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  • Title: Expression of matrix metalloproteinases and their inhibitors at the feto-maternal interface in unruptured ectopic tubal pregnancy.
    Author: Qiu X, Xie Y, Chen L, Gemzell-Danielsson K.
    Journal: Acta Obstet Gynecol Scand; 2011 Sep; 90(9):966-71. PubMed ID: 21644936.
    Abstract:
    OBJECTIVE: To investigate expression of matrix metalloproteinases (MMPs) and the tissue inhibitors of MMPs (TIMPs) at the feto-maternal interface and non-implantation sites in unruptured tubal pregnancies. DESIGN: Prospective study. Setting. University teaching hospital. POPULATION: Eighteen patients with unruptured tubal pregnancy undergoing salpingectomy. METHODS: Immunohistochemistry was used to detect MMP-2, -9 and -14, and TIMP-1, -2 and -3 at the feto-maternal interface and non-implantation regions of the Fallopian tube. Serum levels of human chorionic gonadotropin (β-hCG) were determined, and trophoblastic invasion was histologiclly classified as stage I when limited to the tubal mucosa and stage II when extending to the muscular layer. MAIN OUTCOME MEASURES: The relation between serum β-hCG concentration with the depth of trophoblastic invasion into the tubal wall and differential expression of MMPs and TIMPs. RESULTS: A significant difference in the β-hCG concentrations was seen between stage I and II invasion. Immunoreactivity for MMP-2, -9 and -14, and TIMP-1, -2 and -3 was primarily localized to cytotrophoblasts. At the implantation sites, the intensity of MMPs increased along the invasive pathway towards the maternal interstitium. The expression of MMP-2, MMP-14 and TIMP-3 was localized to the epithelium and smooth muscle cells of the Fallopian tube, while expression of MMP-9, TIMP-1 and TIMP-2 was weak or absent. CONCLUSIONS: Human chorionic gonadotropin correlated positively with invasion stage of trophoblasts. At ectopic implantation sites, the expression of MMPs gradually increased with increasing invasion depth of trophoblasts. TIMP-1 and TIMP-2 were only weakly expressed. The imbalance between expression of MMPs and TIMPs at the ectopic implantation sites may lead to the extensive destructive degradation of the extracellular matrix.
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