Pub Date : 2019-11-30DOI: 10.14390/JSSHP.HRP2019-012
S. Takeda, J. Takeda, S. Makino
Laparoscopic myomectomy (LSM) is a procedure often requested by patients because of its minimal invasiveness. This procedure has, therefore, been widely performed in recent years. However, there is a need for more reports from the obstetric field to determine the effects of this procedure on subsequent pregnancies. In this regard, we searched Japanese medical literature databases for articles on Japanese cases of uterine rupture, placenta increta, or placenta percreta in pregnancy following myomectomy. This review article aims to analyze the retrieved data to clarify the issues involved and to provide useful feedback to gynecologists by sharing information with them on such issues. in pregnancy following LSM, comprising 2 full term cases (8.0%), 18 preterm cases (72.0%), and 5 abortion cases (at 7, 10, 16, 19, and 21 gestational weeks) (20.0%). There was no distinct difference between the frequencies of uterine rupture following LTM and LSM in relation to the abortion period or the preterm period. Cases of uterine rupture following LSM included 3 cases who had undergone subserous myomectomy in which electrocauterization alone was used for resection and hemostasis. In 4 cases, the submucosal myoma had been enucleated, with exposure of the endometrium. intraabdominal rupture
{"title":"Uterine rupture and placenta accreta spectrum following laparoscopic myomectomy in Japan: A message from obstetricians to gynecologic laparoscopists","authors":"S. Takeda, J. Takeda, S. Makino","doi":"10.14390/JSSHP.HRP2019-012","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2019-012","url":null,"abstract":"Laparoscopic myomectomy (LSM) is a procedure often requested by patients because of its minimal invasiveness. This procedure has, therefore, been widely performed in recent years. However, there is a need for more reports from the obstetric field to determine the effects of this procedure on subsequent pregnancies. In this regard, we searched Japanese medical literature databases for articles on Japanese cases of uterine rupture, placenta increta, or placenta percreta in pregnancy following myomectomy. This review article aims to analyze the retrieved data to clarify the issues involved and to provide useful feedback to gynecologists by sharing information with them on such issues. in pregnancy following LSM, comprising 2 full term cases (8.0%), 18 preterm cases (72.0%), and 5 abortion cases (at 7, 10, 16, 19, and 21 gestational weeks) (20.0%). There was no distinct difference between the frequencies of uterine rupture following LTM and LSM in relation to the abortion period or the preterm period. Cases of uterine rupture following LSM included 3 cases who had undergone subserous myomectomy in which electrocauterization alone was used for resection and hemostasis. In 4 cases, the submucosal myoma had been enucleated, with exposure of the endometrium. intraabdominal rupture","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/JSSHP.HRP2019-012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42772157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Report of The 40th Anniversary Congress of the Japan Society for the Study of Hypertension in Pregnancy (JSSHP 2019)","authors":"","doi":"10.14390/jsshp.7.41","DOIUrl":"https://doi.org/10.14390/jsshp.7.41","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43008806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.14390/JSSHP.HRP2019-006
K. Takagi, Mitsue Muraoka
Aim: “En caul” cesarean section can prevent mechanical damage to preterm babies upon cesarean delivery, by intentionally not rupturing the fetal membranes. This survey investigates its prevalence, indications, and advantages and disadvantages in Japan. Methods: Questionnaires were posted to all registered Level 2 and Level 3 maternal and perinatal centers (where most premature babies are delivered) in Japan ( n = 327). Percentages of centers are presented as survey results. Results: Response rate was 53.2%. En caul cesarean section was employed in 43.2% and 81.6% of Level 2 and 3 centers, respectively. Gestational age considered for en caul cesarean section was less than 31 weeks in 75.9% of centers. Low transverse and vertical uterine incisions were made at 64% and 29% of centers, respectively. En caul cesarean section was considered useful by 87% of centers. However, nearly one-third of the respondents noted that this procedure presents some technical difficulties if membranes happen to rupture accidentally before the delivery of the fetus is complete. Conclusions: En caul cesarean section is a routine cesarean delivery technique used for preterm
{"title":"Cesarean delivery “en caul” in Japan: Results of a national survey of maternal and perinatal centers in Japan","authors":"K. Takagi, Mitsue Muraoka","doi":"10.14390/JSSHP.HRP2019-006","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2019-006","url":null,"abstract":"Aim: “En caul” cesarean section can prevent mechanical damage to preterm babies upon cesarean delivery, by intentionally not rupturing the fetal membranes. This survey investigates its prevalence, indications, and advantages and disadvantages in Japan. Methods: Questionnaires were posted to all registered Level 2 and Level 3 maternal and perinatal centers (where most premature babies are delivered) in Japan ( n = 327). Percentages of centers are presented as survey results. Results: Response rate was 53.2%. En caul cesarean section was employed in 43.2% and 81.6% of Level 2 and 3 centers, respectively. Gestational age considered for en caul cesarean section was less than 31 weeks in 75.9% of centers. Low transverse and vertical uterine incisions were made at 64% and 29% of centers, respectively. En caul cesarean section was considered useful by 87% of centers. However, nearly one-third of the respondents noted that this procedure presents some technical difficulties if membranes happen to rupture accidentally before the delivery of the fetus is complete. Conclusions: En caul cesarean section is a routine cesarean delivery technique used for preterm","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43632461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.14390/jsshp.hrp2019-008
N. Natori, R. Oyama, Tsukasa Baba, C. Isurugi, H. Chida, G. Haba, Y. Sasaki, T. Kanasugi, H. Itamochi, A. Kikuchi
Aim: Velocity vector imaging (VVI) is a speckle-tracking ultrasonographic assessment technique used to evaluate myocardial function. However, VVI values show wide deviations. This study aimed to clarify the significance of serial VVI values for assessing fetal cardiac function. Methods: Echocardiographic images of 50 fetuses (normal: n = 29, fetal growth restriction [FGR]: n = 21) were obtained in the four-chamber view during the second and third trimester. VVI images were analyzed for longitudinal velocity, strain, and strain rate in the global and segmental walls of the left ventricle (LV) and right ventricle (RV). Results: Global longitudinal velocity (GLV) of the LV and RV during the third trimester did not significantly differ between FGR and normal fetuses. LVd and RVs appeared to be low in HDP cases, although there were no significant differences compared to no HDP cases. Eighty-two serial images obtained from 13 normal singleton fetuses revealed increased systolic GLV of the LV and RV, increased diastolic GLV in 10 cases, and increased longitudinal velocity in the basal and middle free wall of both the LV and RV. Conclusions: The evaluation of fetal ventricular function using VVI revealed that GLV increases throughout gestation.
{"title":"Velocity vector imaging for evaluation of fetal vertical function throughout gestation","authors":"N. Natori, R. Oyama, Tsukasa Baba, C. Isurugi, H. Chida, G. Haba, Y. Sasaki, T. Kanasugi, H. Itamochi, A. Kikuchi","doi":"10.14390/jsshp.hrp2019-008","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2019-008","url":null,"abstract":"Aim: Velocity vector imaging (VVI) is a speckle-tracking ultrasonographic assessment technique used to evaluate myocardial function. However, VVI values show wide deviations. This study aimed to clarify the significance of serial VVI values for assessing fetal cardiac function. Methods: Echocardiographic images of 50 fetuses (normal: n = 29, fetal growth restriction [FGR]: n = 21) were obtained in the four-chamber view during the second and third trimester. VVI images were analyzed for longitudinal velocity, strain, and strain rate in the global and segmental walls of the left ventricle (LV) and right ventricle (RV). Results: Global longitudinal velocity (GLV) of the LV and RV during the third trimester did not significantly differ between FGR and normal fetuses. LVd and RVs appeared to be low in HDP cases, although there were no significant differences compared to no HDP cases. Eighty-two serial images obtained from 13 normal singleton fetuses revealed increased systolic GLV of the LV and RV, increased diastolic GLV in 10 cases, and increased longitudinal velocity in the basal and middle free wall of both the LV and RV. Conclusions: The evaluation of fetal ventricular function using VVI revealed that GLV increases throughout gestation.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45045298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-30DOI: 10.14390/jsshp.hrp2019-009
J. Ogawa, Shunji Suzuki
Aim: This study aimed to examine the clinical characteristics of pregnancies complicated by both fetal growth restriction (FGR) and placenta previa or low-lying placenta (PPLLP). Methods: A retrospective cohort study was performed to compare clinical characteristics of pregnancies complicated by FGR and/or PPLLP in women who do not habitually smoke or consume alcohol and who underwent delivery of singletons at ≥ 22 weeks’ gestation at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2015. Assessed factors related to patients and perinatal outcomes included maternal age, parity, history of in vitro fertilization, hypertensive disorders, delivery mode, fetal ultrasonographic findings, delivery mode, gestational age at delivery, neonatal asphyxia, and postpartum hemorrhage. Results: There were 24,118 singleton deliveries assessed for eligibility. Of these, 7 were complicated by both FGR and PPLLP. The development of FGR was not associated with the presence of PPLLP (odds ratio 1.12, 95% confidence interval 0.54–2.4, P = 0.69). Multivariate logistic regression analysis revealed that the incidence of preterm cesarean delivery due to massive bleeding in pregnancies
{"title":"Clinical characteristics of pregnancies complicated by both fetal growth restriction and placenta previa or low-lying placenta","authors":"J. Ogawa, Shunji Suzuki","doi":"10.14390/jsshp.hrp2019-009","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2019-009","url":null,"abstract":"Aim: This study aimed to examine the clinical characteristics of pregnancies complicated by both fetal growth restriction (FGR) and placenta previa or low-lying placenta (PPLLP). Methods: A retrospective cohort study was performed to compare clinical characteristics of pregnancies complicated by FGR and/or PPLLP in women who do not habitually smoke or consume alcohol and who underwent delivery of singletons at ≥ 22 weeks’ gestation at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2015. Assessed factors related to patients and perinatal outcomes included maternal age, parity, history of in vitro fertilization, hypertensive disorders, delivery mode, fetal ultrasonographic findings, delivery mode, gestational age at delivery, neonatal asphyxia, and postpartum hemorrhage. Results: There were 24,118 singleton deliveries assessed for eligibility. Of these, 7 were complicated by both FGR and PPLLP. The development of FGR was not associated with the presence of PPLLP (odds ratio 1.12, 95% confidence interval 0.54–2.4, P = 0.69). Multivariate logistic regression analysis revealed that the incidence of preterm cesarean delivery due to massive bleeding in pregnancies","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/jsshp.hrp2019-009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44343055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30DOI: 10.14390/JSSHP.HRP2018-013
S. Takeda, J. Takeda, S. Makino
Numerous trial-and-error approaches have been taken to achieve effective hemostasis for difficult obstetrical uterine hemorrhage cases. In the field of obstetrics, transcatheter arterial embolization (TAE) is known to be highly effective for controlling uterine hemorrhage and hematoma. This procedure achieves a high hemostasis rate, and the frequency of hysterectomy has thus sharply decreased. Although arterial ligation for massive hemorrhage at the time of cesarean section may fail to control bleeding in a number of cases due to an abundance of collateral circulation pathways, various new hemostatic techniques such as compression sutures of the uterus, uterine tamponade with gauze or a balloon, and intraoperative TAE have become available. However, complications including subsequent endometrial hypoplasia, menstruation disorder, infertility, pregnancy loss, placenta accreta, and uterine rupture have been reported even in cases undergoing successful hemostasis with TAE using absorbable embolus. Against this backdrop, we reconsidered fertility-preserving hemostatic strategies for critical obstetrical hemorrhage under these circumstances, and herein discuss how to select the optimal strategy based on our knowledge of and experience with various hemostatic procedures.
{"title":"A minimally invasive hemostatic strategy in obstetrics aiming to preserve uterine function and enhance the safety of subsequent pregnancies","authors":"S. Takeda, J. Takeda, S. Makino","doi":"10.14390/JSSHP.HRP2018-013","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2018-013","url":null,"abstract":"Numerous trial-and-error approaches have been taken to achieve effective hemostasis for difficult obstetrical uterine hemorrhage cases. In the field of obstetrics, transcatheter arterial embolization (TAE) is known to be highly effective for controlling uterine hemorrhage and hematoma. This procedure achieves a high hemostasis rate, and the frequency of hysterectomy has thus sharply decreased. Although arterial ligation for massive hemorrhage at the time of cesarean section may fail to control bleeding in a number of cases due to an abundance of collateral circulation pathways, various new hemostatic techniques such as compression sutures of the uterus, uterine tamponade with gauze or a balloon, and intraoperative TAE have become available. However, complications including subsequent endometrial hypoplasia, menstruation disorder, infertility, pregnancy loss, placenta accreta, and uterine rupture have been reported even in cases undergoing successful hemostasis with TAE using absorbable embolus. Against this backdrop, we reconsidered fertility-preserving hemostatic strategies for critical obstetrical hemorrhage under these circumstances, and herein discuss how to select the optimal strategy based on our knowledge of and experience with various hemostatic procedures.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/JSSHP.HRP2018-013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43962552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30DOI: 10.1093/acprof:oso/9780195647518.003.0019
B. Nanda
{"title":"Congress President","authors":"B. Nanda","doi":"10.1093/acprof:oso/9780195647518.003.0019","DOIUrl":"https://doi.org/10.1093/acprof:oso/9780195647518.003.0019","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42936579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30DOI: 10.14390/JSSHP.HRP2019-007
K. Papadakis
Aim: Fundal pressure during labour is a frequently used manoeuvre for expediting delivery in cases of fetal distress, dystocia and maternal exhaustion. It is often underreported and therefore challenging to accurately estimate its prevalence. It remains a highly controversial topic, having been abandoned in many countries due to its potentially harmful consequences. Still, some health care professionals consider it safe and effective in life-threatening obstetric emergencies. Our objective was to evaluate the evidence behind the merits and drawbacks of its implementation into clinical practice. Methods: This is a critical review based on utilising high-quality references on whether it is justifiable to insist on using fundal pressure in contemporary obstetrics. Results: Fundal pressure is understudied with significant variations worldwide. Reports documenting of any substantial benefit are sparse in the literature. Nevertheless, there is a clear association with various adverse outcomes. An increasing number of experts suggest that fundal pressure should be relinquished. Conclusions: Unless future randomised controlled trials change our views on traditional methods for shortening labour when needed, practitioners should be extra vigilant in avoiding dubious techniques, as deviation from national guidelines could jeopardise aspirations for optimal intrapartum care. In the time being, fundal pressure should be limited for research purposes only within well-designed studies.
{"title":"Critical appraisal of the role of applying uterine fundal pressure in labour: First, do no harm","authors":"K. Papadakis","doi":"10.14390/JSSHP.HRP2019-007","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2019-007","url":null,"abstract":"Aim: Fundal pressure during labour is a frequently used manoeuvre for expediting delivery in cases of fetal distress, dystocia and maternal exhaustion. It is often underreported and therefore challenging to accurately estimate its prevalence. It remains a highly controversial topic, having been abandoned in many countries due to its potentially harmful consequences. Still, some health care professionals consider it safe and effective in life-threatening obstetric emergencies. Our objective was to evaluate the evidence behind the merits and drawbacks of its implementation into clinical practice. Methods: This is a critical review based on utilising high-quality references on whether it is justifiable to insist on using fundal pressure in contemporary obstetrics. Results: Fundal pressure is understudied with significant variations worldwide. Reports documenting of any substantial benefit are sparse in the literature. Nevertheless, there is a clear association with various adverse outcomes. An increasing number of experts suggest that fundal pressure should be relinquished. Conclusions: Unless future randomised controlled trials change our views on traditional methods for shortening labour when needed, practitioners should be extra vigilant in avoiding dubious techniques, as deviation from national guidelines could jeopardise aspirations for optimal intrapartum care. In the time being, fundal pressure should be limited for research purposes only within well-designed studies.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41331727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30DOI: 10.14390/jsshp.hrp2019-010
S. Makino, J. Takeda, S. Takeda, Kazushi Watanabe, K. Matsubara, O. Nakamoto, J. Ushijima, A. Ohkuchi, K. Koide, K. Mimura, M. Morikawa, K. Naruse, Kanji Tanaka, T. Nohira, H. Metoki, I. Kawabata, K. Takagi, M. Yamasaki, A. Ichihara, T. Kimura, S. Saito, H. Seki
{"title":"New definition and classification of “Hypertensive Disorders of Pregnancy (HDP)","authors":"S. Makino, J. Takeda, S. Takeda, Kazushi Watanabe, K. Matsubara, O. Nakamoto, J. Ushijima, A. Ohkuchi, K. Koide, K. Mimura, M. Morikawa, K. Naruse, Kanji Tanaka, T. Nohira, H. Metoki, I. Kawabata, K. Takagi, M. Yamasaki, A. Ichihara, T. Kimura, S. Saito, H. Seki","doi":"10.14390/jsshp.hrp2019-010","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2019-010","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/jsshp.hrp2019-010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45596209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-30DOI: 10.14390/JSSHP.HRP2018-011
Seigo Tanaka, I. Kakizaki, Kanji Tanaka, T. Kodama, Asami Ito-Fukuyama, S. Suto, R. Takahashi, Y. Yokoyama
Aim: This study aimed to examine the effects of the glycosaminoglycan (GAG) chain in urinary trypsin inhibitor (UTI) on uterine cervical fibroblasts (UCFs) and to apply the findings to the development of more effective therapeutic drugs for the management of preterm birth. Methods: We prepared GAG chain-remodeled UTIs by hydrolysis and/or transglycosylation by testicular hyaluronidase. These UTIs were added to UCFs obtained from gynecology operations, and the effects of UTIs on the release of IL-8, IL-6, MMP-8, and MMP-9 were examined. Results: UTIs that were not hydrolyzed tended to reduce IL-8 release more strongly than GAG chain-hydrolyzed UTIs. IL-6 was not affected by GAG chain hydrolysis of UTIs. GAG chain-hydrolyzed UTIs tended to reduce MMP-8 and MMP-9 release more strongly than non-hydrolyzed UTIs. Conclusions: Our findings suggest that the GAG chain of UTI might reduce hyaluronan during cervical ripening by reducing IL-8 release and has opposite effects on reducing MMP-8 and MMP-9 release related to collagen degradation. This insight may be helpful in the development of more effective therapeutic drugs for the management of preterm birth.
{"title":"Development of new therapeutic agents for preterm birth by glycosaminoglycan chain remodeling of urinary trypsin inhibitor","authors":"Seigo Tanaka, I. Kakizaki, Kanji Tanaka, T. Kodama, Asami Ito-Fukuyama, S. Suto, R. Takahashi, Y. Yokoyama","doi":"10.14390/JSSHP.HRP2018-011","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2018-011","url":null,"abstract":"Aim: This study aimed to examine the effects of the glycosaminoglycan (GAG) chain in urinary trypsin inhibitor (UTI) on uterine cervical fibroblasts (UCFs) and to apply the findings to the development of more effective therapeutic drugs for the management of preterm birth. Methods: We prepared GAG chain-remodeled UTIs by hydrolysis and/or transglycosylation by testicular hyaluronidase. These UTIs were added to UCFs obtained from gynecology operations, and the effects of UTIs on the release of IL-8, IL-6, MMP-8, and MMP-9 were examined. Results: UTIs that were not hydrolyzed tended to reduce IL-8 release more strongly than GAG chain-hydrolyzed UTIs. IL-6 was not affected by GAG chain hydrolysis of UTIs. GAG chain-hydrolyzed UTIs tended to reduce MMP-8 and MMP-9 release more strongly than non-hydrolyzed UTIs. Conclusions: Our findings suggest that the GAG chain of UTI might reduce hyaluronan during cervical ripening by reducing IL-8 release and has opposite effects on reducing MMP-8 and MMP-9 release related to collagen degradation. This insight may be helpful in the development of more effective therapeutic drugs for the management of preterm birth.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/JSSHP.HRP2018-011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41344139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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