Changes in Polymorphonuclear Leukocytes in the Vagina of Patients with Preterm Labor

Abstract

To evaluate changes in vaginal polymorphonuclear leukocytes (vPMNL) in patients with preterm labor, we obtained vPMNL-rich suspensions from vaginal fluids of 77 women (21 with preterm labor and 56 control women with uncomplicated pregnancy). Total counts of vPMNL and % viability of vPMNL (viable vPMNL:total vPMNL) were significantly higher in patients with preterm labor (37 ± 92 × 10⁵, 23 ± 29%) vs. controls (11 ± 15 × 10⁵, 6.9 ± 8.3%). The concentration of granulocyte elastase in vaginal fluid diluted to 20 ml was also higher in patients with preterm labor than in controls (4,806 ± 3,818 vs. 2,739 ± 2,556 ng/ml). We conclude that PMNL and granulocyte elastase are abundant in the vagina in patients with preterm labor, which suggests that the PMNL may be involved in the pathogenesis of preterm labor.

Increased Level of Granulocyte Elastase in Cervical Secretion Is an Independent Predictive Factor for Preterm Delivery

“…The previous results [6,7,22] , together with the present data, suggest that granulocyte elastase may play an important role in the process of cervical maturation and may be involved in the pathogenesis of preterm delivery. However, the mechanisms responsible for accumulation of granulocytes in the ripe cervix are still not clear.…”

“…A recent study also demonstrated that polymorphonuclear leukocyte and granulocyte elastase were abundant in the vagina in patients with preterm labor compared with those in uncomplicated pregnant women [7] . In addition, Rivero-Marcotegui et al [22] , who found a high elastase concentration in amniotic fl uid in women with preterm labor, suggested that elastase might be a useful maker of amniotic infection and of preterm delivery.…”

“…A recent study suggests that elastase is one of the neutral proteases, which depolymerize and degrade collagen in the ripening cervix [6] . In addition, a more recent study demonstrates that polymorphonuclear leukocyte and granulocyte elastase are abundant in the vagina in patients with preterm labor compared with those in uncomplicated pregnant women [7] . These results make it likely that granulocyte elastase in the cervical secretions is a sensitive marker for preterm delivery.…”

Comparison of biochemical markers and cervical length for predicting preterm delivery

“…Granulocyte elastase (EL) is one of the neutral serine proteases, which depolymerizes and degrades collagen in the ripening cervix. A recent study suggests that polymorphonuclear leukocytes and EL are more abundant in cervical secretions in patients with preterm labor compared with uncomplicated pregnant women 4 …”

“…A recent study suggests that polymorphonuclear leukocytes and EL are more abundant in cervical secretions in patients with preterm labor compared with uncomplicated pregnant women. 4 Fetal fibronectin (fFN) is an isoform of a family of glycoproteins termed fibronectins. fFN is uniquely produced in fetal tissues as well as in certain malignant tumors, and mainly found in amniotic fluid (AF), the placenta, and in the basement membranes near the choriodecidual interface.…”