Preventing cervical ripening: the primary mechanism by which progestational agents prevent preterm birth? - 21/08/11
Reprints: Michal A. Elovitz, MD, Center for Research on Reproduction and Women’s Health, 1354 Biomedical Research Bldg II/III, 421 Curie Blvd, Philadelphia, PA 19104-6142.Résumé |
Objective |
Recent clinical trials suggest that progestational agents may prevent preterm birth, specifically in women with short cervices. These studies sought to assess novel pathways by which progestational agents (PAs) may modify signal transduction pathways that are involved in cervical ripening.
Study Design |
A microarray analysis was performed on pregnant mouse cervix that was exposed to a MPA. Appropriate microarray and cluster analyses were performed. Target genes of interest were investigated in both PA– and inflammation-exposed cervices by quantitative polymerase chain reaction and immunohistochemistry.
Results |
Microarray analysis identified both the previously recognized and novel pathways that are involved in cervical ripening. PAs differentially rejulate expression of claudin-2, hyaluronan synthase 2, and lipocalin 2. Claudin expression is significantly decreased by inflammation, which is prevented by PAs.
Conclusion |
PAs significantly modulate gene expression in the cervix in the presence and absence of inflammation. The regulation of these pathways, specifically claudin proteins, may be a critical mechanism by which PAs prevent preterm birth, especially in women with premature cervical shortening.
Le texte complet de cet article est disponible en PDF.Key words : cervical ripening, medroxyprogesterone acetate, microarray, preterm birth, progesterone
Plan
| Cite this article as: Xu H, Gonzalez JM, Ofori E, Elovitz MA. Preventing cervical ripening: the primary mechanism by which progestational agents prevent preterm birth? Am J Obstet Gynecol 2008;198:314.e1-314.e8. Part of this research was supported by a grant from the March of Dimes. |
Vol 198 - N° 3
P. 314.e1-314.e8 - mars 2008 Retour au numéro
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