Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People's Republic of China.
Endocr Rev. 2018 Jun 1;39(3):241-260. doi: 10.1210/er.2017-00188.
Human parturition is a complex process involving interactions between the myometrium and signals derived from the placenta, fetal membranes, and fetus. Signals originating from fetal membranes are crucial components that trigger parturition, which is clearly illustrated by the labor-initiating consequence of membrane rupture. It has been recognized for a long time that among fetal tissues in late gestation the fetal membranes possess the highest capacity for cortisol regeneration by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). However, the exact role of this unique feature remains a mystery. Accumulating evidence indicates that this extra-adrenal source of cortisol may serve as an upstream signal for critical events in human parturition, including enhanced prostaglandin and estrogen synthesis as well as extracellular matrix remodeling. This may explain why such high capacity for cortisol regeneration develops in human fetal membranes at late gestation. Therefore, inhibition of 11β-HSD1 may provide a potential therapeutic target for prevention of preterm birth. This review summarizes the current understanding of the functional role of cortisol regeneration by 11β-HSD1 in human fetal membranes.
人类分娩是一个复杂的过程，涉及子宫肌层和来自胎盘、胎膜和胎儿的信号之间的相互作用。来自胎膜的信号是触发分娩的关键组成部分，胎膜破裂引发分娩清楚地说明了这一点。长期以来，人们一直认为，在妊娠晚期的胎儿组织中，胎膜通过 11β-羟类固醇脱氢酶 1（11β-HSD1）具有最高的皮质醇再生能力。然而，这个独特特征的确切作用仍然是个谜。越来越多的证据表明，这种肾上腺外的皮质醇来源可能作为人类分娩中关键事件的上游信号，包括增强前列腺素和雌激素合成以及细胞外基质重塑。这也许可以解释为什么在妊娠晚期，人类胎膜会产生如此高的皮质醇再生能力。因此，抑制 11β-HSD1 可能为预防早产提供一个潜在的治疗靶点。本综述总结了目前对人类胎膜中 11β-HSD1 介导的皮质醇再生的功能作用的理解。
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