OBJECTIVE:
This study was designed to investigate the
presence of matrix metalloproteinase-2 (gelatinase A), matrix
metalloproteinase-9 (gelatinase B), and their natural inhibitors in
both cultured amniochorionic membrane and membrane obtained
from women with infection- associated preterm labor.
STUDY DESIGN:
Amniochorionic membranes were collected from
women with documented intraamniotic infection and from women
not in labor undergoing elective repeat cesarean section with no
signs of infection or other complications of pregnancy. Normal
membranes were cultured and exposed to endotoxin and
peptidoglycan polysaccharide. Messenger ribonucleic acid
expression for gelatinase A, gelatinase B, and tissue inhibitors of
matrix metalloproteinase types 1 and 2 was studied with use of
reverse transcriptase-polymerase chain reaction and localization
of messenger ribonucleic acid was accomplished with use of in
situ hybridization. Release of gelatinases from the membranes
was studied with gelatin zymography. Tissue inhibitors of matrix
metalloproteinase peptides were localized with use of
immunocytochemistry.
RESULTS:
The expression of matrix
metalloproteinase types 2 and 9 was seen in amniochorionic
membranes in culture. Matrix metalloproteinase-2 was seen in
membranes from nonlaboring women and in women with
intraamniotic infection, whereas matrix metalloproteinase-9 was
seen only in membranes from women with intraamniotic infection.
The matrix metalloproteinase-9 expression could also be induced
by lipopolysaccharide or peptidoglycan polysaccharide
stimulation in culture. In situ hybridization localized messenger
ribonucleic acid for these matrix metalloproteinases to both
amnion and chorion. Zymogram studies showed the activity of
matrix metalloproteinase-2 in normal resting membrane and
cultured membrane. Matrix metalloproteinase-9 was induced by
culture conditions. Tissue inhibitor of matrix metalloproteinase-1
and tissue inhibitor of matrix metalloproteinase-2 messenger
ribonucleic acid was seen in normal, infected, and cultured
membranes. In situ hybridization data indicated that these
messages were mainly produced by chorion, but they were also
seen in amnion. Immunohistochemistry demonstrated the
presence of tissue inhibitor of matrix metalloproteinase-1 and
tissue inhibitor of matrix metalloproteinase-2 peptides in both
amnion and chorion and in cells of the reticular layer of the
matrix.
CONCLUSIONS:
Normal amniochorionic membrane is a
source of matrix metalloproteinase-2 and tissue inhibitors of
matrix metalloproteinases. Culture conditions and infection
induce matrix metalloproteinase-9 expression and release from
amniochorion. These findings suggest that these collagenolytic
enzymes may play a role in premature rupture of the membranes
in infection, which can lead to preterm labor.