Document Detail

Minireview: fetal-maternal hormonal signaling in pregnancy and labor.
MedLine Citation:
PMID:  19282364     Owner:  NLM     Status:  MEDLINE    
Mechanisms underlying the initiation of parturition remain unclear. Throughout most of pregnancy, uterine quiescence is maintained by elevated progesterone acting through progesterone receptor (PR). Although in most mammals, parturition is associated with a marked decline in maternal progesterone, in humans, circulating progesterone and uterine PR remain elevated throughout pregnancy, suggesting a critical role for functional PR inactivation in the initiation of labor. Both term and preterm labor in humans and rodents are associated with an inflammatory response. In preterm labor, intraamniotic infection likely provides the stimulus for increased amniotic fluid interleukins and migration of inflammatory cells into the uterus and cervix. However, at term, the stimulus for this inflammatory response is unknown. Increasing evidence suggests that the developing fetus may produce physical and hormonal signals that stimulate macrophage migration to the uterus, with release of cytokines and activation of inflammatory transcription factors, such as nuclear factor kappaB (NF-kappaB) and activator protein 1 (AP-1), which also is activated by myometrial stretch. We postulate that the increased inflammatory response and NF-kappaB activation promote uterine contractility via 1) direct activation of contractile genes (e.g. COX-2, oxytocin receptor, and connexin 43) and 2) impairment of the capacity of PR to mediate uterine quiescence. PR function near term may be compromised by direct interaction with NF-kappaB, altered expression of PR coregulators, increased metabolism of progesterone within the cervix and myometrium, and increased expression of inhibitory PR isoforms. Alternatively, we propose that uterine quiescence during pregnancy is regulated, in part, by PR antagonism of the inflammatory response.
Carole R Mendelson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2009-03-12
Journal Detail:
Title:  Molecular endocrinology (Baltimore, Md.)     Volume:  23     ISSN:  1944-9917     ISO Abbreviation:  Mol. Endocrinol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-29     Completed Date:  2009-10-12     Revised Date:  2013-03-27    
Medline Journal Info:
Nlm Unique ID:  8801431     Medline TA:  Mol Endocrinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  947-54     Citation Subset:  IM    
Departments of Biochemistry and Obstetrics and Gynecology, North Texas March of Dimes Birth Defects Center, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9038, USA.
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MeSH Terms
Endocrine System / physiology
Hormones / physiology*
Inflammation / physiopathology
Labor, Obstetric / physiology*
Maternal-Fetal Exchange / physiology*
Models, Biological
Pregnancy / physiology*
Signal Transduction / physiology
Grant Support
Reg. No./Substance:

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