Neutrophil elastase and interleukin-6 in amniotic fluid as indicators of chorioamnionitis and funisitis.

OBJECTIVE: We wished to assess the diagnostic value of amniotic fluid concentrations of neutrophil elastase and interleukin-6 concentrations for the rapid detection of chorioamnionitis and funisitis. STUDY DESIGN: A retrospective study of 56 women who underwent transabdominal amniocentesis within 48 h before preterm delivery or spontaneous abortion. Statistical analyses included Student's t-test and Tukey-Kamer's HSD test. Receiver operating characteristics (ROC) curves were drawn to assess the predictive performance of the two markers. RESULTS: Neutrophil elastase concentrations differed significantly between patients with chorioamnionitis and other stages of chorioamnionitis, while interleukin-6 concentrations did not. To predict chorioamnionitis, concentrations of 3563 ng/ml for neutrophil elastase and 11,279 pg/ml for interleukin-6 were optimal. Comparison of ROC curves showed that neutrophil elastase was a significantly more sensitive predictor of funisitis than interleukin-6. CONCLUSION: Amniotic fluid concentrations of neutrophil elastase are more sensitive than interleukin-6 for the rapid detection of chorioamnionitis and funisitis.

Expression of CD44 mRNA induced by interleukin-1beta in human cultured uterine cervical fibroblasts.

OBJECTIVE: Hyaluronic acid in the cervix plays an important role in the process of cervical ripening. CD44 is a receptor for hyaluronic acid. We investigated whether CD44 is related to cervical ripening by examining the expression of CD44 mRNA in human cultured cervical fibroblasts with or without inflammatory cytokines. STUDY DESIGN: CD44 mRNA expressions derived from cultured human uterine cervical fibroblasts in the presence or absence of interleukin-1beta (IL-1beta) (1-100 pg/ml) or interleukin-8 (IL-8) (1-100 ng/ml) were analyzed by the Northern blot analysis. The human CD44 cDNA probe was hybridized with three species of mRNA. Sizes of the mRNAs were 1.6, 2.2, and 5.0 kilobases (kb). RESULTS: Interleukin-1beta stimulated the expression of CD44 mRNA in a dose-dependent manner. Interleukin-8 did not stimulate the expression. CONCLUSIONS: It is concluded from the present study that human cervical CD44 mRNA expression is induced by interleukin-1beta. Accordingly, we deduce that the concentration of hyaluronic acid in the cervical tissue is increased because of the expression of CD44.

Expression of tumor necrosis factor-alpha stimulated gene-6 mRNA in cultured human uterine cervical fibroblasts.

BACKGROUND: Uterine cervical ripening process is an active biochemical process similar in part to inflammatory reaction. In this process, hyaluronan plays important roles including facilitation of tissue hydration, release of matrix metalloproteinases and migration of inflammatory cells. The activities of hyaluronan are mediated by the hyaluronan binding proteins, hyaladherins. In the present study, we investigated the mRNA expression of tumor necrosis factor-alpha stimulated gene-6 (TSG-6), a member of the hyaladherin family, in cultured human uterine fibroblasts and uterine cervical tissues. METHODS: We developed one-step RT-PCR method for the quantification of TSG-6 mRNA and quantified the expression of TSG-6 mRNA in cultured human uterine fibroblasts, treated with or not proinflammatory cytokines, and TSG-6 mRNA in uterine cervical tissues. RESULTS: We clarified that [1] TSG-6 mRNA was expressed constitutively in cultured human uterine cervical fibroblasts, [2] expression of TSG-6 mRNA was upregulated in a dose dependent manner by proinflammatory cytokines, such as IL-1beta and TNF-alpha, which were key mediators in the cervical ripening process, [3] expression of TSG-6 mRNA in uterine cervices during parturition was significantly (P < 0.05) higher than that in a non-pregnant state. CONCLUSIONS: Our results suggest that TSG-6 might participate in the cervical ripening process.

Adding HPV16 testing to abnormal cervical smear detection is useful for predicting CIN3: a prospective study.

BACKGROUND: The aim of this prospective study was to estimate whether adding human papillomavirus 16 (HPV16) testing to abnormal cervical smears is useful in the prediction of cervical intraepithelial neoplasia 3 (CIN3). METHODS: Between October 1994 and May 1996, a total of 207 patients at the Akita University Hospital had abnormal smears. Of these patients, 153 patients with CIN1,2 or atypical squamous cells of undetermined significance (ASCUS) were enrolled in this study and followed until June 2001. At the initial visit, a cervical swab was collected for cytology and for HPV16 testing using nested polymerase chain reaction (PCR). When the HPV16 test was positive, HPV16 testing was performed every 3 to 6 months. We compared the prevalence of progression to CIN3 between the HPV16-positive group (n = 16) and the HPV16-negative group (n = 137). We also investigated the risk of progression to CIN3 associated with persistent HPV16 infection. RESULTS: At the end of the study period, four patients (25%) in the HPV16-positive group developed CIN3, and all of these patients were found to have persistent HPV16 infection during this period. Only three patients (2.2%) in the HPV16-negative group developed CIN3. CONCLUSIONS: The prevalence of progression to CIN3 in the HPV16-positive group was significantly higher than that in the negative group (p = 0.0023). The odds ratio of progression to CIN3 was 14.9 [95% confidence interval (CI) 2.98-74.4]. In particular, the risk of progression to CIN3 increased with persistent HPV16 infection. Adding HPV16 testing when abnormal cervical smears are detected promises to be useful for predicting CIN3.