Mak Pawel, Wicherek Lukasz, Suder Piotr, Dubin Adam, Banas Tomasz, Kaim Irena, Klimek Marek
Department of Analytical Biochemistry, Faculty of Biotechnology, Jagiellonian University, Krakow, Poland.
J Soc Gynecol Investig. 2006 May;13(4):285-91. doi: 10.1016/j.jsgi.2006.02.009.
Hemocidins are a novel class of antibacterial peptides generated proteolytically from hemoglobin. These peptides play a particularly important role in maintaining vaginal homeostasis during menstrual bleeding. To investigate the hemoglobin fragmentation process during the last stages of pregnancy, we examined uterine secretion (lochia) samples from a group of 22 healthy women who underwent cesarean delivery at term.
Patients were divided into three groups: (1) the elective cesarean deliveries without symptoms of spontaneous labor, (2) the nonelective cesarean deliveries with spontaneous beginning of labor, and (3) the nonelective cesarean deliveries during advanced labor. The samples were subjected to chromatographic estimation of free hemoglobin and peptides. In three representative patients the identification of all lochial peptides was performed.
All samples contained a significant amount of free hemoglobin and its level increased with labor progression. The presence of peptide fractions was also detected in most lochia samples. They were confirmed to be human hemoglobin fragments, almost identical to the recently described bactericidal hemocidins from menstrual discharge. The level of peptides also increased during labor. The subgroup with advanced labor demonstrated the highest amount of hemocidins.
The presented results prove that proteolysis of free hemoglobin in the female upper reproductive tract begins together with the clinical symptoms of normal labor. We speculate that cesarean delivery affects molecular mechanisms involved in antibacterial hemocidins generation and, in effect, might be responsible for the increased risk of gynecologic infections in cesarean deliveries.
血铁素是一类新的抗菌肽，由血红蛋白经蛋白水解产生。这些肽在月经出血期间维持阴道内环境稳定方面发挥着特别重要的作用。为了研究妊娠末期血红蛋白的片段化过程，我们检查了一组22名足月行剖宫产的健康女性的子宫分泌物（恶露）样本。
患者分为三组：（1）无自然分娩症状的择期剖宫产；（2）自然发动分娩的非择期剖宫产；（3）活跃期非择期剖宫产。对样本进行游离血红蛋白和肽的色谱分析。对三名有代表性的患者的所有恶露肽进行了鉴定。
所有样本均含有大量游离血红蛋白，其水平随产程进展而升高。在大多数恶露样本中也检测到肽段的存在。它们被证实为人血红蛋白片段，几乎与最近描述的月经分泌物中的杀菌血铁素相同。肽的水平在产程中也有所增加。活跃期亚组的血铁素含量最高。
研究结果证明，女性上生殖道游离血红蛋白的蛋白水解与正常分娩的临床症状同时开始。我们推测剖宫产会影响参与抗菌血铁素生成的分子机制，实际上，这可能是剖宫产术后妇科感染风险增加的原因。
