Connective Tissue and Related Disorders and Preterm Birth: Clues to Genes Contributing to Prematurity

Anum, Emmanuel A.; Hill, Lilian H.; Pandya, Arti; Strauss, Jerome F.

doi:10.1016/j.placenta.2008.12.007

Cited by 99 publications

(92 citation statements)

References 123 publications

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“…collagen architecture is likely to be important for cervical remodeling in women as well, as women with genetic defects that alter collagen processing and assembly (e.g. Ehlers Danlos syndrome) are predisposed to PTB resulting from cervical insufficiency (32,33). A noninvasive methodology for visualizing changes in cervical collagen organization thus would have the potential to improve diagnosis and treatment in cases where preterm birth involves premature or abnormal remodeling of cervical collagen.…”

Section: Discussionmentioning

confidence: 99%

A compact fiber-optic SHG scanning endomicroscope and its application to visualize cervical remodeling during pregnancy

Zhang

Akins²,

Murari

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

155

119

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We report the development of an all-fiber-optic scanning endomicroscope capable of high-resolution second harmonic generation (SHG) imaging of biological tissues and demonstrate its utility for monitoring the remodeling of cervical collagen during gestation in mice. The endomicroscope has an overall 2.0 mm diameter and consists of a single customized double-clad fiber, a compact rapid two-dimensional beam scanner, and a miniature compound objective lens for excitation beam delivery, scanning, focusing, and efficient SHG signal collection. Endomicroscopic SHG images of murine cervical tissue sections at different stages of normal pregnancy reveal progressive, quantifiable changes in cervical collagen morphology with resolution similar to that of bench-top SHG microscopy. SHG endomicroscopic imaging of ex vivo murine and human cervical tissues through intact epithelium has also been performed. Our findings demonstrate the feasibility of SHG endomicroscopy technology for staging normal pregnancy, and suggest its potential application as a minimally invasive tool for clinical assessment of abnormal cervical remodeling associated with preterm birth.nonlinear endomicroscopy | fiber-optic scanning probe | cervical collagen remodeling | parturition T he cervix is a connective tissue-rich structure just caudal to the uterus in female mammals. Appropriate remodeling of the cervix during gestation is an essential component of the birth process (1, 2). The cervix must remain closed during pregnancy to maintain the fetus in the womb, and then open sufficiently to allow passage of the fetus at term. This shift in responsibility requires a massive rearrangement of the cervical connective tissue, in particular fibrillar collagen. Collagen is the main structural protein in the cervix. Animal studies reveal rearrangement of collagen structure is achieved in part by a decline in collagen crosslink formation, a reduction in matricellular proteins that regulate collagen fibrillogenesis, and increased synthesis of the matrix disorganizing molecule, hyaluronan (3, 4). Evidence to support a conservation of these processes in cervical remodeling in women is mounting (5). Abnormal or inappropriately timed cervical remodeling can lead to premature birth.Preterm birth (PTB), which accounts for 12.7% of all births in the United States, is the second leading cause of infant mortality and often leads to serious morbidity in surviving infants (6). Despite considerable research, the cause of PTB in 50% of cases remains elusive, and diagnostic methods to detect women at risk of PTB are limited (7). Because clinical and animal studies suggest that cervical changes precede the onset of uterine contractility in both term and PTB, premature cervical changes could be indicative of impending PTB (4, 8-10). The progressive structural changes in fibrillar collagens are directly related to cervical rigidity and thus potentially can serve as a diagnostic indicator for women at risk for PTB.Second harmonic generation (SHG) microscopy is the most effective ...

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Section: Discussionmentioning

confidence: 99%

A compact fiber-optic SHG scanning endomicroscope and its application to visualize cervical remodeling during pregnancy

Zhang

Akins²,

Murari

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

155

119

View full text Add to dashboard Cite

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“…Finally, PPROM has been associated with genetic disorders of collagen structure, such as Ehlers-Danlos syndrome (75), and with a variety of single-nucleotide polymorphisms (76).…”

Section: S T a T E O F T H E A R T R E V I E Wmentioning

confidence: 99%

Prevention of preterm birth: Harnessing science to address the global epidemic

et al. 2014

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“…Besides previous sPTB, short CL during pregnancy can be the consequence of several factors: congenital malformations [40,41], previous surgery of the uterine cervix [42][43][44], subclinical intra-amniotic infection and/or inflammation [45][46][47][48][49] and cervical insufficiency [50,51].…”

Section: Patient Obstetrical and Medical Historymentioning

confidence: 99%