title: Prednisolone treatment reduces endometrial spiral artery development in women with recurrent miscarriage.
abstract: BACKGROUND
  Uterine natural killer (uNK) cells and endometrial blood vessel maturation are increased in the luteal phase of the menstrual cycle in a subset of women with recurrent miscarriage (RM). uNK cell numbers are reduced after treatment with prednisolone (20 mg/day for 3 weeks).
  
  
  OBJECTIVE
  Prednisolone treatment reduces endometrial vascular maturation and angiogenic growth factor expression in women with RM with increased uNK cells.
  
  
  METHODS
  Endometrial biopsies (n = 18 paired samples) from women with RM at LH + 7 before and during prednisolone treatment (20 mg/day for 3 weeks) were snap frozen. Total RNA and cDNA was prepared and used in a human angiogenesis RT-PCR superarray (84 genes, n = 6 pairs) with results validated using RT-PCR (n = 15 pairs). Immunohistochemistry (n = 15 pairs) was performed for Factor VIII, α-smooth muscle actin (α-SMA) and myosin heavy chain (MyHC) and the total number of vessels and the percentage of vessels completely surrounded by vascular smooth muscle cells (VSMCs) were determined.
  
  
  RESULTS
  During prednisolone treatment there was no change in the total number of endometrial blood vessels but the percentage of vessels completely surrounded by VSMCs was decreased (α-SMA P < 0.0001; MyHC P < 0.0001). Endometrial EGF and STAB 1 expression was decreased during prednisolone treatment in samples from woman who went on to have a live birth.
  
  
  CONCLUSIONS
  The effect of prednisolone therapy for some women with RM may be due to altered endometrial angiogenic growth factor expression and reduced blood vessel maturation.
authors: Reproductive and Vascular Biology Group, Institute of Cellular Medicine, Newcastle University, 3rd Floor, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK. g.e.lash@ncl.ac.uk
authors: Gendie E
authors: GE
authors: Lash
authors: Judith N
authors: JN
authors: Bulmer
authors: Barbara A
authors: BA
authors: Innes
authors: Josephine A
authors: JA
authors: Drury
authors: Stephen C
authors: SC
authors: Robson
authors: Siobhan
authors: S
authors: Quenby
mesh_terms: D000026:Abortion, Habitual / Q000188:drug therapy* / Q000473:pathology*; D000199:Actins / Q000378:metabolism; D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000378:metabolism*; D004717:Endometrium / Q000098:blood supply* / Q000187:drug effects; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007694:Killer Cells, Natural / Q000187:drug effects; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000166:cytology / Q000187:drug effects*; D018995:Myosin Heavy Chains / Q000378:metabolism; D018919:Neovascularization, Physiologic / Q000187:drug effects* / Q000502:physiology; D011239:Prednisolone / Q000494:pharmacology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D006113:United Kingdom; D014599:Uterus / Q000166:cytology / Q000276:immunology
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D043925:Angiogenesis Inducing Agents; D005169:Factor VIII; D011239:Prednisolone; D018995:Myosin Heavy Chains