Immunoreactivity of human fetal membranes to peptidoglycan polysaccharide (PGPS): Cytokine response

Objective: Group-B Streptococcus has been associated with preterm labor and other pregnancy related complications. This study was performed to evaluate the effect of peptidoglycan polysaccharide (PGPS) derived from a β hemolytic Streptococcal cell wall on amniochorion cytokine production and to compare PGPS effects with lipopolysaccharide (LPS), which is the Gram negative counterpart of PGPS. Study design: Amniochorionic membranes collected from women not in labor, and undergoing elective repeat C-section were placed in an organ explant system. Membranes were stimulated separately with 50 ng/ml of small (100p), large (10s) fractions of PGPS or LPS respectively immediately after collection and after a stabilization period of 48 hrs. Media samples were collected at 3, 6, 9, 12 and 24 hrs for protein analysis after each stimulation. Media samples were analyzed by ELISA for IL-6 and IL-8. Results: Both forms of PGPS and LPS stimulated IL-6 and IL-8 production by human fetal membranes. Of note is that LPS stimulated IL-6 to a greater degree than IL-8, while PGPS stimulated IL-8 to a greater degree than IL-6. No statistical difference was seen in the levels of either one of these cytokines for the larger or smaller fragments of PGPS. Time course studies documented a 3-hour lag phase when tissues are stimulated directly after collection which was absent when tissues are stimulated after a 48-hour stabilization period. Conclusion: Both PGPS and LPS stimulate cytokine production differently from fetal membranes. This supports the theory that different bacteria may affect the host in contrasting ways which may lead to a distinct host response, ie PROM vs. PTL.