[子宫颈成熟和扩张的生化原理]。

W Rath, R Osmers, H W Stuhlsatz, B C Adelmann-Grill
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引用次数: 0

摘要

宫颈维持妊娠的主要功能是细胞外基质中胶原蛋白、蛋白质、糖胺聚糖(GAG)和纤维连接蛋白的合成增加,从而导致宫颈体积增加,但宫颈稠度没有明显变化。在子宫颈成熟期间,我们发现胶原浓度显著降低,GAG含量增加2.5倍,皮肤硫酸盐浓度从占总GAG含量的41%显著下降到15%,透明质酸浓度增加12倍,纤维连接蛋白显著减少,这些都是通过免疫组织化学方法证明的。因此,胶原蛋白和硫酸化GAGs的缺失可能促进成熟子宫颈的膨胀,而透明质酸的显著增加与水化有关,可能解释了柔软和肿胀的一致性。在这种情况下,透明质酸浓度的增加和纤维连接蛋白的降解可能对随后的宫颈扩张起触发作用。在分娩过程中,子宫颈在几个小时内发生的剧烈变化需要分解代谢酶系统的快速激活和作用。我们的研究表明,唾液酸酶、胶原酶和弹性酶活性在宫颈扩张期间显著增加。这些蛋白酶起源于多形核白细胞(pml),在分娩开始时积聚在子宫颈毛细血管中;随后,在宫颈扩张开始时,大量白细胞浸润于宫颈间质,在进一步扩张时,PML脱颗粒,从而释放胶原酶和其他蛋白酶。这一过程受到产后立即用含有高效蛋白酶抑制剂的血浆隔离子宫颈的限制。我们基础生化研究的临床目的是在妊娠期宫颈病理因果治疗中发展新的概念。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Biochemical principles of cervix ripening and dilatation].

The central function of the cervix to maintain pregnancy is biochemically characterized by an increased synthesis of collagen, proteins, glycosaminoglycans (GAG) and fibronectin within the extracellular matrix, thus leading to an increase of cervical volume without significant changes of cervical consistency. During the time of cervical ripening we found a marked reduction of collagen concentration, a 2.5-fold increase in GAG content, a significant fall in dermatan sulfate concentrations from 41% to 15% of total GAG content, a 12-fold increase in hyaluronate concentrations, and a marked reduction in fibronectin, demonstrated by immunhistochemical methods. Thus, the loss of collagen and sulfated GAGs may facilitate distensibility in the ripened cervix, while the significant gain in hyaluronate associated with hydratation may explain the soft and swollen consistency. In this connection increased hyaluronate concentrations and degradation of fibronectin may play a trigger role for subsequent cervical dilatation. The dramatic changes of the cervix during parturition occurring within a few hours require the rapid activation and action of catabolic enzyme systems. Our studies showed a significant increase of sialidase-, collagenase- and elastase activities during cervical dilatation. These proteinases originate from polymorphonuclear leucocytes (pml), which accumulate in cervical capillaries at the onset of labor; this is followed by a massive leucocyte infiltration of the cervical stroma at the beginning of cervical dilatation and a degranulation of the pml at further dilatation, thus releasing collagenase and other proteinases. This process is limited by the immediate post partum insudation of the cervix by plasma containing highly potent proteinase inhibitors. The clinical aim of our basic biochemical studies is to develop new concepts in the causal treatment of cervical pathology during pregnancy.

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