Hyaluronan in cervical epithelia protects against infection-mediated preterm birth.
نویسندگان
چکیده
Increased synthesis of cervical hyaluronan (HA) from early to late pregnancy has long been proposed to play an essential role in disorganization of the collagen-rich extracellular matrix to allow for maximal compliance and dilation of the cervix during the birth process. Here, we show that HA is not essential for increased cervical distensibility during late pregnancy. Rather, cervicovaginal HA plays an unanticipated important role in epithelial barrier protection of the lower reproductive tract. Specifically, HA depletion in the cervix and vagina resulted in inappropriate differentiation of epithelial cells, increased epithelial and mucosal permeability, and strikingly increased preterm birth rates in a mouse model of ascending vaginal infection. Collectively, these findings revealed that although HA is not obligatory for cervical compliance, it is crucial for maintaining an epithelial and mucosal barrier to limit pathogen infiltration of the lower reproductive tract during pregnancy and thereby is protective against infection-mediated preterm birth.
منابع مشابه
Cervical HSV-2 infection causes cervical remodeling and increases risk for ascending infection and preterm birth
Preterm birth (PTB), or birth before 37 weeks gestation, is the leading cause of neonatal mortality worldwide. Cervical viral infections have been established as risk factors for PTB in women, although the mechanism leading to increased risk is unknown. Using a mouse model of pregnancy, we determined that intra-vaginal HSV2 infection caused increased rates of preterm birth following an intra-va...
متن کاملCervical Mucus Properties Stratify Risk for Preterm Birth
BACKGROUND Ascending infection from the colonized vagina to the normally sterile intrauterine cavity is a well-documented cause of preterm birth. The primary physical barrier to microbial ascension is the cervical canal, which is filled with a dense and protective mucus plug. Despite its central role in separating the vaginal from the intrauterine tract, the barrier properties of cervical mucus...
متن کاملThe Value of Interleukin-8 and Interleukin-6 in Cervical Secretions as Predictors of Preterm Delivery
Background and Objective: Preterm birth occurs in 8% to 11% of all pregnancies and is responsible for 75% to 80% of all neonatal deaths. Cytokines may be involved in the etiology of preterm birth through their stimulation of prostaglandin synthesis. Cytokines may be released intocervicovaginal fluid during the breakdown of the chorio-decidual adhesion or from an inflammatory reactio...
متن کاملAssociation between Anterior Cervical Angle of the Uterus and Preterm Birth
Background Predicting preterm delivery can help obstetricians and midwives for better management of pregnancy care. Therefore, we aimed to investigate the relationship between cervical length and uteroservical angle with the occurrence of preterm delivery. Materials and Methods: The present cohort study was conducted on 100 pregnan...
متن کاملHyaluronan and its binding proteins during cervical ripening and parturition: dynamic changes in size, distribution and temporal sequence.
The uterine cervix undergoes changes during pregnancy and labor that transform it from a closed, rigid, collagen dense structure to one that is distensible, has a disorganized collagen matrix, and dilates sufficiently to allow birth. To protect the reproductive tract from exposure to the external environment, the cervix must be rapidly altered to a closed, undistensible structure after birth. P...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Journal of clinical investigation
دوره 124 12 شماره
صفحات -
تاریخ انتشار 2014