title: Prolidase, matrix metalloproteinases 1 and 13 activity, oxidative-antioxidative status as a marker of preterm premature rupture of membranes and chorioamnionitis in maternal vaginal washing fluids.
abstract: OBJECTIVE
  Etiology of premature preterm rupture of membranes (PPROM) is not yet completely known and chorioamnionitis is one of the most important complications of its. We aimed to evaluate whether prolidase, matrix metalloproteinases, oxidative-antioxidative status, and inflammation markers in vaginal washing fluid (VWF) were associated with etiology of PPROM and whether these markers could be used to predict chorioamnionitis in PPROM.
  
  
  METHODS
  This prospective case control study enrolled fifty pregnant women with PPROM and 50 healthy pregnant women. The VWF samples were taken at the time of admission in the PPROM group and patients were followed for chorioamnionitis. Prolidase, matrix metalloproteinases, oxidative-antioxidative status, and inflammation markers in VWF were assayed.
  
  
  RESULTS
  VWF levels of prolidase, matrix metalloproteinases 1-13 (p< 0.001), oxidative stress parameters, total oxidative stress (TOS) (p < 0.001) and oxidative stress index (OSI) (p = 0.002), and hs-CRP (p = 0.045) were significantly higher in the PPROM group than in the controls. Antioxidative status parameters, levels of paroxanase (PON-1) (p < 0.001) and total antioxidant capacity (TAC) (p < 0.001), were significantly lower in the PPROM group than in the controls. Mean VWF levels of prolidase (p < 0.001), metalloproteinases (p<0.05), and oxidative-antioxidative status parameters (p<0.05) were significantly different in women with versus women without chorioamnionitis in the PPROM group. Prolidase, MMP-13, TOS, TAC, and PON-1 were found as important predictors for chorioamnionitis in the PPROM group by the multivariate logistic regression analysis. When the ROC curve analysis for prolidase, MMP-13, TOS, TAC, and PON-1 were performed, all of them were statistically significant for area under the curve (areas under the curve were 0.94, 0.90, 0.80, 0.25, and 0.19, respectively).
  
  
  CONCLUSIONS
  This study showed that collagen turnover mediators, especially prolidase, and increased oxidative stress are significantly associated with PPROM. Also, chorioamnionitis can be predicted with prolidase, MMP-13, TOS, TAC, and PON-1 in PPROM patients.
authors: Department of Gynecology and Obstetrics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. endersoydinc@hotmail.com
authors: Hatice Ender
authors: HE
authors: Soydinc
authors: Muhammet Erdal
authors: ME
authors: Sak
authors: Osman
authors: O
authors: Evliyaoglu
authors: Mehmet Sıddık
authors: MS
authors: Evsen
authors: Abdulkadir
authors: A
authors: Turgut
authors: Ali
authors: A
authors: Özler
authors: İsmail
authors: İ
authors: Yıldız
authors: Talip
authors: T
authors: Gul
mesh_terms: D000975:Antioxidants / Q000378:metabolism*; D043303:Aryldialkylphosphatase / Q000378:metabolism; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism*; D006801:Humans; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism*; D053509:Matrix Metalloproteinase 13 / Q000378:metabolism*; D018384:Oxidative Stress / Q000502:physiology; D011247:Pregnancy; D011446:Prospective Studies; D014621:Vagina / Q000378:metabolism
chemical_list: D000975:Antioxidants; D043303:Aryldialkylphosphatase; D053509:Matrix Metalloproteinase 13; D020781:Matrix Metalloproteinase 1
keywords: chorioamnionitis; matrix metalloproteinases; paraoxonase-1; premature preterm rupture of membrane; prolidase; total antioxidative capacity; total oxidative status; vaginal washing fluid.
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