一种不依赖感染的松弛素介导的胎膜早破途径。
A relaxin-mediated pathway to preterm premature rupture of the fetal membranes that is independent of infection.
作者信息
Millar L K, Boesche M H, Yamamoto S Y, Killeen J, DeBuque L, Chen R, Bryant-Greenwood G D
机构信息
Pacific Biomedical Research Center, University of Hawaii, Honolulu 96822, USA.
出版信息
Am J Obstet Gynecol. 1998 Jul;179(1):126-34. doi: 10.1016/s0002-9378(98)70262-5.
OBJECTIVE
This study was designed to show whether the overexpression of relaxin in the decidua of patients with preterm premature rupture of the membranes is independent of or a consequence of chorioamnionitis.
STUDY DESIGN
Two experiments were conducted. In the first experiment fetal membranes and decidua were collected from patients with preterm premature rupture of the membranes (n = 17) or preterm labor (n = 17) and were divided according to their degree of histologic infection. Messenger ribonucleic acid was isolated from the tissues and quantitative, sequential Northern analyses were carried out for the expression of human relaxin, interleukin-1beta, interleukin-6, and interleukin-8. The second experiment was aimed at increasing the numbers of messenger ribonucleic acid preparations in the two extreme categories, uninfected and severely infected tissues, with preterm premature rupture of the membranes and preterm labor. Some samples of messenger ribonucleic acid from the first experiment were rerun with the Northern analyses in the second experiment. These repeat samples showed no statistical differences in the results run at different times. Therefore the data from the respective groups of patients in both experiments were pooled for statistical analysis.
RESULTS
In both the first experiment and in the pooled data of the two experiments the expression of the relaxin genes was significantly greater (P < .005) in the tissues from patients with preterm premature rupture of the membranes compared with those with preterm labor, in the absence of infection. No effect of the level of infection on the expression of relaxin was noted. In contrast, interleukin-6 gene expression was significantly increased (P < .05) in severely infected tissues, which was independent of whether the delivery was from preterm premature rupture of the membranes or preterm labor. The expression of the interleukin-1beta and interleukin-8 genes were only marginally increased even in severe infection. Marked patient variability in expression of the interleukin genes, especially in severe infection, was noted.
CONCLUSION
A relaxin-mediated pathway that leads to preterm premature rupture of the membranes may exist independent of infection.
目的
本研究旨在表明胎膜早破患者蜕膜中松弛素的过表达是独立于绒毛膜羊膜炎，还是绒毛膜羊膜炎的结果。
研究设计
进行了两项实验。在第一项实验中，从胎膜早破患者（n = 17）或早产患者（n = 17）中收集胎膜和蜕膜，并根据组织学感染程度进行分组。从组织中分离信使核糖核酸，并对人松弛素、白细胞介素-1β、白细胞介素-6和白细胞介素-8的表达进行定量、连续的Northern分析。第二项实验旨在增加胎膜早破和早产的两个极端类别（未感染和严重感染组织）中信使核糖核酸制剂的数量。第一项实验中的一些信使核糖核酸样本在第二项实验中重新进行Northern分析。这些重复样本在不同时间运行的结果中没有统计学差异。因此，将两项实验中各患者组的数据合并进行统计分析。
结果
在第一项实验以及两项实验的汇总数据中，在无感染的情况下，胎膜早破患者组织中松弛素基因的表达明显高于早产患者（P <.005）。未观察到感染水平对松弛素表达的影响。相比之下，白细胞介素-6基因表达在严重感染的组织中显著增加（P <.05），这与分娩是由于胎膜早破还是早产无关。即使在严重感染时，白细胞介素-1β和白细胞介素-8基因的表达也仅略有增加。注意到白细胞介素基因表达存在明显的患者个体差异，尤其是在严重感染时。
结论
可能存在一条独立于感染的由松弛素介导的导致胎膜早破的途径。
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