Inflammation and Neurotransmission of the Vescico-Uterine Space in Cesarean Sections

European Journal of Inflammation

Letter to the Editor

C. Cavallotti¹  A. Creanza²  A. Malvasi²  G.C. Di Renzo³  A. Tinelli⁴  E. Pacella⁵  O.A. Mynbaev⁶  D. Dell'Edera⁷ 

[1] Department of Human Anatomy, University Sapienza, Rome, Italy;Department of Obstetric and Gynecology, Santa Maria Hospital, Bari, Italy;Department of Obstetric ns Gynecology, University of Perugia, Italy;Department of Obstetrics and Gynecology, Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Lecce, Italy;Department of Ophthalmology, Sapienza University, Rome, Italy;Experimental Researches and Modelling Division, Moscow State University of Medicine and Dentistry, Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples' Friendship University of Russia, Moscow, Russia;Unit of Cytogenetic and Molecular Genetics, Madonna delle Grazie Hospital, Matera, Italy;

关键词: Cesarean section;    inflammation;    cervical ripening;    collagen IV;    laminin;    Neurotensin (NT);    Neuropeptide Tyrosine (NPY);    Protein Gene Product 9.5 (PGP 9.5);    Vescico-Uterine Space (VUS);    lower uterine segment;    labour;    neurotransmitters;    neuropeptides;    VBAC;   

DOI  :  10.1177/1721727X1301100125

 received in 2012-02-13, accepted in 2012-10-30,  发布年份 2013

来源: Sage Journals

【 摘 要 】

Collagen IV and laminin play a key role in regulating stiffness, elasticity and flexibility of the vescico-uterine space (VUS) tissue. The neurotensin (NT), the neuropeptide tyrosine (NPY) and the protein gene product 9.5 (PGP 9.5) possessing vasorelaxation and tissue vascularization activities, play key roles in cervical ripening, scar innervations and pain control. We propose that the integrity of these substances in VUS tissue is compromised after Cesarean section (CS), since wound healing disturbances and pelvic pain, as well as pregnancy and delivery complications, are related with lower uterine segment dysfunctions after CS. Therefore, the contents of collagen IV, laminin, NT, NPY and PGP 9.5 nerve fibres from the VUS tissue samples obtained during the first CS and the repeated CS were comparatively studied. VUS specimens were collected from 104 patients during CS and evaluated by immunohistochemistry. Collagen IV and laminin were mostly found in the vascular membrane bounds and their images were quantitatively evaluated by Quantimet Leica analyzer software. Differences of collagen IV, laminin, NT, NPY and PGP 9.5 values in VUS tissue between the first CS and the repeat CS samples were calculated by Student's Mest. Reduced laminin and increased collagen IV values were observed in the VUS scar tissue after the repeated CS in comparison with those of VUS intact tissue obtained during the first CS. Significantly higher values of nerve fibres, containing NT, NPY and PGP 9.5 were registered in intact VUS tissue samples, respectively 5±0.7, 7±0.6 and 5±0.9 CU, than those of VUS scar tissue samples obtained during the repeated CS, respectively 3±0.6,2±0.4 and 3±0.7 CU (p<0.05). The authors observed increased collagen IV and reduced laminin values after the repeated CS which might be the key signs of inflammatory damage of VUS scar tissue by CS. These findings were strengthened by the registration of decreased NT, NPY and PGP 9.5 values in the same samples, which are important neurotransmitters and are responsible for optimal wound healing, pain control and lower uterine segment functions.

【 授权许可】

Unknown   
© 2013 SAGE Publications