Revisiting reproduction: Prematurity and the puzzle of progesterone resistance.
Revisiting reproduction: Prematurity and the puzzle of progesterone resistance.
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DOI：
10.1038/nm0510-529
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发表时间：
2010-05
期刊：
影响因子：
82.9
通讯作者：
Dey, Sudhansu K.
中科院分区：
文献类型：
--
作者：
Hirota, Yasushi;Cha, Jeeyeon;Dey, Sudhansu K.
分娩是一个复杂而复杂的过程。在母亲的保护范围内，胎儿迅速生长37-42周，直到来自内分泌和机械刺激的正确信号组合诱导分娩，最终导致出生。这些信号的异常可能导致早产或死产。全球每年发生近1300万早产和300多万死产1。早产是所有新生儿死亡的30%的直接原因，每年总计100多万，并经常导致存活的人发育迟缓和严重的长期残疾。很多因素都被认为是早产的原因(图1)。尽管临床上做出了许多努力来降低早产的发生率，但早产的主要潜在机制仍然不清楚，早产发生率高的原因也是如此。孕酮(P4)被称为“妊娠激素”，对妊娠成功至关重要，因为它支持胚胎植入和随后的妊娠维持。P4通过依赖于妊娠阶段的差异基因表达来调节子宫细胞特异性的增殖和分化，如着床、蜕膜化(围绕着床胚胎的子宫基质细胞的增殖和分化)和胎盘形成，从而履行这些职责。P4的主要功能是调节雌激素的作用；为植入和维持妊娠准备子宫内壁；在怀孕期间直到分娩，使子宫肌层处于静止状态，子宫肌层是在分娩期间收缩的子宫壁的肌层。考虑到所有这些功能，研究P4是否可能对早产有影响一直是人们非常感兴趣的。最近的几项临床试验已经测试了P4或其类似物对这种情况的治疗。一项发表在《科学》杂志上的随机对照研究
Parturition is a complex and involved process. Within the protected confines of the mother, the fetus grows rapidly for 37–42 weeks until the right combination of signals, stemming from both endocrine and mechanical stimulation, induces parturition, culminating in birth. Aberrations in these signals may lead to prematurity or stillbirth. Globally, nearly 13 million premature births and more than 3 million stillbirths occur each year1. Prematurity is a direct cause of 30% of all neonatal deaths, totaling more than 1 million annually, and often leads to developmental delays and serious long-term disabilities in those who survive. Many factors have been debated as causes of preterm birth (Fig. 1). Despite numerous clinical efforts to decrease the incidence of preterm birth, the major underlying mechanism of preterm labor remains unclear, as does the reason for the high incidence of preterm birth. Progesterone (P4), known as the ‘hormone of pregnancy,’is crucial for pregnancy success, as it supports embryo implantation and subsequent pregnancy maintenance. P4 fulfills these responsibilities by modulating uterine cell-specific proliferation and differentiation through differential gene expression in a manner dependent on the stage of pregnancy, such as implantation, decidualization (proliferation and differentiation of uterine stromal cells surrounding the implanting embryo) and placentation. Primary functions of P4 are to modulate the actions of estrogen; prepare the uterine lining for implantation and pregnancy maintenance; and, during pregnancy until parturition, confer quiescence of the uterine myometrium, the muscular layer of the uterine wall that contracts during labor. Given all of these functions, there has been a great deal of interest in examining whether P4 might have an effect on preterm delivery. Several recent clinical trials have tested P4 or its analogs for this condition. A randomized control study published in
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DOI：
10.1073/pnas.1633616100
发表时间：
2003-08-05
影响因子：
11.1
作者：
Condon, JC;Jeyasuria, P;Mendelson, CR
通讯作者：
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DOI：
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影响因子：
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DOI：
10.1073/pnas.1732707100
发表时间：
2003-08-19
影响因子：
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作者：
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影响因子：
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作者：
Hirota, Yasushi;Daikoku, Takiko;Dey, Sudhansu K.
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