The entry of fetal and amniotic fluid components into the uterine vessel circulation leads to sterile inflammatory processes during parturition.
The entry of fetal and amniotic fluid components into the uterine vessel circulation leads to sterile inflammatory processes during parturition.
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DOI：
10.3389/fimmu.2012.00321
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发表时间：
2012
影响因子：
7.3
通讯作者：
Kobayashi H
中科院分区：
文献类型：
--
作者：
Kobayashi H
促炎细胞因子在人类分娩过程中起着重要的作用。这篇综述的重点是探讨生物学、生化学和遗传学变化在足月分娩中的作用。这篇文章回顾了关于炎症、激素和免疫因素的英文文献，试图找出人类分娩的分子基础。在足月分娩中上调的大多数基因和蛋白质与四个功能类别相关，即机械牵张介导的损伤相关分子模式（DAMP）激活、免疫应答、炎症信号传导诱导和子宫肌层收缩性进展以及由此产生的足月分娩。机械牵张可促进羊水成分进入子宫血管循环，这是临产前足月常见的生理机制。胎儿或羊水来源的DAMP可激活免疫系统。炎症介质由浸润的活化白细胞和生殖组织本身如子宫肌层产生，随后导致子宫收缩。这篇综述支持无菌炎症假说，即人类分娩至少有两个阶段：羊水成分进入子宫血管的第一波，随后是子宫肌层收缩的第二波。
Pro-inflammatory cytokines play an important role during the process of human parturition. The focus of this review was to explore the contribution of biological, biochemical, and genetic changes in the onset of term labor. This article reviews the English-language literature on inflammatory, hormonal, and immunological factors in an effort to identify the molecular basis of human parturition. The majority of the genes and proteins up-regulated in parturition at term are related to four functional categories, mechanical stretch-mediated damage-associated molecular patterns (DAMPs) activation, response to immunity, induction of inflammatory signaling, and progressive uterine myometrial contractility and resultant term birth. Mechanical stretch could promote the entry of amniotic fluid components into the uterine vessel circulation that is the common physiologic mechanism at term prior to labor. The fetal or amniotic fluid-derived DAMPs could activate the immune system. The inflammatory mediators are produced by infiltrating activated leukocytes and by the reproductive tissues themselves such as myometrium, and subsequently lead to uterine contractions. This review supports the sterile inflammation hypothesis that there are at least two phases of human parturition: the initial wave of the entry of amniotic fluid components into uterine vasculatures would be followed by the second big wave of subsequent myometrial contraction.
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