Investigating differences in gene expression in term laboring myometrium compared to preterm laboring and failed post-date induction myometrium

Abstract

MYOMETRIUM COMPARED TO PRETERM LABORING AND FAILED POST-DATE INDUCTION MYOMETRIUM KIMBERLY PILKINTON, STEVEN ALLEN, KEVIN HUDDLESTON, THOMAS KUEHL, Texas A&M Health Science Center System, Temple, Texas, Scott & White, Temple, Texas, Texas A&MUniversity SystemScott & White Memorial Hospital, Obstetrics and Gynecology, Temple, Texas, Texas A&M University, Obstetrics & Gynecology, Temple, Texas OBJECTIVE: To compare gene expression differences between term laboring myometrium and preterm laboring and failed 41-week induction myometrium. STUDY DESIGN: A 100mg sample of myometrium from the lower uterine segment of patients undergoing C-section was obtained from consenting patients and frozen in liquid nitrogen. Cohorts included: 4 patients >37 weeks in labor, 2 patients !3 4 weeks in non-induced preterm labor, and 4 patients >41 weeks with failed induction. Isolation of mRNA and gene expression analysis by microarray was performed by Clontech labs. cDNA probes were generated, labeled, and hybridized in pairs to 12,000 gene arrays. Computer analyses produced gene expression profiles for each sample. Results were normalized and data compared to identify gene expression that is up or down regulated by at least 5-fold comparing the term laboring versus the preterm laboring cohort and the term laboring to the failed induction cohort. RESULTS: The most common mRNAs in the 10 samples were gamma 2 actin, heat shock 27kD protein 1, and light polypeptide 9 myosin. Compared to term laboring myometrium 2 transcripts were up-regulated more than 5-fold in the preterm cohort, and 40 transcripts were down-regulated. A transcription factor gene, FOXO1A, was upregulated by 44 fold in the preterm cohort compared to the term cohort. Fibronectin 1 was also up-regulated (2.1 fold). Compared to the term laboring cohort 11 genes were up-regulated and 27 genes were downregulated by 5-fold in the post-date cohort. CONCLUSION: Using microarray techniques, differences in term laboring myometrium compared to preterm laboring myometrium have been described. Differences in the myometrium of post-date induction patients that have failed induction compared to term laboring patients are also described. This study reveals new insight into potential genetic changes that take place in preterm laboring patients and gives insight into differences in patients who must be induced and still fail to labor effectively.