adrenomedullin and Pregnancy--Tubal

The occurrence of tubal ectopic pregnancy (tEP) is related to the inflammation of the oviduct. Recently, Adrenomedullin (ADM) was found highly expression in human oviduct. The current study is to investigate whether ADM have a modulatory action on inflammatory cytokines and chemokines in oviductal tissue from women with tubal ectopic pregnancy (tEP).. Oviductal isthmus samples were collected from women with tEP undergoing salpingectomy, and women undergoing hysterectomy for benign gynaecological conditions. The mRNA and protein levels of inflammatory cytokines/chemokines were assayed by PCR (n = 6 for tEP, n = 5 for controls) and protein microarray methods (n = 5 for both tEP and controls) respectively.. Some of the inflammatory cytokines/chemokines were upregulated by ADM in oviducts from tEP patients at both mRNA and protein levels. Incubation of oviduct from tEP patients with ADM for 24 h down-regulated some of these cytokines/chemokines.. Our results suggest an additional mechanism whereby ADM insufficiency may increase the susceptibility to tEP through diminished anti-inflammatory activity. The actual impact of the relationship between ADM and inflammatory process on tubal implantation needs further exploration.

Topics: Adrenomedullin; Adult; Chemokines; Cytokines; Fallopian Tubes; Female; Humans; Middle Aged; Pregnancy; Pregnancy, Tubal

To study adrenomedullin (ADM) expression and its relation to ciliary beat frequency (CBF) in the nasal mucociliated epithelium in tubal ectopic pregnancy (tEP).. Experimental study.. University teaching hospital.. Women with tEP and normal intrauterine pregnancy matched for age and gestational age were recruited. Healthy nonpregnant women were also recruited as nonpregnant controls.. Nasal epithelial brushing.. Adrenomedullin expression in nasal epithelium (measured by real-time reverse transcription-polymerase chain reaction, plasma ADM concentration (measured by ELISA), and CBF (measured by photometric method).. We have demonstrated a similar decrease in ADM expression and CBF in the nasal mucociliated epithelium, as well as in plasma ADM concentration, in women with tEP compared with normal pregnant women. Adrenomedullin up-regulates nasal CBF via the ADM receptor, as in the oviduct. There is significant correlation between nasal and oviductal CBF.. Nasal epithelium ADM and CBF, as well as plasma ADM, are possible predictors of women at risk of tEP.

Topics: Adrenomedullin; Adult; Case-Control Studies; Cilia; Down-Regulation; Fallopian Tubes; Female; Humans; Middle Aged; Nasal Mucosa; Pregnancy; Pregnancy, Tubal; Young Adult

Topics: Adrenomedullin; Cilia; Female; Humans; Nasal Mucosa; Pregnancy; Pregnancy, Tubal

Topics: Adrenomedullin; Cilia; Female; Humans; Nasal Mucosa; Pregnancy; Pregnancy, Tubal

Tubal ectopic pregnancy (tEP) is currently the leading cause of pregnancy-related deaths during the first trimester. Our current knowledge on the molecular pathogenesis is limited.. The objective of the study was to find out the possible role of adrenomedullin (ADM) in the pathogenesis of tEP.. This was an experimental in vitro study on oviductal tissue.. The study was conducted at a university teaching hospital.. Patients included those having oviducts removed surgically during salpingectomy for tEP or hysterectomy for benign gynecological conditions. Oviductal tissues were incubated in hormonal condition mimicking early pregnancy before used for in vitro experiments.. Plasma ADM concentration, oviductal expression of ADM and its receptors, ciliary beat frequency, smooth muscle contraction were measured.. The ciliary beat frequency and frequency of muscle contraction were lower in the oviducts from patients with tEP than those from simulated normal pregnancy. The plasma and oviductal tissue ADM levels were also lower. The decreases in ciliary beat and frequency of contraction were restored to normal after ADM treatment.. The results suggest that the lower ADM level in the oviducts of tEP may lead to the decrease in ciliary beating and muscle contraction, with the result that the embryo is retained and implanted in the oviduct. Our findings explain for the first time the etiology of tubal pregnancy on the basis of an impairment of the transport of the fertilized ovum resulting from an ADM deficiency and raise the possibility of using the plasma ADM level as a predictor for tubal ectopic pregnancy.

Topics: Adrenomedullin; Adult; Biomarkers; Cilia; Embryo Implantation; Fallopian Tubes; Female; Gene Expression; Humans; Middle Aged; Muscle, Smooth; Predictive Value of Tests; Pregnancy; Pregnancy, Tubal; Receptors, Adrenomedullin