Signaling Pathways Regulating Human Cervical Ripening in Preterm and Term Delivery

Abstract

At the end of gestation, the cervical tissue changes profoundly. As a result of these changes, the uterine cervix becomes soft and vulnerable to dilation. The process occurring in the cervical tissue can be described as cervical ripening. The ripening is a process derivative of enzymatic breakdown and inflammatory response. Therefore, it is apparent that cervical remodeling is a derivative of the reactions mediated by multiple factors such as hormones, prostaglandins, nitric oxide, and inflammatory cytokines. However, despite the research carried out over the years, the cellular pathways responsible for regulating this process are still poorly understood. A comprehensive understanding of the entire process of cervical ripening seems crucial in the context of labor induction. Greater knowledge could provide us with the means to help women who suffer from dysfunctional labor. The overall objective of this review is to present the current understanding of cervical ripening in terms of molecular regulation and cell signaling.

Exploring Plasma-Level Gut Microbiota Mediators and Pro-Inflammatory Markers in Pregnant Women with Short Cervix and Gestational Diabetes Mellitus

“…With regard to Hsp70, previous studies have reported elevated levels in the serum of women with preeclampsia compared to those with normal pregnancy [53,54], as well as in vaginal fluid of women with short cervix, suggesting its involvement in the proinflammatory cervico-vaginal milieu leading to cervical shortening [39]. The lower plasmatic concentration of Hsp70 observed in women with short cervix in this study may be attributed to the recall of the pro-inflammatory cells and molecules to the shortening cervix, where they play a role in the cervical tissue remodelling [39,49,55].…”

“…MMP-8 and other MMPs play crucial roles in cervical remodelling, and their concentration and activity have been reported to increase in the lower uterine segment during labor [48]. We hypothesize that the lower plasma MMP-8 levels observed in pregnant women with a short cervix may be associated with higher levels of this enzyme in the placenta or in the lower uterine segment, where inflammation and remodelling may occur [49]. MMP-8 has been shown to compromise epithelial barrier integrity [47] and its levels in vaginal fluid have been associated with cervical shortening [39].…”

Mifepriston fore safe pregnancy termination in 2nd trimester

“…The ripening is a process derivative of enzymatic breakdown and inflammatory response. Therefore, it is apparent that cervical remodeling is a derivative of the reactions mediated by multiple factors such as hor-mones, prostaglandins, nitric oxide, and inflammatory cytokines [11].…”

Mutable Collagenous Tissue: A Concept Generator for Biomimetic Materials and Devices

“…Collagenous tissue is an important structural biomaterial in most multicellular animals. The mechanical properties of collagenous tissue are usually relatively stable, with any significant non-pathological changes taking place over timescales of days (during relaxation of the mammalian uterine cervix [1]) to years (during maturation and ageing [2]). However, all five living classes of the phylum Echinodermata (sea lilies and featherstars, sea-urchins, sea-cucumbers, starfish, brittlestars) possess collagenous tissue that can drastically alter its mechanical properties within a timescale of seconds under the direct control of the nervous system.…”