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- Title
The Role of Epithelial to Mesenchymal Transition in Human Amniotic Membrane Rupture.
- Authors
Janzen, Carla; Sen, Suvajit; Lei, Margarida Y Y; Gagliardi de Assumpcao, Marina; Challis, John; Chaudhuri, Gautam
- Abstract
<bold>Context: </bold>Biochemical weakening of the amnion is a major factor preceding preterm premature rupture of membranes (PPROMs), leading to preterm birth. Activation of matrix metalloproteinases (MMPs) is known to play a key role in collagen degradation of the amnion; however, epithelial to mesenchymal transition (EMT) that is also induced by MMP activation has not been investigated as a mechanism for amnion weakening.<bold>Objective: </bold>To measure amniotic EMT associated with vaginal delivery (VD) compared with unlabored cesarean sections (CSs), and to assess changes in amniotic mechanical strength with pharmacologic inhibitors and inducers of EMT, thus testing the hypothesis that EMT is a key biochemical event that promotes amniotic rupture.<bold>Findings: </bold>(1) Amnions taken from VD contained a significantly increased number of mesenchymal cells relative to epithelial cells compared with unlabored CS by fluorescence-activated cell sorting analysis (60% vs 10%); (2) tumor necrosis factor (TNF)-α stimulation of amniotic epithelial cells increased expression of the mesenchymal marker vimentin after 2 days; (3) EMT inhibitor, etodolac, significantly increased the time and mechanical pressure required to rupture the amnion; and (4) TNF-α and another pharmacologic EMT inducer, ethacridine, decreased the time and mechanical pressure required for amnion rupture, further confirming that the mesenchymal phenotype significantly weakens the amnion.<bold>Conclusions: </bold>This work demonstrated amniotic cell EMT was associated with labor and EMT decreased the tensile strength of the amnion. These findings suggest a role for EMT in the pathophysiology of PPROM and may provide a basis for development of therapies to prevent preterm labor.
- Subjects
AMNION; NONSTEROIDAL anti-inflammatory agents; PREGNANCY complications; RESEARCH funding; TUMOR necrosis factors; CYCLOOXYGENASE 2; TENSILE strength; MATRIX metalloproteinases; ETODOLAC; PHARMACODYNAMICS
- Publication
Journal of Clinical Endocrinology & Metabolism, 2017, Vol 102, Issue 4, p1261
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2016-3150