High MMP-9 and TNF-α expression increase in preterm premature rupture of membranes
Abstract: Preterm delivery is
one of the causes of high perinatal morbidity and mortality. Matrix
metalloproteinase 9 (MMP-9) is important for extracellular matrix (ECM)
remodeling and may cause preterm labor and premature rupture of membranes
(PROM). Tumor necrosis factor-α (TNF-α) as a pro-inflammatory cytokine plays a
role in stimulating uterine activity and cervical ripening by degrading the ECM
of the amniotic membranes through MMP-9. This study aimed to determine
differences between MMP-9 and TNF-α expression of the membranes in preterm
delivery with premature rupture of membranes (PPROM) and without PROM.
An analytic observational study with cross-sectional approach was
conducted in 24 subjects, who were divided into 2 groups, with 12 subjects in
the preterm delivery group with PROM and 12 subjects in the preterm delivery
group without PROM. The expression of MMP-9 and TNF-α in the amniotic membrane
was determined by immunohistochemistry. Data were analyzed using the t test.
MMP-9 expression in the amniotic membrane of preterm delivery subjects
with PROM (8.6 ± 3.1%/field) differed significantly with that of preterm
delivery subjects without PROM (5.5 ± 2.3 %/ field) (p=0.001). TNF-α expression
in the amniotic membrane of preterm delivery subjects with PROM (8.0
±3.0%/field) also differed significantly with that of preterm delivery subjects
without PROM (3,3 ± 1.5%/field) (p=0.000).
Expression of MMP-9 and TNF-α was higher in the amniotic membrane of
preterm delivery subjects with PROM than in preterm delivery subjects without
PROM and can thus be used as predictor to avoid PPROM.
Author: Sri Sulistyowati, Yuniarsih
Zakia, Soetrisno Khasan
Journal Code: jpkedokterangg160043