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Infectious Diseases in Obstetrics and Gynecology
Volume 2010, Article ID 378472, 8 pages
http://dx.doi.org/10.1155/2010/378472
Review Article

TLR-Mediated Preterm Birth in Response to Pathogenic Agents

Department of Pediatrics, Women and Infants' Hospital of Rhode Island—Warren Alpert Medical School of Brown University, Providence, RI 02905, USA

Received 7 May 2010; Revised 28 June 2010; Accepted 2 July 2010

Academic Editor: Bryan Larsen

Copyright © 2010 Jessica E. Thaxton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The incidence of preterm birth in developed countries has risen in the past decades. Underlying causes for this enigmatic pregnancy complication are numerous, yet infectious agents that induce dysregualtion of immunity at the maternal-fetal interface pose one of the most probable causes of preterm birth. This paper highlights two factors regarding maternal infections that trigger unscheduled inflammatory sequences that are deleterious to the maternal-fetal balance necessary to maintain pregnancy. Firstly, we discuss the role of Toll-like receptors (TLRs) as sentinels of uterine immunity in the context of response to pathogens. We highlight the idea that particular TLR activations lead to differential immune cascades that induce preterm birth. Secondly, two alternative routes of pathogenic entry may prove to be critical for inducing preterm birth via a cytokine storm or a secondary and currently unknown cell-mediated mechanism of uterine inflammation. This paper summarizes pathways that underlie activation of adverse and diverse immune responses to foreign agents that may result in preterm birth.