Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Antimicrobial Properties of Amniotic and Chorionic Membranes: A Comparative Study of Two Human Fetal Sacs

Authors
Majid Zare-Bidaki 1
Sajad Sadrinia 2
Soheila Erfani 3
Ehsan Afkar 4
Nahid Ghanbarzade 3
1 Infectious Diseases Research Center, Faculty of Paramedical Sciences, Birjand University of Medical Sciences, Birjand, Iran
2 Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
3 Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
4 Deputy of Research and Technology, Birjand University of Medical Sciences, Birjand, Iran
Abstract
Background: There is evidence of antibacterial properties of human chorioamniotic layer. However, the distinctive contribution of its individual parts, amniotic and chorionic membranes, to these effects is still unknown. The aim of present study was comparison of the antibacterial effects between amniotic and chorionic membranes. Methods: Chorioamniotic layer was removed from placenta belonging to 43 healthy mothers whose infants were delivered by caesarean section. Their amniotic and chorionic fetal tissues were manually peeled in sterile conditions. The antibacterial effects of all membrane samples were evaluated on 8 standard strains of bacterial collection using disk diffusion method on bacteriologic media. Results of bacterial growth inhibition in the presence of amniotic or chorionic membranes were measured and recorded as median±IQR. For data analysis and statistical comparison of samples, Kruskal-Wallis and Mann-Whitney U-test were applied using SPSS (v. 18). Results: Amniotic and chorionic membranes significantly showed different level of growth inhibitory effects on 8 bacterial strains including seven pathogens: E. coli, Bacillus cereus, Klebsiella pneumonia, Streptococcus pyogenes, Pseudomonas aeruginosa, Staphylococcus aureus, Shigella flexneri and one probiotic: Lactobacillus plantarum (p=0.018 and p<0.001, respectively). The number of bacterial growth inhibition zones around chorionic membranes was more than of what found around amniotic membranes. Conclusion: The superiority of antibacterial effects of the chorionic membrane compared with the amniotic membrane can represent the key role of maternal part in placenta in protecting the fetus against possible infections. The antimicrobial effect of amniotic and chorionic membranes is significantly different on various bacteria.
Keywords
Amniotic membrane
Antibacterial Effect
Chorionic membrane
  1. Stirling KM, Hussain N, Sanders MM, Campbell W. Association between maternal genital mycoplasma colonization and histologic chorioamnionitis in preterm births. J Neonatal Perinatal Med. 2016;9(2):201-9.
  2. Nadeau HC, Subramaniam A, Andrews WW. Infection and preterm birth. Semin Fetal Neonatal Med. 2016;21(2):100-5.
  3. Vinturache AE, Gyamfi-Bannerman C, Hwang J, Mysorekar IU, Jacobsson B; Preterm Birth International Collaborative (PREBIC). Maternal microbiome - A pathway to preterm birth. Semin Fetal Neonatal Med. 2016;21(2):94-9.
  4. Yoneda N, Yoneda S, Niimi H, Ueno T, Hayashi S, Ito M, et al. Polymicrobial amniotic fluid infection with Mycoplasma/Ureaplasma and other bacteria induces severe intra-amniotic inflammation associated with poor perinatal prognosis in preterm labor. Am J Reprod Immunol. 2016;75(2):112-25.
  5. Stock SJ, Kelly RW, Riley SC, Calder AA. Natural antimicrobial production by the amnion. Am J Obstet Gynecol. 2007;196(3):255.e1-6.
  6. Sadler TW. Langman's medical embryology. 12th ed. Philadelphia: Lippincott Williams & Wilkins; 2015. 400 p.
  7. Talmi YP, Sigler L, Inge E, Finkelstein Y, Zohar Y. Antibacterial properties of human amniotic membranes. Placenta. 1991;12(3):285-8.
  8. Kjaergaard N, Hein M, Hyttel L, Helmig RB, Schonheyder HC, Uldbjerg N, et al. Antibacterial properties of human amnion and chorion in vitro. Eur J Obstet Gynecol Reprod Biol. 2001;94(2):224-9.
  9. Sangwan VS, Basu S. Antimicrobial properties of amniotic membrane. Br J Ophthalmol. 2011;95(1):1-2.
  10. Zare Bidaki M, Lessani T, Khazaie Z. [Evaluation of anti-bacterial effects of chorionic membranes in vitro]. Birjand Univ Med Sci J. 2012;19(2):140-6. Persian.
  11. Parthasarathy M, Sasikala R, Gunasekaran P, Raja J. Antimicrobial activity of human amniotic and chorionic membranes. J Acad Ind Res. 2014;2(10):545-7.
  12. Clinical and Laboratory Standards Institute (CLSI). Performance standard for antimicrobial susceptibility testing standard M02-A12. Clinical and Laboratory Standards Institute; 2015. 16 p.
  13. Soltan-Dallal MM, Kalafi Z, Rastegar-Lari A, Hosseini S, Rahimi-Foroushani A, Deilami-Khiabani Z, et al . The effect of reduced bacterial dilution on human amniotic membrane antibacterial activity, in vitro. Zahedan J Res Med Sci. 2013;15(5):6-8.
  14. Asi Tehrani F, Peirovi H, Niknejad H. [Determination of antibacterial effect of the epithelial and mesenchymal surfaces of amniotic membrane on Escherichia coli, Staphylococcus aureus]. Qom Univ Med Sci J. 2013;7(4):12-22. Persian.
  15. Cunha SP, Berezowski AT, Costa MW, Costa JC, Ribeiro dos Santos R, Duarte G. Demonstration of the presence of IgA in the human chorioamniotic membrane. Int J Gynaecol Obstet. 1984;22(2):107-10.
  16. Berezoswski AT, Cunha SP, da Costa JC, Bacchi CE. Quantification of immunoglobulin A in chorioamniotic membrane of patients with premature rupture of membranes. Int J Gynaecol Obstet. 1994;47(1):23-6.
  17. Ganz T. Defensins: antimicrobial peptides of innate immunity. Nat Rev Immunol. 2003;3(9):710-20.
  18. Szukiewicz D, Alkhalayla H, Pyzlak M, Watroba M, Szewczyk G, Wejman J. Human beta-defensin 1, 2 and 3 production by amniotic epithelial cells with respect to human papillomavirus (HPV) infection, HPV oncogenic potential and the mode of delivery. Microb Pathog. 2016;97:154-65.
  19. Buhimschi IA, Jabr M, Buhimschi CS, Petkova AP, Weiner CP, Saed GM. The novel antimicrobial peptide beta3-defensin is produced by the amnion: a possible role of the fetal membranes in innate immunity of the amniotic cavity. Am J Obstet Gynecol. 2004;191(5):1678-87.
  20. Denison FC, Kelly RW, Calder AA, Riley SC. Secretory leukocyte protease inhibitor concentration increases in amniotic fluid with the onset of labour in women: characterization of sites of release within the uterus. J Endocrinol. 1999;161(2):299-306.
  21. Majchrzak-Gorecka M, Majewski P, Grygier B, Murzyn K, Cichy J. Secretory leukocyte protease inhibitor (SLPI), a multifunctional protein in the host defense response. Cytokine Growth Factor Rev. 2016;28:79-93.
  22. Williams SE, Brown TI, Roghanian A, Sallenave JM. SLPI and elafin: one glove, many fingers. Clin Sci (Lond). 2006;110(1):21-35.
  23. Kanyshkova TG, Buneva VN, Nevinsky GA. Lactoferrin and its biological functions. Biochemistry (Mosc). 2001;66(1):1-7.
  24. Higa K, Shimmura S, Shimazaki J, Tsubota K. Hyaluronic acid-CD44 interaction mediates the adhesion of lymphocytes by amniotic membrane stroma. Cornea. 2005;24(2):206-12.
  25. Yoshio H, Tollin M, Gudmundsson GH, Lagercrantz H, Jornvall H, Marchini G, et al. Antimicrobial polypeptides of human vernix caseosa and amniotic fluid: implications for newborn innate defense. Pediatr Res. 2003;53(2):211-6.
  26. Espinoza J, Chaiworapongsa T, Romero R, Edwin S, Rathnasabapathy C, Gomez R, et al. Antimicrobial peptides in amniotic fluid: defensins, calprotectin and bacterial/permeability-increasing protein in patients with microbial invasion of the amniotic cavity, intra-amniotic inflammation, preterm labor and premature rupture of membranes. J Matern Fetal Neonatal Med. 2003;13(1):2-21.
  27. Tambor V, Kacerovsky M, Andrys C, Musilova I, Hornychova H, Pliskova L, et al. Amniotic fluid cathelicidin in PPROM pregnancies: from proteomic discovery to assessing its potential in inflammatory complications diagnosis. PLoS One. 2012;7(7):e41164.
Journal of Reproduction & Infertility
Volume 18, Issue 2
Spring 2017
Pages 218-224