Klimek Marek
Department of Gynecology and Infertility, Jagiellonian University, Krakow, Poland.
Neuro Endocrinol Lett. 2005 Aug;26(4):337-41.
Normal function of the hypothalamo-adrenal axis is important for the regulation of feto-maternal intrauterine homeostasis including immunomodulating activity and may influence the timing of parturition. ACTH is produced during pregnancy by mother pituitary gland and by trophoblast cells, which are the place of oxytocinase production. Oxytocinase is basically secreted by syncytiotrophoblast cells and rises progressively during pregnancy until the labor. Oxytocinase may play a role as one of the main factors suppressing uterine contractions, controlling the vascular resistance and the volume of the retroplacental blood pool.
The study group consisted of 102 patients with pregnancy following infertility treatment. The assessment was provided longitudinally in six selected groups progressively according to the gestational age. Immunoassay was used to measure ACTH plasma concentration. Oxytocinase plasma activity was established using l-cystine-di-beta-naphthylamide as a substrate.
Significantly increased oxytocinase plasma level was identified during pregnancy, progressive rise was observed beginning with the first trimester of pregnancy, until the labor. ACTH plasma concentration was observed to be at comparable level in the first and second trimester of pregnancy, while sudden statistically significant increase of ACTH plasma level was noted beginning with 28th week of gestation.
The assessment of ACTH and oxytocinase plasma concentration might be useful for the evaluation of pregnancy development.
下丘脑 - 肾上腺轴的正常功能对于调节母胎宫内稳态（包括免疫调节活性）很重要，并且可能影响分娩时间。促肾上腺皮质激素（ACTH）在孕期由母体垂体以及滋养层细胞产生，滋养层细胞是催产素酶产生的部位。催产素酶主要由合体滋养层细胞分泌，在孕期逐渐升高直至分娩。催产素酶可能作为抑制子宫收缩、控制血管阻力和胎盘后血池容积的主要因素之一发挥作用。
研究组由102例接受不孕治疗后怀孕的患者组成。根据孕周，在六个选定的组中逐步进行纵向评估。采用免疫测定法测量血浆促肾上腺皮质激素浓度。以L - 胱氨酸 - 二 - β - 萘酰胺为底物测定血浆催产素酶活性。
孕期血浆催产素酶水平显著升高，从妊娠早期开始观察到逐渐上升，直至分娩。妊娠第一和第二孕期血浆促肾上腺皮质激素浓度处于可比水平，而从妊娠第28周开始观察到血浆促肾上腺皮质激素水平突然出现统计学显著升高。
评估血浆促肾上腺皮质激素和催产素酶浓度可能有助于评估妊娠进展。
