Cervical Remodeling During Pregnancy and Parturition

Overview

Journal Trends Endocrinol Metab

Specialty Endocrinology

Date 2010 Feb 23

PMID 20172738

Citations 146

Authors

Brenda Timmons

Meredith Akins

Mala Mahendroo

Affiliations

Soon will be listed here.

Abstract

Appropriate and timely cervical remodeling is key for successful birth. Premature cervical opening can result in preterm birth which occurs in 12.5% of pregnancies. Research focused on the mechanisms of term and preterm cervical remodeling is essential to prevent prematurity. This review highlights recent findings that better define molecular processes driving progressive disorganization of the cervical extracellular matrix. This includes studies that redefine the role of immune cells and identify diverse functions of the cervical epithelia and hyaluronan in remodeling. New investigations proposing that infection-induced premature cervical remodeling is distinct from the normal process are presented. Recent advances in our understanding of term and preterm cervical remodeling provide new directions for investigation and compel investigators to reevaluate currently accepted models.

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References

Thomson A, Telfer J, Young A, Campbell S, Stewart C, Cameron I . Leukocytes infiltrate the myometrium during human parturition: further evidence that labour is an inflammatory process. Hum Reprod. 1999; 14(1):229-36. View

Chiquet-Ehrismann R, Chiquet M . Tenascins: regulation and putative functions during pathological stress. J Pathol. 2003; 200(4):488-99. DOI: 10.1002/path.1415. View

Bollapragada S, Bollopragada S, Youssef R, Jordan F, Greer I, Norman J . Term labor is associated with a core inflammatory response in human fetal membranes, myometrium, and cervix. Am J Obstet Gynecol. 2009; 200(1):104.e1-11. DOI: 10.1016/j.ajog.2008.08.032. View

Midwood K, Williams L, Schwarzbauer J . Tissue repair and the dynamics of the extracellular matrix. Int J Biochem Cell Biol. 2004; 36(6):1031-7. DOI: 10.1016/j.biocel.2003.12.003. View

Filipovich Y, Lu S, Akira S, Hirsch E . The adaptor protein MyD88 is essential for E coli-induced preterm delivery in mice. Am J Obstet Gynecol. 2009; 200(1):93.e1-8. DOI: 10.1016/j.ajog.2008.08.038. View

Sakamoto Y, Moran P, Searle R, Bulmer J, Robson S . Interleukin-8 is involved in cervical dilatation but not in prelabour cervical ripening. Clin Exp Immunol. 2004; 138(1):151-7. PMC: 1809197. DOI: 10.1111/j.1365-2249.2004.02584.x. View

Mitchell B, Taggart M . Are animal models relevant to key aspects of human parturition?. Am J Physiol Regul Integr Comp Physiol. 2009; 297(3):R525-45. DOI: 10.1152/ajpregu.00153.2009. View

Ruscheinsky M, de la Motte C, Mahendroo M . Hyaluronan and its binding proteins during cervical ripening and parturition: dynamic changes in size, distribution and temporal sequence. Matrix Biol. 2008; 27(5):487-97. PMC: 2492578. DOI: 10.1016/j.matbio.2008.01.010. View

Bradshaw A, Sage E . SPARC, a matricellular protein that functions in cellular differentiation and tissue response to injury. J Clin Invest. 2001; 107(9):1049-54. PMC: 209289. DOI: 10.1172/JCI12939. View

10.

Wira C, Grant-Tschudy K, Crane-Godreau M . Epithelial cells in the female reproductive tract: a central role as sentinels of immune protection. Am J Reprod Immunol. 2005; 53(2):65-76. DOI: 10.1111/j.1600-0897.2004.00248.x. View

11.

Timmons B, Fairhurst A, Mahendroo M . Temporal changes in myeloid cells in the cervix during pregnancy and parturition. J Immunol. 2009; 182(5):2700-7. PMC: 2752643. DOI: 10.4049/jimmunol.0803138. View

12.

Hassan S, Romero R, Haddad R, Hendler I, Khalek N, Tromp G . The transcriptome of the uterine cervix before and after spontaneous term parturition. Am J Obstet Gynecol. 2006; 195(3):778-86. DOI: 10.1016/j.ajog.2006.06.021. View

13.

Almond A . Hyaluronan. Cell Mol Life Sci. 2007; 64(13):1591-6. PMC: 11136421. DOI: 10.1007/s00018-007-7032-z. View

14.

Mahendroo M, Cala K, Russell D . 5 alpha-reduced androgens play a key role in murine parturition. Mol Endocrinol. 1996; 10(4):380-92. DOI: 10.1210/mend.10.4.8721983. View

15.

JUNQUEIRA L, Zugaib M, Montes G, TOLEDO O, Krisztan R, Shigihara K . Morphologic and histochemical evidence for the occurrence of collagenolysis and for the role of neutrophilic polymorphonuclear leukocytes during cervical dilation. Am J Obstet Gynecol. 1980; 138(3):273-81. DOI: 10.1016/0002-9378(80)90248-3. View

16.

Kokenyesi R, Armstrong L, Agah A, Artal R, Bornstein P . Thrombospondin 2 deficiency in pregnant mice results in premature softening of the uterine cervix. Biol Reprod. 2003; 70(2):385-90. DOI: 10.1095/biolreprod.102.014704. View

17.

Zanzinger K, Schellack C, Nausch N, Cerwenka A . Regulation of triggering receptor expressed on myeloid cells 1 expression on mouse inflammatory monocytes. Immunology. 2009; 128(2):185-95. PMC: 2767308. DOI: 10.1111/j.1365-2567.2009.03091.x. View

18.

Ozasa H, Tominaga T, Nishimura T, Takeda T . Lysyl oxidase activity in the mouse uterine cervix is physiologically regulated by estrogen. Endocrinology. 1981; 109(2):618-21. DOI: 10.1210/endo-109-2-618. View

19.

Weber B, Saurer L, Mueller C . Intestinal macrophages: differentiation and involvement in intestinal immunopathologies. Semin Immunopathol. 2009; 31(2):171-84. DOI: 10.1007/s00281-009-0156-5. View

20.

Timmons B, Mahendroo M . Timing of neutrophil activation and expression of proinflammatory markers do not support a role for neutrophils in cervical ripening in the mouse. Biol Reprod. 2005; 74(2):236-45. DOI: 10.1095/biolreprod.105.044891. View