RESUMEN
BACKGROUND: Accumulating evidence supports the idea of activin A as a modulator of inflammation. In human pregnancy, elevated activin A concentrations in amniotic fluid are reported in women with intra-amniotic infection and inflammation- induced pre-term birth. AIM: To test the hypothesis that activin A was involved in the pathophysiology of amnionitis, we evaluated the effects of tumor necrosis factor-α and lipopolysaccharide on activin A production in human amniotic epithelial cells, and the effects of activin A on the expression of collagen mRNA in amniotic mesenchymal cells. MATERIALS AND METHODS: Amniotic membranes were obtained from patients without systemic disease, signs of premature delivery or fetal complications, during elective cesarean sections at term. Amniotic epithelial cells and mesenchymal cells were separately obtained by enzymatic digestion and cultured. Activin A was measured by enzyme-linked immunosorbent assay and collagen mRNA levels were assessed by quantitative PCR. RESULTS: Amniotic epithelial cells produced activin A in a cell density- and time-dependent manner. Tumor necrosis factor- α enhanced activin A production in a time-dependent (48-120 h) and dose-dependent (10-300 ng/ml) manner in amniotic epithelial cells. Lipopolysaccharide also stimulated activin A production, but the effect was less prominent. In amniotic mesenchymal cells, the effect of activin A on the expression of type I and type III collagen mRNA was suppressive. CONCLUSIONS: Tumor necrosis factor-α and lipopolysaccharide stimulated activin A production in amniotic epithelial cells, and activin A modulated expression of collagen mRNA in amniotic mesenchymal cells. These results support the idea that activin A is involved in the pathophysiology of amnionitis.