Yellon S M, Mackler A M, Kirby M A
Loma Linda University School of Medicine, Center for Perinatal Biology, Department of Physiology, Loma Linda, California 92350, USA.
J Soc Gynecol Investig. 2003 Sep;10(6):323-38. doi: 10.1016/s1071-5576(03)00116-3.
This review focuses on the contribution of immune cell trafficking and activities during the initial phase of activation in the process of parturition. Although uterine contractile activity has been the predominant focus for the mechanism that initiates labor, significant cellular and biochemical changes cause remodeling of the cervix well before term. A convergence of evidence suggests that inflammatory processes that involve prostaglandins, nitric oxide, cytokines, as well as systemic and paracrine endocrine mediators may enhance uterine contractility, promote ripening of the cervix, and thus constitute an integrative hypothesis for the initiation of labor.
Techniques to study the uterus and cervix of pregnant and virgin C3H/HeN mice included light and fluorescence microscopy. Tissues were processed by histochemistry and immunofluorescence. Analytic approaches to enumerate macrophages and assess activation included quantitative stereologic morphometry and laser scanning cytometry.
The transition between relative quiescence of the uterus and enhanced contractility involved migration of macrophages from the uterine endometrium and activation of macrophages in the cervix. Before birth, macrophages migrate into the cervix and are activated in the myometrium.
Immune cell trafficking and activation are part of the initial mechanism that promotes ripening of the cervix, enhances uterine contractility, and initiates parturition. Markers for the conclusion of pregnancy may have diagnostic or therapeutic value to assess the normal progress of labor or identify women at risk of preterm labor.
本综述聚焦于分娩过程中激活初始阶段免疫细胞的迁移和活动所起的作用。尽管子宫收缩活动一直是启动分娩机制的主要关注点，但在足月前，显著的细胞和生化变化会导致子宫颈重塑。越来越多的证据表明，涉及前列腺素、一氧化氮、细胞因子以及全身和旁分泌内分泌介质的炎症过程可能会增强子宫收缩力，促进子宫颈成熟，从而构成分娩启动的综合假说。
研究怀孕和未孕C3H/HeN小鼠子宫和子宫颈的技术包括光学显微镜和荧光显微镜检查。组织通过组织化学和免疫荧光进行处理。用于计数巨噬细胞和评估激活的分析方法包括定量体视形态学和激光扫描细胞术。
子宫从相对静止到收缩增强的转变涉及巨噬细胞从子宫内膜迁移以及子宫颈中巨噬细胞的激活。出生前，巨噬细胞迁移到子宫颈并在子宫肌层中被激活。
免疫细胞的迁移和激活是促进子宫颈成熟、增强子宫收缩力并启动分娩的初始机制的一部分。妊娠结束的标志物可能对评估分娩的正常进程或识别有早产风险的女性具有诊断或治疗价值。
