Preterm labor in the absence of acute histologic chorioamnionitis is characterized by cellular senescence of the chorioamniotic membranes

Am J Obstet Gynecol. 2017 Nov;217(5):592.e1-592.e17. doi: 10.1016/j.ajog.2017.08.008. Epub 2017 Aug 25.

Abstract

Background: Decidual senescence has been considered a mechanism of disease for spontaneous preterm labor in the absence of severe acute inflammation. Yet, signs of cellular senescence have also been observed in the chorioamniotic membranes from women who underwent the physiological process of labor at term.

Objective: We aimed to investigate whether, in the absence of acute histologic chorioamnionitis, the chorioamniotic membranes from women who underwent spontaneous preterm labor or labor at term exhibit signs of cellular senescence.

Study design: Chorioamniotic membrane samples were collected from women who underwent spontaneous preterm labor or labor at term. Gestational age-matched nonlabor controls were also included. Senescence-associated genes/proteins were determined using reverse transcription quantitative polymerase chain reaction analysis (n = 7-9 each for array; n = 26-28 each for validation), enzyme-linked immunosorbent assays (n = 7-9 each), immunoblotting (n = 6-7 each), and immunohistochemistry (n = 7-8 each). Senescence-associated β-galactosidase activity (n = 7-11 each) and telomere length (n = 15-22 each) were also evaluated.

Results: In the chorioamniotic membranes without acute histologic chorioamnionitis: (1) the expression profile of senescence-associated genes was different between the labor groups (term in labor and preterm in labor) and the nonlabor groups (term no labor and preterm no labor), yet there were differences between the term in labor and preterm in labor groups; (2) most of the differentially expressed genes among the groups were closely related to the tumor suppressor protein (TP53) pathway; (3) the expression of TP53 was down-regulated in the term in labor and preterm in labor groups compared to their nonlabor counterparts; (4) the expression of CDKN1A (gene coding for p21) was up-regulated in the term in labor and preterm in labor groups compared to their nonlabor counterparts; (5) the expression of the cyclin kinase CDK2 and cyclins CCNA2, CCNB1, and CCNE1 was down-regulated in the preterm in labor group compared to the preterm no labor group; (6) the concentration of TP53 was lower in the preterm in labor group than in the preterm no labor and term in labor groups; (7) the senescence-associated β-galactosidase activity was greater in the preterm in labor group than in the preterm no labor and term in labor groups; (8) the concentration of phospho-S6 ribosomal protein was reduced in the term in labor group compared to its nonlabor counterpart, but no differences were observed between the preterm in labor and preterm no labor groups; and (9) no significant differences were observed in relative telomere length among the study groups (term no labor, term in labor, preterm no labor, and preterm in labor).

Conclusion: In the absence of acute histologic chorioamnionitis, signs of cellular senescence are present in the chorioamniotic membranes from women who underwent spontaneous preterm labor compared to those who delivered preterm in the absence of labor. However, the chorioamniotic membranes from women who underwent spontaneous labor at term did not show consistent signs of cellular senescence in the absence of histologic chorioamnionitis. These results suggest that different pathways are implicated in the pathological and physiological processes of labor.

Keywords: acute histologic chorioamnionitis; cell cycle; cyclin kinases; cyclin-dependent kinase inhibitor 1 (p21); cyclins; decidua parietalis; human; intraamniotic infection; parturition; pregnancy; preterm birth; preterm labor; senescence-associated β-galactosidase; sterile inflammation; telomere length; tumor suppressor protein 53.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amnion / cytology*
  • Amnion / metabolism
  • Cellular Senescence / genetics*
  • Chorioamnionitis / pathology
  • Chorion / cytology*
  • Chorion / metabolism
  • Cyclin A2 / genetics
  • Cyclin B1 / genetics
  • Cyclin E / genetics
  • Cyclin-Dependent Kinase 2 / genetics
  • Cyclin-Dependent Kinase Inhibitor p21 / genetics
  • Down-Regulation
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gestational Age
  • Humans
  • Immunohistochemistry
  • Labor, Obstetric / genetics*
  • Labor, Obstetric / metabolism
  • Obstetric Labor, Premature / genetics*
  • Obstetric Labor, Premature / metabolism
  • Oncogene Proteins / genetics
  • Phosphoproteins / metabolism
  • Pregnancy
  • Reverse Transcriptase Polymerase Chain Reaction
  • Ribosomal Protein S6 / metabolism
  • Transcriptome
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism
  • Up-Regulation
  • Young Adult
  • beta-Galactosidase / metabolism

Substances

  • CCNA2 protein, human
  • CCNB1 protein, human
  • CCNE1 protein, human
  • CDKN1A protein, human
  • Cyclin A2
  • Cyclin B1
  • Cyclin E
  • Cyclin-Dependent Kinase Inhibitor p21
  • Oncogene Proteins
  • Phosphoproteins
  • Ribosomal Protein S6
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • CDK2 protein, human
  • Cyclin-Dependent Kinase 2
  • beta-Galactosidase