Pathogenic bacteria of premature rupture of membranes complicated with chorioamnionitis and association of NLRC5 mRNA TLR-4 mRNA,Caspase-1 mRNA with disease progression
OBJECTIVE To analyze the pathogenic bacteria of premature rupture of membranes(PROM)complicat-ed with chorioamnionitis(CAM)and association of the expression of messenger RNA(mRNA)of nucleotide-binding oligomerization domain-like receptor 5(NLRC5),Toll-like receptor-4(TLR-4)and caspase-1 mRNA with the progress of the disease.METHODS A total of 178 cases of pregnant women with PROM admitted to the Peo-ple's Hospital affiliated to Shandong First Medical University from Jan.2021 to May 2023 were selected and divid-ed into CAM group(82 cases)and non-CAM group(96 cases)according to the histologic findings of the fetal membrane tissues at the time of delivery.The pathogenic bacteria detected in patients with PROM complicated with CAM were counted,and the expression levels of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membrane tissue of the two groups were compared,and receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes in patients with CAM.Accord-ing to the degree of inflammation,PROM patients with CAM were divided into mild group(26 cases),moderate group(29 cases)and severe group(27 cases).The expression levels of NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes of patients with different degrees of inflammation were compared,and the correlation between NLRC5,TLR-4 and Caspase-1 mRNA in fetal membranes and the condition of PROM patients with CAM was an-alyzed.RESULTS A total of 97 strains of pathogenic bacteria were isolated from 82 patients with PROM and CAM,mainly Escherichia coli and Enterococcus faecalis.The NLRC5 mRNA,TLR-4 mRNA,and Caspase-1 mRNA in the CAM group were 1.54±0.51,15.86±4.79,and 1.48±0.47,respectively,higher than those in the non-CAM group(P＜0.05).The area under the curve(AUC)of fetal membrane NLRC5 mRNA,TLR-4 mRNA and Caspase-1 mRNA combined for diagnosis of PROM patients complicated with CAM was higher than that of the three tests alone(P＜0.05).The levels of NLRC5 mRNA,TLR-4 mRNA and Caspase-1 mRNA in fetal membranes of mild group,moderate group and severe group showed an increasing trend(P＜0.05).NLRC5 mR-NA,TLR-4 mRNA and Caspase-1 mRNA in fetal membranes were positively correlated with the severity of PROM complicated with CAM(r=0.563,0.618,0.537,P all＜0.05).CONCLUSIONS Escherichia coli and En-terococcus faecalis were the main pathogens of infection in patients with CAM in PROM.The combination of NL-RC5 mRNA,TLR-4 mRNA and Caspase-1 mRNA had good diagnostic value for patients with CAM in PROM,and their expression levels were closely related to the patient's condition.
Premature rupture of membranesChorionic amnionitisPathogenNucleotide binding oligomerization domain-like receptor 5 mRNAToll-like receptor-4 mRNACaspase-1 mRNADegree of illnessRelativity
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