Prostaglandin treatment is associated with a withdrawal of progesterone and androgen at the receptor level in the uterine cervix.
Treatment with prostaglandin(PG)-E2 is clinically efficient for cervical priming. The aim of this study was to evaluate the impact of PG-E2 on the expression of the progesterone (PR), androgen (AR) and glucocorticoid (GR) receptors in human uterine cervix in prolonged pregnancy. The study groups were postterm nulliparous women with unripe cervices undergoing cervical priming with PG-E2 before labor induction. Responders (n = 12) who delivered vaginally were compared with non-responders (n = 10), who underwent cesarean section due to failure to progress to the active phase of labor. Controls (n = 18) with vaginal partus at a normal gestational age served as a reference group. Cervical levels of PR-A and PR- B isoforms, AR and GR, serum levels of their ligands and sex hormone-binding globulin (SHBG) were quantified. The responder group displayed lower total PR-AB and AR protein levels as compared to non-responders, and lower PR-B and AR protein levels as compared to controls. In addition, the PR mRNA level was lower in responders as compared to non-responders. The GR protein level did not differ between the groups. We conclude that successful PG-E2 priming was followed by a progesterone and androgen withdrawal at the receptor level in the uterine cervix.
Division for Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. ylva.vladic-stjernholm@karolinska.se
Ylva
Y
Vladic-Stjernholm
Tomislav
T
Vladic
Chellakkan S
CS
Blesson
Gunvor
G
Ekman-Ordeberg
Lena
L
Sahlin
D000328:Adult; D000728:Androgens / Q000097:blood / Q000378:metabolism; D002584:Cervix Uteri / Q000187:drug effects* / Q000378:metabolism; D015232:Dinoprostone / Q000494:pharmacology* / Q000627:therapeutic use; D015536:Down-Regulation / Q000187:drug effects / Q000235:genetics; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007751:Labor, Induced / Q000379:methods; D011247:Pregnancy; D011374:Progesterone / Q000097:blood / Q000378:metabolism; D011944:Receptors, Androgen / Q000235:genetics / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000235:genetics / Q000378:metabolism*; D016896:Treatment Outcome; D055815:Young Adult
D000728:Androgens; D012739:Gonadal Steroid Hormones; D011944:Receptors, Androgen; D011980:Receptors, Progesterone; D011374:Progesterone; D015232:Dinoprostone