Shaw Julia C, Palliser Hannah K, Palazzi Kerrin, Hirst Jonathan J
1 School of Biomedical Sciences and Pharmacy, University of Newcastle, New South Wales, Australia.
2 Mothers and Babies Research Centre, Hunter Medical Research Institute, New South Wales, Australia.
Reprod Sci. 2018 Mar;25(3):395-405. doi: 10.1177/1933719117715125. Epub 2017 Jun 20.
Progesterone is administered to pregnant women at risk of premature labor, despite systematic reviews showing conflicting outcomes regarding its use, highlighting doubt over the effectiveness of the therapy. Progesterone can be rapidly metabolized into a number of steroids, but to date, there has been a lack of investigation into the fetal steroid profiles following administration and whether this impacts fetal neurodevelopment. The objective of this study was to determine the effect of progesterone treatment on allopregnanolone and cortisol levels in the fetus and on a marker of myelination in the fetal brain. We used a guinea pig model where pregnant dams were administered vehicle (β-cyclodextrin) or progesterone orally throughout pregnancy (GA29-61). Maternal and fetal fluids and tissues were collected at both preterm (GA61) and term (GA68) ages. Maternal and fetal progesterone and cortisol were analyzed by enzyme immunoassay and allopregnanolone by radioimmunoassay. Measurement of myelination of fetal brains (hippocampus, cingulum, and subcortical white matter) at preterm and term ages was performed by immunohistochemistry staining for myelin basic protein. We found that dams receiving progesterone had significantly elevated progesterone and cortisol concentrations, but there was no effect on allopregnanolone. Interestingly, the increased cortisol concentrations were not reflected in the fetuses, and there was no effect of progesterone treatment on myelination. Therefore, we conclude that in our guinea pig model, maternal administration of progesterone has no effect on cortisol levels or markers of mature oligodendrocytes in the fetus and suggest this is potentially due to the protective cortisol barrier in the placenta.
尽管系统评价显示使用孕激素的结果相互矛盾,突出了对该疗法有效性的怀疑,但仍会给有早产风险的孕妇使用孕激素。孕激素可迅速代谢为多种甾体,但迄今为止,尚未对给药后胎儿的甾体谱以及这是否会影响胎儿神经发育进行研究。本研究的目的是确定孕激素治疗对胎儿中别孕烯醇酮和皮质醇水平以及胎儿大脑髓鞘形成标志物的影响。我们使用了豚鼠模型,在整个孕期(妊娠29 - 61天)给怀孕的母鼠口服载体(β - 环糊精)或孕激素。在早产(妊娠61天)和足月(妊娠68天)时收集母鼠和胎儿的体液及组织。通过酶免疫测定法分析母鼠和胎儿的孕激素和皮质醇,通过放射免疫测定法分析别孕烯醇酮。通过对髓鞘碱性蛋白进行免疫组织化学染色,对早产和足月时胎儿大脑(海马体、扣带回和皮质下白质)的髓鞘形成进行测量。我们发现接受孕激素的母鼠孕激素和皮质醇浓度显著升高,但对别孕烯醇酮没有影响。有趣的是,皮质醇浓度的升高在胎儿中并未体现,并且孕激素治疗对髓鞘形成没有影响。因此,我们得出结论,在我们的豚鼠模型中,母体给予孕激素对胎儿的皮质醇水平或成熟少突胶质细胞标志物没有影响,并表明这可能是由于胎盘的保护性皮质醇屏障所致。