elafin and Fetal-Membranes--Premature-Rupture

The prevention of infection in pregnancy is critical to provide an appropriate fetal development and term delivery. Natural antimicrobials are the mediators of innate immune system with antibacterial, anti-viral and anti-fungal properties. It has been found that these antimicrobials play the great role in a homeostasis of bronchial and intestine epithelium, endometrium and epidermis. The activity of elafin--neutrophil elastase inhibitor--has been found in female reproductive system microenvironment (cervix, endometrium and fallopian tube) with the highest expression in the endometrium of non-pregnant women during ovulation and menstruation. The influence of elafin has been established on the maintenance of early pregnancy and the patomechanism of preterm labor and other pathology of pregnancy. Elafin level in amniotic fluid has been confirmed to be decreased in cases of preterm rupture of membranes (PROM). The protein may be a good marker of preterm labor and use in its diagnostics and treatment.

Topics: Amniotic Fluid; Biomarkers; Elafin; Endometrium; Female; Fetal Membranes, Premature Rupture; Humans; Menstruation; Obstetric Labor, Premature; Ovulation; Pregnancy; Protease Inhibitors

Elafin is a low molecular weight protein with antileukoproteinase, anti-inflammatory, antibacterial and immunomodulating properties. The profile of Elafin in fetal membranes is not well characterized. This study determined the changes in Elafin expression and concentration in human fetal membrane from patients with preterm prelabor rupture of membranes (PPROM) and in vitro in response to intra-amniotic polymicrobial pathogens.. Elafin messenger RNA (mRNA) expressions were studied in fetal membranes from PPROM, normal term as well as in normal term not in labor membranes in an organ explant system treated (24 h) with lipopolysaccharide (LPS), using quantitative reverse transcription-polymerase chain reaction (RT-PCR). Enzyme-linked immunosorbent assay (ELISA) measured Elafin concentrations in culture supernatants from tissues treated with LPS and polybacterial combinations of heat-inactivated Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Gardnerella vaginalis (GV).. Elafin mRNA expression in fetal membranes from women with PPROM was significantly higher compared to women who delivered at term after normal pregnancy (5.09±3.50 vs. 11.71±2.21; P<0.05). In vitro, LPS-stimulated membranes showed a significantly increased Elafin m-RNA expression (P<0.05). However, the protein levels after LPS stimulation was not changed. Similarly, polymicrobial-treated fetal membranes also showed no changes in Elafin protein concentrations compared to untreated controls.. Higher Elafin expression in PPROM fetal membranes suggests a host response to an inflammatory pathology. However, lack of Elafin response to LPS and polymicrobial treatment is indicative of the minimal anti-inflammatory impact of this molecule in fetal membranes.

Topics: Elafin; Extraembryonic Membranes; Female; Fetal Membranes, Premature Rupture; Host-Pathogen Interactions; Humans; In Vitro Techniques; Inflammation; Lipopolysaccharides; Organ Culture Techniques; Pregnancy