Positive Fibronectin Research Articles

Atosiban versus placebo in the treatment of threatened preterm birth between 30 and 34 weeks gestation: study protocol of the 4-year APOSTEL 8 follow-up

IntroductionCurrently, the majority of women worldwide with threatened preterm birth are treated with tocolytics. Although tocolytics can effectively delay birth for 48 hours, no tocolytic drug has convincingly been shown...

Detection of serum telomerase and fibronectin as precursor markers of cervix cancer in patients with a positive Pap test

Abstract Introduction: Cervical cancer is a type of cancer that appears in cervical cells, in the lower part of the uterus, being characterized by the proliferation of atypical cancerous cells, which can spread rapidly, representing a serious disease, with significant medical and social impact among affected individuals, and a severe evolution particularly when detected in advanced stages. The aim of this study was to evaluate the alterations found in cervical cells, caused by persistent HPV infection, using inflammatory protein biomarkers such as fibronectin and telomerase. Material and method: This study included a total of 169 women, both asymptomatic and symptomatic, aged between 30 and 64 years. Those women underwent routine gynecological consultations or were referred to a gynecologist because of their symptoms. After selecting the patients, a Pap test and blood samples (5 ml) were taken. Using a questionnaire, information regarding sexual characteristics and behaviors, as well as personal medical history, were collected. Results: The median value for telomerase was 0.1 ng/ml, with a minimum of 0.01 ng/ml and a maximum of 30.09 ng/ml. Based on the telomerase results, 66 (39.1%) patients had positive results (more than 0.215 units) and 103 (60.9%) had negative results. The median value for fibronectin was 3.72 ng/ml with a minimum of 0.55 ng/ml and a maximum of 89.9 ng/ml. Of all women included in the study, 36 (21.3%) had positive results (more than 10 ng/ml), and 133 (78.7%) had negative results. Also, 15.2% of patients with positive telomerase and 16.7% with positive fibronectin presented Atypical Squamous Cells of Undetermined Significance. Mature squamous metaplasia and inflammatory cells have been identified among positive and negative results of fibronectin and telomerase. Conclusions: Positive and negative results for fibronectin and telomerase were similar in correlation with cytological results and information about HPV infection or sexual practices/characteristics were similar.

Self-reported pain scores as a predictor of preterm birth in symptomatic twin pregnancy: a retrospective study

BackgroundTo evaluate the self-reported pain scores as a predictor of preterm birth (PTB) in symptomatic twin pregnancy and to develop a nomogram for the prediction model.MethodsWe conducted a retrospective study of 148 cases of symptomatic twin pregnancies before 34 weeks of gestation visited at Seoul national university hospital from 2013 to 2018. With other clinical factors, self-reported pain score was evaluated by the numerical rating scale (NRS) pain scores for pain intensity. By multivariate analyses and logistic regression, we developed a prediction model for PTB within 7 days. Using the Cox proportional hazards model, the curves were plotted to show the predictability of the PTB according to NRS pain score, while adjusting the other covariates.ResultsTwenty-three patients (15.5 %) delivered preterm within 7 days. By a logistic regression analysis, higher NRS pain score (OR 1.558, 95 % CI 1.093–2.221, P < 0.05), shorter cervical length (OR 3.164, 95 % CI 1.262–7.936, P < 0.05) and positive fibronectin results (OR 8.799, 95 % CI 1.101–70.330, P < 0.05) affect PTB within 7 days. Using the variables, the area under the receiver operating characteristic curve (AUROC) of the prediction model was 0.917. In addition, we developed a nomogram for the prediction of PTB within 7 days.ConclusionsSelf-reported pain scores combined with cervical length and fetal fibronectin are useful in predicting impending PTB in symptomatic twin pregnancy.

Selenium Deficiency Leads to Changes in Renal Fibrosis Marker Proteins and Wnt/β-Catenin Signaling Pathway Components.

Renal fibrosis is the final result of the progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD). Earlier studies confirmed that selenium (Se) displays a close association with kidney diseases. However, the correlation between Se and fibrosis has rarely been explored. Thus, this article mainly aimed to investigate the effect of Se deficiency on renal fibrosis and the Wnt/β-catenin signaling pathway. Twenty BALB/c mice were fed a diet containing 0.02-mg/kg Se (Se-deficient diet) or 0.18-mg/kg Se (standard diet) for 20 weeks. A human glomerular mesangial cell (HMC) cell line was transfected with lentiviral TRNAU1AP-shRNA vector to establish a stable Se deficiency model in vitro. As indicated in this study, the glutathione (GSH) content in the Se-deficient group displayed an obvious decline compared with that in the control group, whereas the content of malondialdehyde (MDA) was obviously elevated. The results of Masson staining showed fibrosis around the renal tubules, and the results of immunohistochemistry showed that the area of positive fibronectin expression increased. In the Se-deficient group, the levels of collagen I, collagen III, matrix metalloproteinase 9 (MMP9), and other fibrosis-related proteins changed significantly in vivo and in vitro. Compared with the control group, the TRNAU1AP-shRNA group showed markedly reduced cell proliferation and migration abilities. Our data indicate that Se deficiency can cause kidney damage and renal fibrosis. Furthermore, the Wnt pathway is critical for the development of tissue and organ fibrosis. The data of this study demonstrated that the expression of Wnt5a, β-catenin, and dishevelled 1 (Dvl-1) was significantly upregulated in the Se-deficient group. Therefore, the Wnt/β-catenin pathway may play an important role in renal fibrosis caused by Se deficiency.

Fetal Fibronectin; A New Tool for The Prediction of Successful Induction of Labor

Enlistment of work falsely matures the cervix and starts uterine compressions in ladies who are not effectively in the process of giving birth, prompting reformist expansion of the cervix to accomplish vaginal birth of a child at any development past the legitimate meaning of fetal viability.Fetal fibronectin (fFN) is a glycoprotein present in the amniotic liquid and in the zones between the decidua and the chorion and engaged with the bond of cells present in the extracellular lattice of decidua basalis, contiguous the intervillous space. The point of this investigation was to survey fetal fibronectin as another device for fruitful enlistment of Labor in lady going through acceptance of Labor. Techniques: 100 ladies going through work acceptance in the third trimester of pregnancy among those went to antenatal facility of Benha University Hospital and Benha Teaching Hospital were contemplated. Results: This examination showed that: According to sign of acceptance, post-term pregnancy was the most habitually experienced explanation behind enlistment. Acceptance was effective in 72% of the investigation subjects, while 28% of the moms experienced bombed enlistment. There was genuinely huge relationship between fetal fibronectin to the expectation of fruitful work enlistment. A positive fibronectin test had an affectability, explicitness, positive prescient worth, and negative prescient estimation of 90.3%, 57.2%, 84.4%, and 69.5%, separately, for expectation of the acceptance achievement. Decision: Fetal fibronectin is a decent instrument for effective acceptance of work, and it very well might be abetter device than Bishop score evaluation.

Study protocol for a randomised trial for atosiban versus placebo in threatened preterm birth: the APOSTEL 8 study

IntroductionPreterm birth complicates >15 million pregnancies annually worldwide. In many countries, women who present with signs of preterm labour are treated with tocolytics for 48 hours. Although this delays birth,...

Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM).

Progesterone prophylaxis is widely used to prevent preterm birth but is not licensed and there is little information on long-term outcome. To determine the effect of progesterone prophylaxis in women at high risk of preterm birth on obstetric, neonatal and childhood outcomes. Double-blind, randomised placebo-controlled trial. Obstetric units in the UK and Europe between February 2009 and April 2013. Women with a singleton pregnancy who are at high risk of preterm birth because of either a positive fibronectin test or a negative fibronectin test, and either previous spontaneous birth at ≤ 34 weeks+0 of gestation or a cervical length of ≤ 25 mm. Fibronectin test at 18+0 to 23+0 weeks of pregnancy to determine risk of preterm birth. Eligible women were allocated (using a web-based randomisation portal) to 200 mg of progesterone or placebo, taken vaginally daily from 22+0 to 24+0 until 34+0 weeks' gestation. Participants, caregivers and those assessing the outcomes were blinded to group assignment until data collection was complete. There were three primary outcomes, as follows: (1) obstetric - fetal death or delivery before 34+0 weeks' gestation; (2) neonatal - a composite of death, brain injury on ultrasound scan (according to specific criteria in the protocol) and bronchopulmonary dysplasia; and (3) childhood - the Bayley-III cognitive composite score at 22-26 months of age. In total, 96 out of 600 (16%) women in the progesterone group and 108 out of 597 (18%) women in the placebo group had the primary obstetric outcome [odds ratio (OR) 0.86, 95% confidence interval (CI) 0.61 to 1.22]. Forty-six out of 589 (8%) babies of women in the progesterone group and 62 out of 587 (11%) babies of women in the placebo group experienced the primary neonatal outcome [OR 0.72, 95% CI 0.44 to 1.17]. The mean Bayley-III cognitive composite score of the children at 2 years of age was 97.3 points [standard deviation (SD) 17.9 points; n = 430] in the progesterone group and 97.7 points (SD 17.5 points; n = 439) in the placebo group (difference in means -0.48, 95% CI -2.77 to 1.81). Overall compliance with the intervention was 69%. There were no major harms, although there was a trend of more deaths from trial entry to 2 years in the progesterone group (20/600) than in the placebo group (16/598) (OR 1.26, 95% CI 0.65 to 2.42). In this study, progesterone had no significant beneficial or harmful effects on the primary obstetric, neonatal or childhood outcomes.The OPPTIMUM trial is now complete. We intend to participate in a comprehensive individual patient-level data meta-analysis examining women with a singleton pregnancy with a variety of risk factors for preterm birth. Current Controlled Trials ISRCTN14568373. This trial was funded by the Medical Research Council (MRC) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership.

Gene editing of the extra domain A positive fibronectin in various tumors, amplified the effects of CRISPR/Cas system on the inhibition of tumor progression.

BackgroundThe low efficiency of clustered, regularly interspaced, palindromic repeats-associated Cas (CRISPR/Cas) system editing genes in vivo limits the application. A components of the extracellular matrix (ECM), the extra domain A positive fibronectin (EDA+FN), may be a target for CRISPR/Cas system for the pro-oncogenic effects. The exclusion of EDA exon would alter the microenvironment and inhibit tumor progression, even the frequency of gene editing is still limited.ResultsThe pro-oncogenic effects were confirmed by the exclusion of EDA exon from the fibronectin gene, as illustrated by the down-regulated proliferation, migration and invasion of CNE-2Z or SW480 cells (P<0.05). Furthermore, although the efficacy of EDA exon knockout through CRISPR/Cas system was shown to be low in vivo, the EDA+FN protein levels decrease obviously, inhibiting the tumor growth rate significantly (P<0.05), which was accompanied by a decrease in Ki-67 expression and microvessel numbers, and increased E-cadherin or decreased Vimentin expression (P<0.05).Methods and materialsHuman nasopharyngeal carcinoma cell line CNE-2Z, and the colorectal carcinoma cell line SW480 were transfected with CRISPR/Cas9 plasmids targeting EDA exon. The effects of the exclusion of EDA on the cell proliferation, motility and epithelial-mesenchymal transition (EMT) were investigated, and the western blot and real-time PCR were performed to analyze the underlying mechanisms. Furthermore, CRISPR/Cas9 plasmids were injected into xenograft tumors to knockout EDA exon in vivo, and tumor growth, cell proliferation, EMT rate, or vascularization were investigated using western blot, PCR and immunohistochemistry.ConclusionCRISPR/Cas system targeting ECM components was shown to be an effective method for the inhibition of tumor progression, as these paracrine or autocrine molecules are necessary for various tumor cells. This may represent a novel strategy for overcoming the drug evasion or resistance, in addition, circumventing the low efficiency of CRISPR/Cas system in vivo.

Effectiveness of a cervical pessary for women who did not deliver 48h after threatened preterm labor (Assessment of perinatal outcome after specific treatment in early labor: Apostel VI trial).

BackgroundPreterm birth is a major cause of neonatal mortality and morbidity. As preventive strategies are largely ineffective, threatened preterm labor is a frequent problem that affects approximately 10 % of pregnancies. In recent years, risk assessment in these women has incorporated cervical length measurement and fetal fibronectin testing, and this has improved the capacity to identify women at increased risk for delivery within 14 days. Despite these improvements, risk for preterm birth continues to be increased in women who did not deliver after an episode of threatened preterm labor, as indicated by a preterm birth rate between 30 to 60 % in this group of women. Currently no effective treatment is available. Studies on maintenance tocolysis and progesterone have shown ambiguous results. The pessary has not been evaluated in women with threatened preterm labor, however studies in asymptomatic women with a short cervix show reduced rates of preterm birth rates as well as perinatal complications.The APOSTEL VI trial aims to assess the effectiveness of a cervical pessary in women who did not deliver within 48 h after an episode of threatened preterm labor.Methods/DesignThis is a nationwide multicenter open-label randomized clinical trial. Women with a singleton or twin gestation with intact membranes, who were admitted for threatened preterm labor, at a gestational age between 24 and 34 weeks, a cervical length between 15 and 30 mm and a positive fibronectin test or a cervical length below 15 mm, who did not deliver after 48 h will be eligible for inclusion. Women will be allocated to a pessary or no intervention (usual care). Primary outcome is preterm delivery < 37 weeks. Secondary outcomes are amongst others a composite of perinatal morbidity and mortality. Sample size is based on an expected 50 % reduction of preterm birth before 37 weeks (two-sided test, α 0.05 and β 0.2). Two hundred women with a singleton pregnancy need to be randomized. Analysis will be done by intention to treat.DiscussionThe APOSTEL VI trial will provide evidence whether a pessary is effective in preventing preterm birth in women who did not deliver 48 h after admission for threatened preterm labor and who remain at high risk for preterm birth.Trial registrationTrial is registered at the Dutch Trial Register: http://www.trialregister.nl, NTR4210, date of registration: October 16th 2013.

Abnormal regulation of fibronectin production by fibroblasts in psoriasis.

Data indicate that in psoriasis, abnormalities are already present in nonlesional skin. Transforming growth factor-β and keratinocyte growth factor (KGF), together with fibronectin and α5β1 integrin, were suggested to play a crucial role in the pathogenesis of psoriasis by influencing inflammation and keratinocyte hyperproliferation. To investigate the expression of KGF, fibroblast growth factor receptor (FGFR)2, fibronectin (FN) and extra domain A (EDA)-positive FN in healthy and nonlesional psoriatic skin, and to study the effect of KGF on the regulation of FN and EDA(+) FN production by fibroblasts. Healthy, nonlesional psoriatic skin and lesional psoriatic skin were immunostained for α5 integrin, KGF, FGFR2, EDA(+) FN and signal transducer and activator of transcription (STAT)1. KGF-treated cell cultures were analysed for FN and EDA(+) FN mRNA and protein by real-time reverse-transcriptase polymerase chain reaction and flow cytometry, respectively. The major downstream signalling of KGF was investigated by blocking experiments using inhibitors of mitogen-activated protein kinase (MAPK) kinase (MEK1), AKT1/2, STAT1 and STAT3. The expression of α5 integrin, EDA(+) FN, KGF and its receptor FGFR2 is elevated in psoriatic nonlesional skin compared with healthy skin. KGF mildly induced EDA(+) FN, but not FN expression in healthy fibroblasts through MAPK signalling. Fibroblasts express the FGFR2-IIIc splice variant. STAT1 negatively regulates both FN and EDA(+) FN expression in healthy fibroblasts, and this regulation is compromised in fibroblasts derived from nonlesional psoriatic dermis. We detected active STAT1 in healthy and lesional skin, similarly to a previous report. However, in the nonlesional skin STAT1 activation was absent in tissues far away from lesions. The production of FN and EDA(+) FN by fibroblasts and the signalling of STAT1 are abnormally regulated in psoriatic nonlesional skin.

Fetal fibronectin is more valuable than ultrasonographic examination of the cervix or Bishop score in predicting successful induction of labor

ObjectiveTo compare fetal fibronectin (fFN) assessment, ultrasound parameters, and Bishop score in the prediction of successful induction of labor at term when cervix is unfavorable. Materials and MethodsSeventy-three nulliparous women undergoing labor induction at term with Bishop score less than 5 were enrolled in this study. Successful labor induction was defined as vaginal delivery occurring within 24 hours of initiation of induction. fFN obtained from vaginal secretion was measured by immunoassay. ResultsPatients who delivered within 24 hours (n = 33) differed significantly from the remaining patients by a positive fFN (84.8% vs. 15.2%, p = 0.002). The mean cervical length or Bishop scores were not statistically different between women who delivered vaginally before 24 hours of induction and those who did not (28.9 mm vs. 27.9 mm, p = 0.468 and 3.3 vs. 3.2, p = 0.928, respectively). Binary logistic regression analysis showed only the fFN immunoassay to be an independent statistically significant predictor of vaginal delivery within 24 hours of induction (odds ratio 6.168; 95% confidence interval 1.897–20.059; p = 0.002). A positive fibronectin assay had a sensitivity and specificity of 84.9% and 50%, respectively. ConclusionsIn cases with unfavorable cervix, presence of vaginal fFN predicts the success of labor induction.

Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)

BackgroundPreterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for women with threatening preterm delivery in most centres. However, there is controversy as to which tocolytic agent is the drug of first choice. Previous trials have focused on tocolytic efficacy and side effects, and are probably underpowered to detect clinically meaningfull differences in neonatal outcome. Thus, the current evidence is inconclusive to support a balanced recommendation for clinical practice. This multicenter randomised clinical trial aims to compare nifedipine and atosiban in terms of neonatal outcome, duration of pregnancy and maternal side effects.Methods/DesignThe Apostel III trial is a nationwide multicenter randomised controlled study. Women with threatened preterm labour (gestational age 25 – 34 weeks) defined as at least 3 contractions per 30 minutes, and 1) a cervical length of ≤ 10 mm or 2) a cervical length of 11-30 mm and a positive Fibronectin test or 3) ruptured membranes will be randomly allocated to treatment with nifedipine or atosiban. Primary outcome is a composite measure of severe neonatal morbidity and mortality. Secondary outcomes will be time to delivery, gestational age at delivery, days on ventilation support, neonatal intensive care (NICU) admittance, length admission in neonatal intensive care, total days in hospital until 3 months corrected age, convulsions, apnoea, asphyxia, proven meningitis, pneumothorax, maternal side effects and costs. Furthermore, an economic evaluation of the treatment will be performed. Analysis will be by intention to treat principle. The power calculation is based on an expected 10% difference in the prevalence of adverse neonatal outcome. This implies that 500 women have to be randomised (two sided test, β 0.2 at alpha 0.05).DiscussionThis trial will provide evidence on the optimal drug of choice in acute tocolysis in threatening preterm labour.Trial registrationClinical trial registration: NTR2947, date of registration: June 20th 2011.

Test that predicts premature labour: efficacy of foetal fibronectin test and its cost implications

IntroductionMany women come to labour ward with threatened premature labour but only 50% actually deliver. The foetal fibronectin can be used to identify women who will not deliver within 14...

472: Do pregnancies complicated by preterm births with a negative fetal fibronectin screen have different characteristics compared to those that have positive fibronectin results?

As a result of the high negative predictive value, there is limited data on pregnancies with a negative fetal fibronectin (fFN) test that deliver preterm. Our objective is to compare pregnancy characteristics between fFN positive and negative patients that delivered within 14 days of testing.

Cost-effectiveness of fibronectin testing in a triage in women with threatened preterm labor: alleviation of pregnancy outcome by suspending tocolysis in early labor (APOSTEL-I trial)

BackgroundAt present, women with threatened preterm labor before 32 weeks of gestation are, after transfer to a perinatal center, treated with tocolytics and corticosteroids. Many of these women are treated unnecessarily. Fibronectin is an accurate predictor for the occurrence of preterm birth among women with threatened preterm labor. We will assess whether triage of these women with fibronectin testing, cervical length or their combination is cost-effective.Methods/DesignWe will investigate a prospective cohort of women referred to a perinatal centre for spontaneous threatened preterm labor between 24 and 34 weeks with intact membranes. All women will be tested for fibronectin and cervical length. Women with a cervical length <10 mm and women with a cervical length between 10-30 mm in combination with a positive fibronectin test will be treated with tocolytics according to local protocol. Women with a cervical length between 10-30 mm in combination with a negative fibronectin test will be randomised between treatment with nifedipine (intervention) and placebo (control) for 48 hours. Women with a cervical length > 30 mm will be managed according to local protocol. Corticosteroids may be given to all women at the discretion of the attending physician. Primary outcome measure will be delivery within 7 days. Secondary outcome measures will be neonatal morbidity and mortality, complications of tocolytics, costs and health related quality of life. The analysis will be according to the intention to treat principle. We anticipate the probability on preterm birth within 7 days in the group of women with a negative fibronectine test to be 5%. Two groups of 110 women will be needed to assure that in case of non-inferiority the difference in the proportion of preterm deliveries < 7 days will be within a prespecified boundary of 7.5% (one sided test, β 0.2, α 0.05). Data obtained from women with a positive and negative fibronectin tests in both the cohort study and the trial will be integrated in a cost-effectiveness analysis that will assess economic consequences of the use of fibronectin.DiscussionThis study will provide evidence for the use of fibronectin testing as safe and cost-effective method in a triage for threatened preterm labor.Trial registrationNederlands Trial Register (NTR) number 1857, .

Prédiction de la réussite du déclenchement du travail. Comparaison entre le score de Bishop et le dosage de la fibronectine fœtale

The aim of our study is to determine whether the fetal fibronectin is a better predictor of successful induction of labor than the Bishop score. A prospective observational non-randomized study was conducted in our unit including 234 patients scheduled for induction of labor from October 2000 to June 2004. Fetal fibronectin was assayed by taking sample from the endocervix and the cervical status was evaluated using the Bishop score. Data were analysed by Chi-square test of Mantel-Haenzel and Cox stepwise multiple regression using SPSS version 12 software. The likelihood ratios for predicting that vaginal delivery would occur within 24h of induction for positive fetal fibronectine were 1.34 (95% CI 1.04-1.73, p=0.027) all patients included and 1.51(95% CI 1.00-2.33, p=0.048) for the nulliparas and 1.92 (95% CI 1.51-2.42, p=0.0001) for the Bishop score. On multiple regressions, the only variables independently associated with a successful induction were the Bishop score, the parity and the age of the patient. No significant association was found between the presence of cervical fibronectin and the caesarean section rate: 21.84% for positive fibronectin versus 21.78% for negative fibronectin. The fetal fibronectine is probably useless in this context, given the additional cost and no improvement compared with the simple Bishop score.

Comparison of Bedside Test Kits for Prediction of Preterm Delivery: Phosphorylated Insulin-like Growth Factor Binding Protein-1 (pIGFBP-1) Test and Fetal Fibronectin Test

The objective of the study was to compare the effectiveness of bedside test kits for pIGFBP-1 and fetal fibronectin test in predicting preterm delivery. Patients presenting with symptoms of preterm labour between 24 and 34 weeks of gestation were recruited. Both pIGFBP-1 and fetal fibronectin bedside tests were performed. Managing obstetricians and patients were blinded to the pIGFBP-1 and fetal fibronectin results. Tocolysis and steroid therapy were administered to all the recruited patients. Outcome data were collected after delivery. One hundred and eight patients were recruited into the study. Fourteen patients had to be excluded from the final analysis due to incomplete data and failure to meet inclusion criteria. Ninety-four patients had complete data for analysis. Among those with negative pIGFBP-1 and fetal fibronectin results, the median [+/-standard deviation (SD)] gestational age at delivery was 37.4 weeks (+/-2.8 weeks) and 37.4 weeks (+/-2.1 weeks), respectively. Among those with positive pIGFBP-1 and fetal fibronectin results, the median (+/-SD) gestational age at delivery was 32.9 weeks (+/-4.0 weeks) and 34.2 weeks (+/-4.2 weeks), respectively (P <0.001 for both pIGFBP-1 and fetal fibronectin). A positive result with either test was associated with a significantly reduced admission-to-delivery interval. The median admission-to-delivery interval was 2.8 weeks shorter in the group with positive pIGFBP-1 results compared to those with a negative pIGFBP-1 result (2.3 weeks compared with 5.1 weeks) (P <0.001). This is 1.8 weeks shorter in the group with positive fibronectin results, compared to those with a negative result (3.3 weeks compared with 5.1 weeks) (P=0.002). Both pIGFBP-1 and fetal fibronectin tests have high negative predictive value (NPV) in predicting risk of delivery within 48 hours, 7, or 14 days (1.00; 0.92; 0.92 and 0.97; 0.89; 0.89, respectively). Both pIGFBP-1 and fetal fibronectin tests are effective adjuvant bedside test kits for the prediction of preterm delivery in patients presenting with signs or symptoms of preterm labour. pIGFBP-1 has the higher NPV of 1.00 in predicting risk of delivery within 48 hours.

Histological and immunohistochemical analysis of initial and early subepithelial connective tissue attachment at chemically modified and conventional SLA®titanium implants. A pilot study in dogs

The aim of the present pilot study was to histologically/immunohistochemically investigate initial and early subepithelial connective tissue attachment at transmucosal parts of modified (mod) and conventional sandblasted, large grit and acid-etched (SLA) titanium implants. Implantation of modSLA and SLA implants was performed bilaterally in both the mandible and maxilla of four beagle dogs. The implants were submerged to prevent bacterial contamination. The animals were killed after 1, 4, 7 and 14 days. Peri-implant tissue reactions were assessed histologically (Masson Goldner Trichrome stain-MG) and immunohistochemically (IH) using monoclonal antibodies to fibronectin (FN) and proliferating cell nuclear antigen (PCNA). The surgical procedure of implant submerging resulted in the formation of an artificial gap in the transmucosal area of both types of implants. After 14 days of healing, MG stain revealed the formation of well-organized collagen fibres and numerous blood vessels in a newly formed loose connective tissue zone adjacent to modSLA. While some fibres were oriented in a parallel direction, others have started to extend and attach partially perpendicular to the implant surface. In contrast, SLA implants appeared to be clearly separated by a dense connective tissue zone with parallel-running collagen fibres and rare blood vessel formation. First signs of a positive FN and PCNA staining adjacent to both implant surfaces were observed at day 4. Within the limits of a pilot study, it might be concluded that modSLA titanium surfaces might possess the potential to promote subepithelial connective tissue attachment at the transmucosal part of the implant.

Sonographic Measurement of Cervical Length ad Fetal Fibronectin Testing in Threatened Preterm Labor

When measured in women with preterm contractions, both the presence or absence of fetal fibronectin in cervicovaginal secretions and sonographically measured cervical length have been reported to distinguish true from false labor, essentially between women who will and will not deliver within the next 7 days. The present study, which prospectively enrolled 195 women with singleton pregnancies who were seen at 24 to 36 weeks gestation, attempted to determine whether combining these 2 tests is more predictive than either test by itself. Participants presented with regular painful uterine contractions but were less than 3 cm dilated and had intact membranes. Fetal fibronectin concentrations were measured by immunoassay in cervicovaginal secretions taken from the posterior fornix or endocervix followed by digital assessment of cervical dilation. Transvaginal sonography was then performed to measure cervical length. The clinician caring for each patient was blinded to the test results. The women presented at a median gestational age of 31 weeks; 19 of them (9.7%) delivered within 1 week. The rate of preterm delivery was 51.4% in women whose cervical length was less than 15 mm and 0.6% in those having a longer cervix. Similarly, the preterm delivery rate for women with positive fetal fibronectin was 21.2% compared with 0.9% for fibronectin-negative women. The positive and negative likelihood ratios for delivery within 1 week were 9.8 and 0.05, respectively, for a cervical length less than 15 mm, and 2.6 and 0.08 for a positive fibronectin test. The rate of delivery within 7 days increased exponentially as cervical length decreased. Cervical length correlated inversely with positive fetal fibronectin; the shorter the cervix, the more likely that fibronectin was positive. On multiple logistic regression analysis, the only factor that independently and significantly predicted preterm delivery was cervical length. Excluding cervical length, positive fibronectin contributed significantly to predicting delivery within 1 week. Other predictive factors included Afro-Caribbean ethnicity and gestational age at the time of presentation. Analysis of receiver-operating characteristic curves indicated that predictions based on cervical length were better than those provided by the fibronectin test. In women presenting with threatened preterm labor, a short cervix on sonography more accurately identifies those at high risk than does the presence of fetal fibronectin in cervicovaginal secretions. Measurements of cervical length can provide a basis for hospitalizing women and administering a tocolytic agent or steroid. If sonography is not available, risk status may be inferred from ethnic origin, gestational age, and the results of a fetal fibronectin test.

Human Endothelial Cell Interaction with Biomimetic Surfactant Polymers Containing Peptide Ligands from the Heparin Binding Domain of Fibronectin

Biomimetic materials that mimic the extracellular matrix (ECM) provide a means to control cellular functions such as adhesion and growth, which are vital to successful engineering of tissue-incorporated biomaterials. Novel "ECM-like" biomimetic surfactant polymers consisting of a poly(vinyl amine) backbone with pendant cell-adhesive peptides derived from one of the heparin-binding domains of fibronectin were developed to improve endothelial cell adhesion and growth on vascular biomaterials. Heparin-binding peptide (HBP) sequences, alone and in combination with RGD peptides, were examined for their ability to promote human pulmonary artery endothelial cell (HPAEC) adhesion and growth (HBP1, WQPPRARI; HBP2, SPPRRARVT; HBP1:RGD; and HBP2:RGD) and compared with cell adhesion and growth on fibronectin and on negative control polymer surfaces in which alanines were substituted for the positively charged arginine residues in the two peptides. The results showed that HPAECs adhered and spread equally well on all HBP-containing polymers and the positive fibronectin control, showing similar stress fiber and focal adhesion formation. However, the HBP alone was unable to support long-term HPAEC growth and survival, showing a loss of focal adhesions and cytoskeletal disorganization by 24 h after seeding. With the addition of RGD, the surfaces behaved similarly or better than fibronectin. The negative control polymers showed little to no initial cell attachment, and the addition of soluble heparin to the medium reduced initial cell adhesion on both the HBP2 and HBP2:RGD surfaces. These results indicate that the HBP surfaces promote initial HPAEC adhesion and spreading, but not long-term survival.