Infection, innate immunity, and placental vascular disease

Abstract

Thrombotic vascular disease in the placenta has been associated with stillbirth, neonatal death, organ thrombosis, and cerebral palsy. Vascular disease in the placenta can be identified by the study of umbilical artery Doppler flow velocity waveforms, and a high resistance pattern predicts adverse outcome. We have shown that endothelial cell activation and a proinflammatory cytokine response are present in the villous placental circulation in these cases. Activation of the Toll-like receptors, central to innate immunity and the most primitive host defense against infection, causes these responses. We studied TLR4 receptor activation (the ligand is LPS) to examine whether infection may cause placental vascular disease.