FETAL FIBRONECTIN INCREASE BEFORE LABOR NOT W/ CYTOKINE OR UTERINE CONTRACTION

胎儿纤维连接蛋白（FFN）水平已被用来预测劳动 女性发病。 体外研究表明， 细胞因子诱导羊膜合成FFN（JSGI 3 85，1996）。 我们 希望确定是否实验性诱导羊水 细胞因子在分娩存在或不存在的情况下刺激升高的FFN。 怀孕的动物被插入羊膜内导管， 肌电电极与母胎血管 导尿管 监测子宫活动（UA; HCA=mmHg.sec/hr 不断地。 将动物分为四组：1）组B 链球菌（GBS）接种（102-105 cfu，n=5）至绒毛膜蜕膜 2）10 fg白细胞介素-1（IL-1）注入羊膜腔， 存在或不存在吲哚美辛（INDO，50 mg口服BID持续5天， n=4）; 3）增加剂量的催产素（4-32 mU/kg/hr），直到 诱导收缩并维持至少3小时（n=8）; （4）足月自然分娩未治疗组（n=2）。 FFN 在刺激或夜间UA后96小时内采集样本 根据深度，大于10，000 HCA的模式（中度UA，第4组） 使用Adeza Biomedical通过ELISA进行测定 套件 FFN浓度高于人体阈值水平50 ng/ml （测定检测限）被认为升高。 催产素诱导的 早产动物的UA与FFN升高无关。 UA 与随后的分娩（自然足月或早产）相关 由GBS或IL-1诱导）具有增加的FFN。 GBS和IL-1均无 不会提前分娩的动物的FFN增加。 这 表明在没有FFN的情况下，在阴道中检测不到FFN。 其他机制导致分娩开始。 * UA响应n % elev。 FFN治疗前 * 治疗后和范围 * GBS重3 66 <50 326 （<50-845）GBS光2 0 <50 <50（<50）IL-1 + INDO光5 20 <50 <50 （<50-89）IL-1重4 75 <50 272（<50-337）催产素重8 25 <50 <50 （<50-1000）足月产重2 100 <50 827（645-1000）* FFN中位数 (ng/ml）

Fetal fibronectin (FFN) levels have been used to predict labor onset in women. In vitro studies demonstrate that pro-inflammatory cytokines induce synthesis of FFN by amnion (JSGI 3 85, 1996). We wished to determine if experimental induction of amniotic fluid cytokines stimulates elevated FFN in the presence or absence of labor. Pregnant animals were instrumented with intraamniotic catheters, electromyographic electrodes and maternal and fetal vascular catheters. Uterine activity (UA; HCA=mmHg.sec/hr) was monitored continuously. Animals were divided into four groups 1) Group B streptococcus (GBS) inoculations (102-105 cfu, n=5) to choriodecidual space; 2) 10 fg interleukin-1 (IL-1 ) to amniotic cavity in the presence or absence of indomethacin (INDO, 50mg oral BID for 5 days, n=4); 3) oxytocin in increasing doses (4-32 mU/kg/hr) until contractions were induced and maintained for a minimum of 3 hr (n=8); and 4) no treatment with spontaneous delivery at term (n=2). FFN samples were obtained within 96 hr after stimulus or nocturnal UA pattern greater than 10,000 HCA (moderate UA, Group 4) by deep posterior fornix swabs and assayed by ELISA using Adeza Biomedical kits. Concentrations of FFN above human threshold level of 50 ng/ml (assay limit of detection) were considered elevated. Oxytocin-induced UA in preterm animals was not associated with elevated FFN. UA associated with subsequent delivery (spontaneous term or preterm induced by GBS or IL-1 ) had increased FFN. Neither GBS nor IL-1 increased FFN in animals not destined to deliver prematurely. This suggests that FFN is not detected in the vagina in the absence of other mechanisms leading to labor onset. ***** UA response n % elev. FFN Pre-Treatment* Post-Treatment and Range* GBS heavy 3 66 <50 326 (<50-845) GBS light 2 0 <50 <50 (<50) IL-1 + INDO light 5 20 <50 <50 (<50-89) IL-1 heavy 4 75 <50 272 (<50-337) Oxytocin heavy 8 25 <50 <50 (<50-1000) Term Labor heavy 2 100 <50 827 (645-1000) *median FFN (ng/ml)