Abstract

Background: Human labor is a complex series of cellular and molecular events that occur at the materno-fetal and uterine levels. Many hypotheses have been proposed for the initiation of human labor, one hypothesis suggests that maturation of the fetus releases a signal in the amniotic fluid that will be transmitted to myometrium via the fetal membranes and initiate uterine contractions. There is strong evidence that prostaglandins (PGs) play a central role in initiation and progression of human labor.Objectives: In this study we intended to investigate the expression of prostaglandin F synthase and the prostaglandin transporter in the human fetal membranes and to explore the relationship between cytokines and PGs in the mechanism of human labor.Methods: We used fetal membranes obtained before labor at term and after spontaneous labor at term or preterm to identify the changes in prostaglandin F synthase (AKR1B1) and human prostaglandin transporter (SLCO2A1) proteins in relation to parturition. Using fetal membranes explants we tested the effect of cytokines (interleukin-1 and tumor necrosis factor alpha) on PG production and the concomitant changes in cyclooxygenase-2 (PTGS2), AKR1B1 and SLCO2A1 expression.Results: Expression of PTGS2 and AKR1B1 was upregulated in the fetal membranes in association with term labor while SLCO2A1 was downregulated with advancing gestation and during term labor. Before labor, IL-1 increased the expression of PTGS2, however during labor TNF upregulated PTGS2 and AKR1B1 proteins.Conclusions: The prostaglandin F synthase AKR1B1 is upregulated while prostaglandin transporter is downregulated during term labor. The amnion is more responsive than choriodecidua to stimulation with pro-inflammatory cytokines. The mechanisms of term and preterm labor are different.

Highlights

  • Labor is the result of strong uterine contractions that lead to expulsion of the fetus to the extrauterine environment

  • Expression of production and the concomitant changes in cyclooxygenase-2 (PTGS2) and AKR1B1 was upregulated in the fetal membranes in association with term labor while SLCO2A1 was downregulated with advancing gestation and during term labor

  • IL-1 increased the expression of PTGS2, during labor tumor necrosis factor-alpha (TNF) upregulated PTGS2 and AKR1B1 proteins

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Summary

Introduction

Labor is the result of strong uterine contractions that lead to expulsion of the fetus to the extrauterine environment. Interaction between several pathways might be essential to initiate the process of labor and may include changes in estrogen and progesterone levels, elevation of corticotropin-releasing hormone (CRH), increased production of prostaglandins (PGs) and increased sensitivity of the uterus to oxytocin (Navitsky et al, 2000). It is not known whether labor is due to stimulation of uterine contraction or loss of inhibitory mechanisms that keep the uterus quiescent during pregnancy (Lopez Bernal et al, 1995). There is strong evidence that prostaglandins (PGs) play a central role in initiation and progression of human labor

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