epidermal-growth-factor and Fetal-Membranes--Premature-Rupture

Preterm premature rupture of membranes (PPROM) interrupts normal lung development, resulting in neonatal respiratory morbidity. Although post-PPROM risks have been researched, only a few studies have investigated noninvasively obtained amniotic fluid (AF) to predict neonatal outcomes. In this study, we aimed to determine whether epidermal growth factor (EGF) in vaginally-collected AF is a significant predictor of neonatal respiratory outcomes after PPROM. We analyzed EGF in vaginally-obtained AF from 145 women with PPROM at 22−34 weeks of gestation. The following neonatal outcomes were included: respiratory distress syndrome, surfactant need, duration and type of respiratory support, and bronchopulmonary dysplasia. We found that EGF concentration was associated with gestational age, and its medians were lower in neonates with respiratory morbidities than unaffected ones. EGF concentrations gradually declined, the lowest being in the most clinically ill patients. EGF < 35 pg/mL significantly predicted the odds of severe respiratory outcomes. EGF in noninvasively collected AF may be a reliable predictor for respiratory outcomes of preterm neonates with PPROM before 34 weeks of gestation. The results of our study may have implications for further research both in noninvasive amniotic fluid analysis and the management of patients after PPROM.

Topics: Amniotic Fluid; Epidermal Growth Factor; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant, Newborn; Lung; Pregnancy; Pregnancy Outcome

To investigate whether damaged human amniotic epithelial cells (HAEC) could be repaired on the matrix of formulated fibrin clot in vitro and the effects of epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and transforming growth factor beta(1) (TGF-beta(1)) on the proliferation of HAEC.. Ring drill was used to drill the HAEC layer on culture sheets to make quantified models of damaged HAEC, on which the lacks were then covered with fibrin clot. Subsequently, EGF (EGF group), bFGF (bFGF group) and TGF-beta(1) (TGF-beta(1) group) of different concentration were added into the sheets respectively. After the predesigned culturing time, the growing and transiting conditions of HAEC were observed under inverted microscope after Giemsa stain. Also, the proliferating conditions of HAEC were detected by using 5-bromodeoxyuridine (BrdU).. In all groups, HAEC could transit toward damaged area on fibrin clot and grow there. Higher transiting speed and larger cell numbers were observed in the EGF and bFGF groups followed by the control group, while the TGF-beta(1) group showed the relatively poorer results. Proliferating rates of HAEC were 17.8%, 28.0%, 35.3%, 51.6%, 34.1%, 34.2% and 26.0% respectively by EGF of different cultured concentration (1.0 ng/ml, 5.0 ng/ml, 10.0 ng/ml, 20.0 ng/ml, 40.0 ng/ml, 80.0 ng/ml and 160.0 ng/ml). Proliferating rates of HAEC were 18.0%, 35.7%, 43.0%, 52.7%, 67.4%, 43.6% and 30.5% respectively by bFGF of different cultured concentration (1.0 ng/ml, 5.0 ng/ml, 10.0 ng/ml, 20.0 ng/ml, 40.0 ng/ml, 80.0 ng/ml and 160.0 ng/ml). Compared with the control group, EGF groups (EGF concentration ranging from 10 ng/ml to 80 ng/ml) and bFGF groups (bFGF concentration ranging from 5 ng/ml to 80 ng/ml) showed better proliferating effects of HAEC (P < 0.05), especially the 20 ng/ml EGF group and 40 ng/ml bFGF group had the best proliferating results among their own respective groups (P < 0.05). Proliferating rates of HAEC were 17.1%, 15.1%, 9.3%, 6.2%, 4.8%, 3.6%, 2.0% and 1.2% respectively by TGF-beta(1) of different cultured concentration (0.1 ng/ml, 0.2 ng/ml, 0.4 ng/ml, 0.8 ng/ml, 1.6 ng/ml, 3.2 ng/ml, 6.4 ng/ml and 12.8 ng/ml). Proliferating rates of HAEC in TGF-beta(1) groups (TGF-beta(1) concentration ranging from 0.8 ng/ml to 12.8 ng/ml) were significantly lower than that in the control group (P < 0.05).. HAEC could transit and grow on the matrix of fibrin clot and repair the damaged area. EGF and bFGF could obviously stimulate HAEC proliferation, while TGF-beta(1) might have the inhibitive effects.

Topics: Amnion; Cell Movement; Cell Proliferation; Cells, Cultured; Cytokines; Epidermal Growth Factor; Epithelial Cells; Female; Fetal Membranes, Premature Rupture; Fibrin; Fibroblast Growth Factor 2; Humans; Pregnancy; Transforming Growth Factor beta

To evaluate the role of interleukins (IL-1, IL-6), tumor necrosis factor alpha (TNFalpha) and for the first time interferon gamma (IFNgamma) and epidermal growth factor (EGF) in the pathogenesis of premature rupture of membranes (PROM) with and without confirmed intrauterine infection.. Amniotic fluid was retrieved by transabdominal amniocentesis from 30 patients with PROM and 20 normal pregnant women with intact membranes of matched gestational age. Microbial state of amniotic cavity included culture for aerobic and anaerobic bacteria, mycoplasmas and ureaplasma whether or not clinical signs of chorioamnionitis were present. Maternal serum and amniotic fluid IL-1, IL-6, TNFalpha and IFNgamma concentrations were determined by the corresponding immunoradiometric assay, whereas EGF concentration was determined by a specific radioimmunoassay.. Nearly all cases of PROM with infection revealed elevated amniotic fluid cytokines (IL-1beta, IL-6, TNFalpha, IFNgamma, EGF) whereas half of them revealed elevated serum cytokines. In cases of PROM without confirmed infection, there were no significant changes of maternal serum cytokines, whereas two-thirds of them revealed elevated amniotic fluid cytokines.. The rise of cytokines in amniotic fluid of cases of PROM with infection may represent: (a) enhanced macrophage activity for immunosurveillance of the fetus; (b) a preparatory step for the initiation of labor; and (c) a valuable tests for diagnosing chorioamnioitis. The mechanism responsible for PROM in the presence or absence of infection is likely to be of different nature.

Topics: Adult; Amniotic Fluid; Chorioamnionitis; Cytokines; Epidermal Growth Factor; Female; Fetal Membranes, Premature Rupture; Humans; Interferon-gamma; Interleukin-1; Interleukin-6; Pregnancy; Prospective Studies; Tumor Necrosis Factor-alpha