Collagenase activity in the cervix of non-pregnant and pregnant women

Osmers, R.; Rath, Werner; Adelmann-Grill, B. C.; Fittkow, Cordula; Severényi, M.; Kuhn, Walther

doi:10.1007/bf02389578

Cited by 31 publications

(6 citation statements)

References 28 publications

(34 reference statements)

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“…Pro-inflammatory cytokines act to further drive the production of COX-2 and PGE 2 in amnion (21)(22)(23)(24). Likewise, cervical ripening and dilation is dependent on leukocyte infiltration (14,25), pro-inflammatory cytokine, matrix metalloproteinase (26)(27)(28), and prostaglandin production. PGE 2 decreases the concentration of collagen (29), increases the synthesis of proteoglycans (30), enhances migration of leukocytes towards the cervix the (31) and augments the potency of pro-inflammatory chemokines (32).…”

Section: Biochemical Processes Of Labourmentioning

confidence: 99%

Efficacy of progesterone for prevention of preterm birth

Sykes¹,

Bennett²

2018

Best Practice & Research Clinical Obstetrics & Gynaecol

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Preterm birth (PTB) occurs in 5-18% of pregnancies and is the leading cause of neonatal morbidity, mortality and infant death. Up to 30% of PTBs are due to iatrogenic reasons, but the remainder are due to the spontaneous onset of labour or pre-labour premature rupture of membranes (P-PROM). During pregnancy, the uterus remains quiescent and the cervix remains long and closed. Although the exact mechanisms that lead to spontaneous PTB (sPTB) are not fully understood, it is likely that the terminal pathways that are common to term labour are activated prematurely. Despite continued research efforts to develop preventative strategies, there have been no major advances resulting in the reduction of sPTB rates. Progesterone is the most researched prophylactic agent, yet, there is lack of consistency in the reported beneficial effects for the prevention of PTB and improvement in neonatal outcome. This is likely to stem from the multifactorial aetiology of sPTB, the varied patient cohorts recruited and the use of different preparations and routes of administration for progesterone. This review summarises the scientific rationale supporting the efficacy of progesterone and the results of major randomised controlled trials and finally emphasizes how targeted studies with more detailed patient stratification are essential to understand which population would benefit.

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Section: Biochemical Processes Of Labourmentioning

confidence: 99%

Efficacy of progesterone for prevention of preterm birth

Sykes¹,

Bennett²

2018

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…45 Much work has focused on the regulation of fibrillar collagen synthesis and degradation in cervical remodeling, although less is known about the regulation of steps involved in collagen assembly to form mature cross-linked collagen. [46][47][48][49] Activity and mRNA expression of lysyl oxidase (Lox), one of several collagen cross-linking enzymes, is suppressed during pregnancy and increased shortly after birth. 21,22 During cervical softening in the mouse, collagen solubility is increased, suggesting changes in collagen cross-linking.…”

Section: Identification Of Genes With Potential Roles In Cervical Remodelingmentioning

confidence: 99%

Processes Regulating Cervical Ripening Differ From Cervical Dilation and Postpartum Repair: Insights From Gene Expression Studies

Timmons

Mahendroo

2007

Reprod. Sci.

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A greater understanding of the processes that regulate cervical remodeling during pregnancy, parturition, and the postpartum period is required to understand causes of preterm and posterm birth in which abnormal cervical function is the primary culprit. In the current study, gene expression patterns unique to cervical ripening as compared with cervical dilation and/or postpartum repair are identified in a mouse model. Genes differentially regulated from gestation day 15 to late day 18 reveal processes important for cervical ripening. Genes differentially regulated from late day 18 to 2 hours after birth reveal processes that could be important during cervical dilation or the postpartum recovery period. Based on expression patterns, cervical ripening requires a downregulation of collagen assembly genes; increased synthesis of glycosaminoglycans that disrupt the matrix, such as hyaluronan; increased metabolism of progesterone; and changes in epithelial barrier properties. The latter phases of dilation and postpartum recovery are associated with increased assembly of mature collagen, synthesis of matrix proteins that promote a dense connective tissue, activation of inflammatory responses, prostaglandin synthesis, and further changes in epithelial barrier properties and differentiation. Processes/gene expression required for cervical ripening are distinct from those important in latter phases of cervical remodeling and highlight the importance of timing of tissue collection for understanding the molecular mechanisms of cervical ripening.

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“…Although the mechanisms of spontaneous cervical ripening are still unknown, there is ample evidence to suggest that cervical collagen changes during pregnancy and labour. Changes such as: (i) an increase in the interior space between collagen fibres; (ii) a shortening of the length of collagen fibres; and (iii) an increase in the collagen acidic solubility, occur as the pregnancy approaches term (Fosang and Handley, 1988;Osmers et al, 1990;Yu et al, 1995).…”

Section: Cervical Collagen Content Measured By Light-induced Autofluomentioning

confidence: 99%

Control and assessment of the uterus and cervix during pregnancy and labour

Garfield

Saade²,

Buhimschi

et al. 1998

Human Reproduction Update

189

129

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Preterm labour and resultant preterm birth are the most important problems in perinatology. Countless efforts have failed to establish a single effective treatment of preterm labour, partly because the mechanisms regulating the uterus and cervix during pregnancy are not well understood. New knowledge is needed to inhibit early progression of labour (uterine contractility and cervical ripening), and adequate quantitative tools to evaluate the uterus and cervix during pregnancy are lacking. In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labour. This step is not easily identifiable with present methods to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties to make muscle more excitable and responsive to produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone appears to have a dominant role in controlling both the uterus and cervix, as antiprogestins induce early, preterm conditioning leading to preterm labour. Apparently, nitric oxide (NO) also controls conditioning of the uterus and cervix. In the uterus, NO, in concert with progesterone, inhibits uterine contractility. At term, NO production by the uterus and placenta are decreased and allow labour to progress. In contrast, NO in the cervix increases at the end of pregnancy and it may be the final pathway for stimulating cervical ripening by activation of metalloenzymes. The progress of labour can be assessed non-invasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labour. EMG activity also increases substantially during preterm labour in humans and rats. This method may be used one day to predict impending preterm labour and identify control steps and treatments. A quantitative method also assesses the cervix, using an optical device which measures collagen fluorescence in the cervix. The collascope estimates cervical collagen content from a fluorescent signal generated when collagen cross-links are illuminated with excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy, and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy, and indicate control and treatments.

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Collagenase activity in the cervix of non-pregnant and pregnant women

Cited by 31 publications

References 28 publications

Efficacy of progesterone for prevention of preterm birth

Efficacy of progesterone for prevention of preterm birth

Processes Regulating Cervical Ripening Differ From Cervical Dilation and Postpartum Repair: Insights From Gene Expression Studies

Control and assessment of the uterus and cervix during pregnancy and labour

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