title: Connexin 43 is overexpressed in human fetal membrane defects after fetoscopic surgery.
abstract: OBJECTIVE
  We examined whether surgically induced membrane defects elevate connexin 43 (Cx43) expression in the wound edge of the amniotic membrane (AM) and drives structural changes in collagen that affects healing after fetoscopic surgery.
  
  
  METHODS
  Cell morphology and collagen microstructure was investigated by scanning electron microscopy and second harmonic generation in fetal membranes taken from women who underwent fetal surgery. Immunofluoresence and real-time quantitative polymerase chain reaction was used to examine Cx43 expression in control and wound edge AM.
  
  
  RESULTS
  Scanning electron microscopy showed dense, helical patterns of collagen fibrils in the wound edge of the fetal membrane. This arrangement changed in the fibroblast layer with evidence of collagen fibrils that were highly polarised along the wound edge but not in control membranes. Cx43 was increased by 112.9% in wound edge AM compared with controls (p < 0.001), with preferential distribution in the fibroblast layer compared with the epithelial layer (p < 0.01). In wound edge AM, mesenchymal cells had a flattened morphology, and there was evidence of poor epithelial migration across the defect. Cx43 and COX-2 expression was significantly increased in wound edge AM compared with controls (p < 0.001).
  
  
  CONCLUSIONS
  Overexpression of Cx43 in the AM after fetal surgery induces morphological and structural changes in the collagenous matrix that may interfere with normal healing mechanisms. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
authors: Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK.
authors: David W
authors: DW
authors: Barrett
authors: Institute for Women's Health, University College London, London, UK.
authors: Anna L
authors: AL
authors: David
authors: Department of Cell and Developmental Biology, University College London, London, UK.
authors: Christopher
authors: C
authors: Thrasivoulou
authors: Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK.
authors: Alvaro
authors: A
authors: Mata
authors: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
authors: David L
authors: DL
authors: Becker
authors: Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors: Alex C
authors: AC
authors: Engels
authors: Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors: Jan A
authors: JA
authors: Deprest
authors: Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK. t.t.chowdhury@qmul.ac.uk.
authors: Tina T
authors: TT
authors: Chowdhury
mesh_terms: D000328:Adult; D000650:Amnion / Q000293:injuries / Q000378:metabolism* / Q000648:ultrastructure; D016022:Case-Control Studies; D018031:Connexin 43 / Q000235:genetics* / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000235:genetics* / Q000378:metabolism; D005109:Extracellular Matrix; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery; D005332:Fetoscopy; D024021:Fibril-Associated Collagens; D005455:Fluorescent Antibody Technique; D005865:Gestational Age; D065630:Hernias, Diaphragmatic, Congenital / Q000601:surgery; D006801:Humans; D008855:Microscopy, Electron, Scanning; D011247:Pregnancy; D012333:RNA, Messenger / Q000378:metabolism*; D060888:Real-Time Polymerase Chain Reaction; D014945:Wound Healing; D055815:Young Adult
chemical_list: D018031:Connexin 43; D024021:Fibril-Associated Collagens; C500216:GJA1 protein, human; D012333:RNA, Messenger; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human