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Dermatitis as a component of the fetal inflammatory response syndrome is associated with activation of Toll-like receptors in epidermal keratinocytes
Article first published online: 6 OCT 2006
Volume 49, Issue 5, pages 506–514, November 2006
How to Cite
Kim, Y. M., Romero, R., Chaiworapongsa, T., Espinoza, J., Mor, G. and Kim, C. J. (2006), Dermatitis as a component of the fetal inflammatory response syndrome is associated with activation of Toll-like receptors in epidermal keratinocytes. Histopathology, 49: 506–514. doi: 10.1111/j.1365-2559.2006.02542.x
- Issue published online: 26 OCT 2006
- Article first published online: 6 OCT 2006
- Date of submission 28 April 2006 Accepted for publication 19 July 2006
- fetal dermatitis;
- fetal inflammatory response syndrome;
- fetal skin;
- Toll-like receptors
Aims Microbial invasion of the amniotic cavity (MIAC) elicits a fetal inflammatory response such as funisitis and chorionic vasculitis. However, little is known about the changes of fetal skin during MIAC. Toll-like receptors recognize microbial products and initiate an immune response. The aims of this study were to examine histopathological features of fetal skin exposed to MIAC and to assess the changes in Toll-like receptor (TLR)-2 and TLR-4 expression.
Methods and results Skin samples were obtained from fetal autopsies (n = 12). The cases were classified according to the presence (n = 8) or absence (n = 4) of acute chorioamnionitis and analysed by immunohistochemistry using a panel of antibodies. Leucocytic infiltrates into the superficial dermis were observed in cases with chorioamnionitis; the majority of inflammatory cells were neutrophils, lymphocytes and histiocytes. TLR-2 immunoreactivity in the skin was stronger in fetuses with chorioamnionitis than in those without this condition. However, immunoreactivity of TLR-4 in the fetal skin was constitutively expressed, regardless of the presence or absence of chorioamnionitis.
Conclusions This study demonstrates for the first time that fetal dermatitis can be detected and is part of the fetal inflammatory response syndrome (FIRS). We propose that this ‘FIRS-associated fetal dermatitis’ is a fetal counterpart of chorioamnionitis.