title: Progestin and thrombin regulate tissue factor expression in human term decidual cells.
abstract: BACKGROUND
  Perivascular cell membrane-bound tissue factor (TF) initiates hemostasis via thrombin generation. The identity and potential regulation of TF-expressing cells at the human maternal-fetal interface that confers hemostatic protection during normal and preterm delivery is unclear.
  
  
  OBJECTIVE
  The objective of the study were to identify TF-expressing cells at the maternal-fetal interface in term and preterm decidual sections by immunohistochemistry and evaluate progestin, thrombin, TNF-alpha, and IL-1beta effects on TF expression by cultured human term decidual cells (DCs).
  
  
  METHODS
  Serial placental sections were immunostained for TF. Leukocyte-free term DC monolayers were incubated with 10(-8) M estradiol (E2) or E2 plus 10(-7) M medroxyprogestrone acetate (MPA) +/- thrombin or TNF-alpha or IL-1beta. ELISA and Western blotting assessed TF in cell lysates. Quantitative real-time RT-PCR measured TF mRNA levels.
  
  
  RESULTS
  Immunolocalized TF in DC membranes in preterm and term placental sections displayed higher Histologic Scores than villous mesenchymal cells (P < 0.05). TF was undetected in interstitial or extravillous trophoblasts. Compared with DCs incubated with E2, MPA and 2.5 U/ml thrombin each doubled TF levels (P < 0.05) and E2 + MPA + thrombin further doubled TF levels (P < 0.05), whereas TNF-alpha and IL-1beta were ineffective. Western blotting confirmed the ELISA results. Quantitative RT-PCR revealed corresponding changes in TF mRNA levels.
  
  
  CONCLUSIONS
  In human term placental sections, DC-expressed TF exceeds that of other cell types at the maternal-fetal interface and is localized at the cell membranes in which it can bind to factor VII and meet the hemostatic demands of labor and delivery via thrombin formation. Unlike the general concept that TF is constitutive in cells that highly express it, MPA and thrombin significantly enhanced TF expression in term DC monolayers.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Lockwood
authors.forename: W
authors.initials: W
authors.lastname: Murk
authors.forename: U A
authors.initials: UA
authors.lastname: Kayisli
authors.forename: L F
authors.initials: LF
authors.lastname: Buchwalder
authors.forename: S-T
authors.initials: ST
authors.lastname: Huang
authors.forename: E F
authors.initials: EF
authors.lastname: Funai
authors.forename: G
authors.initials: G
authors.lastname: Krikun
authors.forename: F
authors.initials: F
authors.lastname: Schatz
mesh_terms: D002478:Cells, Cultured; D003656:Decidua / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D053583:Interleukin-1beta / Q000494:pharmacology; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology; D011247:Pregnancy; D011372:Progestins / Q000494:pharmacology*; D047929:Term Birth / Q000235:genetics* / Q000378:metabolism; D013917:Thrombin / Q000494:pharmacology*; D013925:Thromboplastin / Q000235:genetics* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000494:pharmacology
chemical_list: D053583:Interleukin-1beta; D011372:Progestins; D014409:Tumor Necrosis Factor-alpha; D013925:Thromboplastin; D017258:Medroxyprogesterone Acetate; D013917:Thrombin