Journal of the Society for Gynecologic Investigation最新文献

Objective: Fgl2 and thrombin potentially play roles during inflammation-induced preterm delivery. These studies sought to demonstrate functional prothrombinase enzyme activity in rat uterus, consistent with the expression of Fgl2 in this tissue.

Methods: Myometrial and other tissue obtained from non-pregnant and timed-pregnant rats was homogenized in Tris-buffered saline. Prothrombinase activity was determined based on the kinetic metabolism of a chromogenic thrombin substrate. Homogenates were incubated with prothrombin followed by the addition of the thrombin substrate. Thrombin activity was determined by comparing tissue activity to a standard curve generated using 0.01 to 0.04 units of active thrombin. Western blot studies were also performed to confirm tissue prothrombinase activity in myometrial homogenates. Prothrombin was incubated with tissue homogenates; the reactions were then terminated with sodium dodecyl sulfate (SDS) loading buffer.

Results: Prothrombinase activity in myometrial tissue was observed to be 0.047 to 0.077 U thrombin/10 min/microg protein. Heat denaturation and calcium removal eliminated prothrombinase activity, whereas the addition of Factor V enhanced activity. The Western blots confirmed the presence of prothrombin, the anticipated prethrombin fragments, and thrombin. Consistent with the enzyme studies, the thrombin band formed upon incubation with myometrial homogenates from pregnant and nonpregnant rats. In contrast, the thrombin band was not apparent with removal of calcium, heat denaturation and treatment with serine protease inhibitors.

Conclusions: In summary, these studies have confirmed functionally active prothrombinase activity in rat myometrium, supporting the hypothesis that Fgl2 is expressed in this tissue.

Objective: The purpose of the present study was to quantify the effect of chronic hypoxia on endothelial nitric oxide synthase (eNOS) gene and protein expression of fetal coronary artery segments and cardiac tissue of fetal guinea pig hearts.

Methods: Time-mated pregnant guinea pigs (term = 65 days) were housed in room air (NMX, n = 6) or in a hypoxic chamber containing 10.5% O2 for 14 days (HPX14, n = 6). At near term (60 days gestation), fetuses were excised from anesthetized animals via hysterotomy and hearts were removed and weighed. Both coronary artery segments and cardiac ventricle were excised from the same hearts, frozen, and stored at -80 C until ready for study. eNOS mRNA was quantified using real-time polymerase chain reaction (PCR) based on SYBR Green I labeling (BioRad Laboratories, Hercules, CA) using eNOS primers obtained from GeneBank normalized to 18S. eNOS proteins were quantified by Western immunoblotting using eNOS antibody (1:200) and normalized to normoxic controls. eNOS cell-specific localization in the fetal guinea pig heart was performed by double immunofluorescence staining.

Results: Both coronary artery endothelial cells (EC) and cardiomyocytes (CM) but not vascular smooth muscle cells of normoxic hearts exhibited positive immunostaining of eNOS protein. Chronic hypoxia significantly (P < .05) increased both eNOS mRNA and protein levels of coronary artery segments (by 210.6% and 51.4%, respectively) but decreased (P < .05) mRNA and protein of cardiac tissue (by 50.0% and 40.6%, respectively) in the same hearts.

Conclusions: Chronic fetal hypoxia, after 14 days, induces sustained changes in eNOS gene and eNOS protein expression that differ between coronary and cardiac tissue in the fetal guinea pig heart. This study suggests that while the functional roles of altered eNOS expression in hypoxic fetal hearts remain unclear, the site at which eNOS expression is altered may be important in the adaptive response of the fetal heart to hypoxia.

Objective: Adenosine triphosphate cell viability assay (ATP-CVA) was used previously to evaluate chemotherapy in uterine cancer cell lines. In this study, we have performed the ATP-CVA on endometrial cancer patients to study the feasibility of using ATP-CVA in endometrial cancer to determine the intrinsic chemosensitivity of the cytotoxic drugs.

Methods: Thirty-three patients with endometrial adenocarcinoma who presented for a staging operation were recruited. Endometrial cancer samples were obtained at the time of operation. In vitro ATP-CVA and chemosensitivity testing was performed using cisplatin, carboplatin, paclitaxel, etoposide, doxorubicin, 4-epidoxorubicin, and topotecan.

Results: Thirty-two of the 33 endometrial cancer samples were evaluable for SF50 (survival fraction at 50% of the peak plasma concentration [PPC]) using ATP-CVA. The median SF50 of carboplatin (0.33) was significantly less than the median SF50 of cisplatin (0.71), topotecan (0.93), paclitaxel (0.68), doxorubicin (1.0), etoposide (0.70), or 4-epidoxorubicin (0.88) (Wilcoxon signed rank test, P <.001).

Conclusion: This study showed the feasibility of using the ATP-CVA in endometrial cancer to determine the intrinsic chemosensitivity of cytotoxic drugs.

Background: Alpha-2 Macroglobulin (A2M) is a protease inhibitor that is present in both human and rat decidual tissue. In mice, decidual A2M prevents excessive trophoblastic invasion; however, its role in human decidual tissue is unknown. It is possible that A2M may also influence trophoblast invasion in human pregnancy, which would be reflected in increased A2M production in decidua basalis. The aim of the current study was to determine and compare A2M production from first trimester human decidua basalis and decidua parietalis.

Methods: Human decidual tissues were obtained from patients undergoing surgical termination at 9 to 12 gestational weeks. Strips of decidua basalis and decidua parietalis were obtained by uterine curettage under real-time ultrasound guidance. Tissue samples were fixed in 10% formalin or snap-frozen for immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) analysis, respectively. Protein and mRNA production between the two sites were compared using the Mann-Whitney U test.

Results: Paired basal and parietal decidua were analyzed by immunohistochemistry (n = 9) and by RT-PCR (n = 10). There was no significant difference in A2M mRNA expression between decidua basalis and decidua parietalis (P = .5). Immunohistochemical staining intensity for A2M protein was significantly higher in basalis than in parietalis (P = .004), but the extent of positively stained cells were not significantly different (P = .051). Strong A2M staining in decidua basalis was mainly localized in the intracellular storage vesicles, which may suggest a role of A2M in this site.

Conclusions: We conclude that the expression pattern of A2M in human decidua basalis and decidua parietalis is not consistent with an important role of this gene during the observed gestational period. Contrary to its role in rodent implantation, A2M is probably not involved in regulating human implantation and trophoblastic invasion during this gestational window frame.

Objective: Phospholipid scramblases (PLSCRs), a family of novel membrane proteins, facilitate the translocation of aminophospholipids from the inner to the exterior leaf of the cell membrane. Four isoforms of PLSCR (PLSCR1-4) have been reported in mouse and human. The studies described in this report sought to characterize the uterine expression of the PLSCR isoforms in the near-term pregnant rat.

Methods: Uterine tissue was obtained from timed-pregnant Sprague-Dawley rats. Total RNA was isolated, treated with DNase, and used in qualitative and quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) studies utilizing PLCSR isoform PCR primers. A rat spleen cDNA bacteriophage library was used as a template for PCR-based sequencing to determine the cDNA and translated amino acid sequences for the PLSCR3 and PLSCR4 homologs expressed in rats. The 5' and 3' untranslated regions were obtained using 5' and 3' Rapid Amplification of cDNA Ends (RACE) techniques.

Results: RT-PCR studies confirmed expression of PLSCR3 and PLSCR4 in the endometrial and myometrial layers of the pregnant rat uterus; in contrast, PLSCR1 and PLSCR2 were not found in uterine tissues. The cDNA sequence for the rat PLSCR3 homolog was found to be 1642 nucleotides, having 92% identity with mouse and 80% with human PLSCR3. The rat PLSCR4 homolog has a cDNA sequence of 1879 nucleotides, having an 89% identity with mouse and 72% identity with human PLSCR4 homologs.

Conclusion: The intrauterine expression of PLSCR3 and PLSCR4 provides a dynamic mechanism by which aminophospholipid translocation can be regulated, thereby modulating the activity of various membrane proteins that are involved in inflammation and coagulation-related events.

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. Several theories have been proposed to explain the pathogenesis of this disease. According to Sampson's retrograde menstruation theory, endometrial cells are refluxed through the fallopian tubes during the menstruation and implant onto peritoneum or pelvic organs. Since retrograde menstruation is a very common phenomenon among women of reproductive age, there must be other factors that may contribute to the pathophysiology and/or pathogenesis of endometriosis. Genetic predisposition, environmental factors, and alterations in immune and endocrine functions are believed to play significant roles in the establishment and maintenance of endometriosis. Although the eutopic endometriums of women with and without endometriosis are histologically similar, studies revealed that there are many fundamental differences between these two tissues. Invasive properties, decreased apoptosis, alterations in expression of specific gene and proteins, and increased steroid and cytokine production have been identified in eutopic endometrium of women with endometriosis. Furthermore, significant biochemical differences exist even between ectopic and autologous eutopic endometrium. These differences can be explained by the direct effects of an inflammatory peritoneal environment.

Objective: Joint pain increases after menopause with more than 50% of woman suffering from arthralgies. Since pain and inflammation of joints originate from synovial tissue, we aimed to discover whether estrogen receptors are present in the human synovia.

Methods: This in vitro study was performed on samples of human synovial tissue, obtained from pre- (n = 8) and postmenopausal woman (n = 11) and men (n = 5) following surgery due to traumatic lesions. Fresh synovial tissue specimens were assessed for the localization as well as the presence of estrogen receptor-alpha (ER alpha) and estrogen receptor-beta (ER beta) by means of immunohistochemistry, as well as Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR), respectively.

Results: ER beta protein and mRNA were found to be equally and highly expressed in synovial stroma and lining cells of all explants independent of sex or menopausal status. In contrast, weak ER alpha staining was localized in the synovial lining cells in only three of 24 explants. ER alpha protein was found to be weakly expressed in three of ten explants. ER alpha mRNA was found with highly variable amounts in seven of ten explants.

Conclusion: In view of our observation that ER beta but not ER alpha is expressed regularly in normal human synovia in high amounts, we propose that estrogen could play a significant role in synovial membrane function in women and men, operating preferably via the ER beta isoform.

Objective: In this study, it was aimed to investigate oxidant/antioxidant status in placenta and in blood and cord blood samples from pregnant women supplemented with iron during pregnancy.

Methods: For this purpose, 27 pregnant women at admission for delivery participated in the study. Fifteen of them did not take iron tablets and the others took oral iron supplements during pregnancy. Following delivery, part of the placenta and blood and cord blood samples were taken from the mothers. In these samples, oxidant parameters (malondialdehyde [MDA] levels and xanthine oxidase [XO] activities) and antioxidant parameters (antioxidant potential [AOP] values, superoxide dismutase [SOD], catalase [CAT] and glutathione peroxidase [GSH-Px] activities) were studied.

Results: It was found that MDA level and SOD activities increased significantly in the placentas from the iron-supplemented group as compared with those from the control group. We also observed that activities of SOD and XO enzymes in maternal erythrocytes, XO in cord blood erythrocytes and GSH-Px activities in cord blood plasma decreased significantly. However, activities of CAT and GSH-Px enzymes in cord blood erythrocytes and MDA levels in maternal plasma increased in the iron-supplemented group as compared with those from the control group.

Conclusion: Increased MDA levels in the maternal plasma and the placenta in the iron-supplemented group suggests that iron supplementation may contribute to increased oxidative stress in women taking iron supplements during pregnancy.

Objective: The matrix metalloproteinases (MMPs) are a family of zinc-dependent proteases that degrade all the components of the extracellular matrix (ECM). Several studies have demonstrated association between MMP gene polymorphisms and various cancers. The object of this study was to investigate whether the MMP-1 and MMP-9 gene promoter polymorphisms are associated with endometrial carcinomas in a Japanese population.

Methods: We compared the allele frequencies and genotype distributions of each single nucleotide polymorphism in the promoter regions of MMP-1 (-1607 1G/2G) and MMP-9 (-1562 C/T) in 107 endometrial carcinoma cases and 213 controls using polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) analysis.

Results: The allele frequencies of MMP-1 -1607 2G and MMP-9 -1562T were 64.0% and 10.7% in the cases and 70.0% and 16.7% in the controls, respectively. No significant differences in the allele frequencies or genotype distributions were found between cases and controls for the MMP-1 -1607 1G/2G polymorphism. However, a small but significant difference in the allele frequency of the MMP-9 -1562T allele was noted between cases and controls (P = .046; odds ratio [OR] = 1.01; 95% confidence interval [CI], 1.01 to 2.73). Stratification by histology revealed a significant difference in the frequency of the MMP-9 -1562T allele between endometrioid carcinoma cases (10.2%) and controls (P = .043; OR = 1.76; 95% CI, 1.02 to 3.03); we did not find a significant difference in the frequency of the MMP-9 -1562T allele between non-endometrioid carcinoma cases (13.2%) and controls.

Conclusion: These results suggest that the MMP-9 -1562 C/T polymorphism may be associated with susceptibility to endometrioid carcinoma in the Japanese population.

Background: We have recently described two distinct pathways of intrauterine prostaglandin (PG) synthesis: a cortisol-dependent/estradiol-independent mechanism within trophoblast tissue leading to elevations in fetal plasma PGE2, and an estradiol-dependent mechanism within maternal endometrium that leads to increased maternal plasma PGF2(2alpha). We hypothesized that the differential effects of cortisol and estradiol on intrauterine PGH synthase-II (PGHS-II) expression and PG production may be because of the tissue specific expression of the glucocorticoid and estradiol receptors (GR and ER, respectively) within the intrauterine tissues. In addition, we suggest that these two pathways of PG production are linked through the expression of P450(C17hydroxylase) (P450(C17)) and subsequent increase in placental estradiol synthesis.

Methods: To test the hypotheses, we infused singleton, chronically catheterized fetal sheep beginning at day 125 of gestation (term 147 to 150 days) with (1) cortisol (0.45 mg/mL; n = 5); (2) cortisol and 4-hydroxyandrostenedione, a P450(aromatase) inhibitor (4-OHA: 1.44 mg/h; n = 5); (3) saline (n = 5); or (4) saline and 4-OHA (n = 5). PGHS-II, ER alpha, ER beta, and GR alpha were localized using immunohistochemistry. ER alpha, ER beta, P450(C17), and GR alpha protein expressions were determined by Western blot analysis. Data were analyzed by analysis of variance (ANOVA) (P < or =.05).

Results: Fetal cortisol infusion in the presence or absence of a rise in placental estrogen synthesis increased placental expression of GR alpha; both PGHS-II and GR alpha localized to the uninucleate trophoblast cells of the placentome and were excluded from the maternal stroma and binucleate cells. Both forms of ER were excluded from the trophoblast tissue of the placentome. ER alpha, ER beta, and PGHS-II showed a similar pattern of distribution within the luminal epithelium of the endometrium; there were no alterations in the level of the ER in the presence of cortisol +/- 4-OHA. Placental P450(C17) protein expression was increased in the presence of a rise in fetal cortisol independent of changes in placental estrogen synthesis.

Conclusions: We concluded that the differential effects of cortisol and estradiol on intrauterine PGHS-II expression and PG production may be due to the tissue-specific expression of the GR and ER within the intrauterine tissues. Glucocorticoid effects on trophoblast PG production may be mediated in a positive feed-forward manner. We further suggest that either cortisol or a cortisol-stimulated intermediate, like PGE2, increased P450(C17) expression, leading to a rise in placental estradiol synthesis and triggering maternal intrauterine tissue PG production.