Distinct pathophysiologic pathways induced by in vitro infection and cigarette smoke in normal human fetal membranes

Ramkumar Menon, Stephen J. Fortunato

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: The purpose of this study was to document distinct pathways that are initiated by lipopolysaccharide and cigarette smoke stimulation of normal term fetal membranes. Study Design: Fetal membranes from nonsmoking women at term, not in labor, from cesarean deliveries were placed in an organ explant system and stimulated with cigarette smoke extracts (CSEs), lipopolysaccharide, or lipopolysaccharide + CSE. Media were assayed for an interleukin (IL)-1β, -1 receptor antagonist, -6, -8, -10, tumor necrosis factor α, soluble tumor necrosis factor receptors 1 and 2, and matrix metalloproteinases 1, 2, 3, 8, 9, and 12. Tissue homogenates were assayed for apoptotic markers (p53, caspase 3 activity, and cleaved poly [ADP-ribose] polymerase-1). Results: Lipopolysaccharide stimulation resulted in higher cytokine and matrix metalloproteinase concentrations, whereas it was lower after CSE and CSE + lipopolysaccharide stimulations, compared with control specimens. Apoptotic factors were several folds higher after CSE or CSE + lipopolysaccharide stimulation, compared with control specimens or lipopolysaccharide stimulations. Conclusion: Cigarette smoke showed immunoinhibitory properties that potentially were mediated by apoptosis and lipopolysaccharide-induced proinflammatory response. This study demonstrated 2 independent pathophysiologic pathways that may alter pregnancy outcome.

Original languageEnglish (US)
Pages (from-to)334.e1-334.e8
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Mar 2009
Externally publishedYes


  • behavioral factor
  • cigarette smoke
  • cytokine
  • fetal membrane
  • pPROM
  • toxin

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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