title: Tissue-type plasminogen activator and plasminogen activator inhibitor type-1 mRNA and their protein expression levels in human decidua after early pregnancy termination by mifepristone plus misoprostol.
abstract: OBJECTIVE
  To investigate the mechanism of prolonged uterine hemorrhage after terminating early pregnancy by mifepristone plus misoprostol.
  
  
  METHODS
  Forty-five decidua specimens were obtained from 45 pregnant women with amenorrhea of 6-7 week duration. Fifteen women were treated with mifepristone and 15 were treated with mifepristone plus misoprostol. The remaining 15 served as controls. The tPA and PAI-1 mRNA levels were estimated by reverse transcription-polymerase chain reaction. Chromogenic assay and enzyme-linked immunosorbent assay were used to detect tPA activity and PAI-1 protein level in decidua.
  
  
  RESULTS
  The activities of tPA in the mifepristone plus misoprostol group and in the mifepristone group were 46.91 +/- 20.74 IU/mg.protein and 64.25 +/- 35.81 IU/mg.protein respectively, lower than those in the normal decidua group (99.76 +/- 58.61 IU/mg.protein, P < 0.05). tPA mRNA levels in the mifepristone plus misoprostol group were the highest (1.43 +/- 0.39) among the groups. In the mifepristone group, tPA mRNA level (0.90 +/- 0.16) was not significantly different from that in the normal decidua group (0.94 +/- 0.17). The protein and mRNA expression levels of PAI-1 were not significantly different among the three groups (P > 0.05).
  
  
  CONCLUSIONS
  Mifepristone plus misoprostol decreased tPA activity in human early decidua by post-transcription pathways, which may influence decidua shedding, endometrial angiogenesis, endometrial remodeling, and cause prolonged uterine hemorrhage after drug abortion.
authors.affiliation: Women's Hospital, Zhejiang University, School of Medicine, Hangzhou 310006, China. hlili@telekbird.com.cn
authors.forename: L
authors.initials: L
authors.lastname: Huang
authors.forename: Y
authors.initials: Y
authors.lastname: Shi
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology; D000028:Abortion, Induced; D000328:Adult; D002863:Chromogenic Compounds; D003656:Decidua / Q000187:drug effects* / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D015735:Mifepristone / Q000494:pharmacology*; D016595:Misoprostol / Q000494:pharmacology*; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics* / Q000378:metabolism; D011247:Pregnancy; D012333:RNA, Messenger / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D010959:Tissue Plasminogen Activator / Q000235:genetics* / Q000378:metabolism
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D002863:Chromogenic Compounds; D017395:Plasminogen Activator Inhibitor 1; D012333:RNA, Messenger; D016595:Misoprostol; D015735:Mifepristone; D010959:Tissue Plasminogen Activator