"We found that premature labor induced by activating T cells caused several effects that were not seen when premature labor was prompted by triggering the innate immune system. For example, in the former model but not the latter, we found activated T cells in the animals' decidua, along with immune molecules called macrophages that were in a more inflammation-inducing state than in the other two models. Immune cells called neutrophils, however, were absent when inflammation and preterm labor were caused by activating T cells rather than stimulating the innate immune system."

"Some people might say by activating the T cells we're causing the same sort of inflammation that occurs when an infection induces preterm birth," Dr. Gomez-Lopez says. "What we showed is that activating the T cells causes inflammation in a similar way to an infection, but it also causes specific, unique responses. In other words, not all types of inflammation - and not all preterm labor and births - are the same."

"Finally, we gave the hormone progesterone to pregnant mice after inducing preterm labor by activating their T cells. Progesterone is used to halt premature labor in women with an uncommon condition called a 'short cervix,' and it similarly prevented premature labor in those mice by tamping down inflammation. This suggests that progesterone might help prevent premature labor in more women than was previously thought."

"Now we can take a strategy that is used for this small subset of patients with a short cervix and we can apply it to this other subset of women who have inflammation caused by T cells," Dr. Gomez-Lopez says. "If we can expand that strategy, we can help more women."

Reference:[1] Effector and Activated T Cells Induce Preterm Labor and Birth That Is Prevented by Treatment with Progesterone. Arenas-Hernandez M, Romero R, Xu Y, Panaitescu B, Garcia-Flores V, Miller D, Ahn H, Done B, Hassan SS, Hsu CD, Tarca AL, Sanchez-Torres C, Gomez-Lopez N. J Immunol. 2019; 202(9):2585-2608. doi: https://doi.org/10.4049/jimmunol.1801350.

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