Cytokines, prostaglandins and parturition - A review
Cytokines, prostaglandins and parturition - A review
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DOI：
10.1053/plac.2002.0948
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发表时间：
2003-04-01
期刊：
影响因子：
3.8
通讯作者：
Mitchell, MD
中科院分区：
文献类型：
--
作者：
Keelan, JA;Blumenstein, M;Mitchell, MD
细胞因子、趋化因子和免疫调节蛋白在胎盘和妊娠膜中的作用已经在正常和异常妊娠和分娩的背景下得到了广泛的研究。胎儿膜和蜕膜中细胞因子的表达模式表明，炎症激活在足月分娩时适度发生，但在早产时更为强烈，特别是在存在宫内感染的情况下。趋化因子表达增强，在羊膜腔感染的分娩中尤其明显，可能是将浸润性白细胞招募到膜上，从而放大炎症过程，加速膜破裂和分娩的原因。抗炎细胞因子抑制胎盘中的炎症反应，但在某些情况下可能在膜中以促炎方式起作用。细胞因子的细胞内信号是由SOCS（细胞因子信号沉默者）-1、-2和-3等蛋白调节的。这些蛋白丰度的变化发生在足月分娩时，暗示它们是分娩前后细胞因子作用的调节剂。前列腺素是在拉伸和促炎细胞因子作用下由细胞膜释放的，它不仅作用于肌层。但也可能对细胞活力和基质蛋白完整性产生旁分泌/自分泌作用。前列腺素异构酶负责将PGH(2)（来源于前列腺素H合酶-1和-2）转化为具有生物活性的前列腺素，其定位和调控正在这些组织中进行研究，特别是在细胞因子相互作用的背景下。虽然已知妊娠组织是PGD(2)、PGJ(2)及其衍生物的来源，但这些前列腺素的产生调控尚未得到详细研究，它们的作用（可能包括细胞凋亡和炎症抑制）仍不明确。毫无疑问，随着目前的研究取得成果，对怀孕和分娩中细胞因子-前列腺素相互作用的这些方面的更全面的了解将会展开。(C) 2003 IFPA和Elsevier Science Ltd.版权所有。
The elaboration of cytokines, chemokines and immunomodulatory proteins in the placenta and gestational membranes has been extensively investigated in the context of both normal and abnormal pregnancy and delivery. Patterns of expression of cytokines in the foetal membranes and decidua suggest that inflammatory activation occurs modestly with term labour, but much more robustly in preterm delivery, particularly in the presence of intrauterine infection. Enhanced chemokine expression, particularly evident in deliveries with an infected amniotic cavity, is presumably responsible for recruiting infiltrating leukocytes into the membranes thereby amplifying the inflammatory process and hastening membrane rupture and delivery. Anti-inflammatory cytokines suppress inflammatory reactions in the placenta, but under some circumstances may act in a pro-inflammatory fashion in the membranes. Intracellular signalling by cytokines is modulated by proteins such as SOCS (Silencer Of Cytokine Signalling)-1, -2 and -3. Changes in the abundance of these proteins occur with term labour, implicating them as modulators of cytokine actions around the time of parturition. Prostaglandins, released by the membranes in response to stretch and the actions of pro-inflammatory cytokines, act not only upon the myometrium. and cervix, but may also exert paracrine/autocrine effects on cell viability and matrix protein integrity. The localization and regulation of prostanoid isomerases, responsible for converting PGH(2) (derived from prostaglandin H synthase-1 and -2) to bioactive prostanoids, are being studied in these tissues, particularly in the context of cytokine interactions. Although the gestational tissues are known to be sources of PGD(2), PGJ(2) and its derivatives, the regulation of production of these prostaglandins has yet to be studied in any detail and their actions, which may include apoptosis and suppression of inflammation, remain poorly defined. A more complete understanding of these aspects of cytokine-prostaglandin interactions in pregnancy and parturition will, no doubt, unfold as current studies come to fruition. (C) 2003 IFPA and Elsevier Science Ltd. All rights reserved.