Examination of specific responses in major organs to elucidate the pathology of amniotic fluid embolism

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09467
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Naoaki Tamura 浜松医科大学, 医学部附属病院, 講師 (90402370)
• Co-Investigator(Kenkyū-buntansha): 小田 智昭 浜松医科大学, 医学部附属病院, 医員 (00884743) ; 磯村 直美 浜松医科大学, 医学部附属病院, 助教 (80647595)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 羊水塞栓症

Outline of Final Research Achievements

The lungs, uterus, myocardium, liver, kidneys, and adrenal glands of 13 cases diagnosed with amniotic fluid embolism were collected, formalin-fixed sections were prepared, and specific antibodies were used for tryptase, c-Kit, and C5a receptors. Immunohistochemical staining was performed, the positive area per square micrometer was measured, and comparisons were made with a control group with non-amniotic fluid embolism. The tryptase-positive area was significantly larger in the alveoli of patients with amniotic fluid embolism, and the C5a receptor-positive area was significantly larger in the alveoli and myometrium of patients with amniotic fluid embolism. Furthermore, in comparison between organs, the tryptase-positive area was significantly larger in the lungs and uterus than in other organs. These results suggest that anaphylactoid reactions in amniotic fluid embolism are likely to occur in the lungs and uterus.

Free Research Field

周産期医学

Academic Significance and Societal Importance of the Research Achievements

羊水塞栓症は妊産婦死亡の原因となる疾患の一つであり、その病態として羊水・胎児成分の母体循環内への流入による機械的塞栓や母体のアナフィラクトイド反応が関与することが示唆されているが、今日でも不明な点は多く、突然の発症と急激な全身状態の悪化に対して確立した治療法がないことが問題である。本研究は羊水塞栓症における主要臓器の病理組織検体を用いて病態との関連を調べ、羊水塞栓症では特に肺と子宮におけるアナフィラクトイド反応が特徴的であることが分かった。羊水塞栓症のターゲット臓器を同定した本研究成果は、これらの臓器障害を軽減させる治療が必要であることを裏付けるもので治療戦略の解明に寄与する可能性が高い。