The Study Of The Relationship And Expression Between MIF And MMP-9 In Fetal Membranes Of Pregnant Women With Premature Rupture Of Membrane

Objective: To investigation the distributions and expressions of MIF and MMP-9 inthe PROM puerperants, and compared with the normal puerperants,find out their differentiation of the expressions.Approaching the role ofMIF and MMP-9 in the pathogenesy of PROM, searching for a newmethod to prevent PROM. Found study the variabilities of theexpressions of MIF and MMP-9 in patients with chorioamnionitis andunchorioamnionitis in histopathology diagnosis, and approaching theirrelationship. To provide a new way and scientific basic to diagnosis thePROM combined with subclinical chorioamnionitis and institute theclinical method of prevention and cure.Method: 76 patients with puerperants who delivered in the General Hospital ofTianjin Medical Univercity between June 2005 and December 2006 wereselected. There are two sub-groups included in the experimental andcontrol group separately: one is full term PROM cesarean section deliverygroup (PROM), the other is pro-full term PROM vaginal delivery group(PPROM) in the experimental group, one is full term cesarean sectiondelivery group (control group 1), the other is full term vaginal delivery group (control group 2) in control group. Detecting the distributions andexpressions of MIF and MMP-9 in the embryolemma by the method ofimmunohistochemistry and analyzing their statistic variability.chorioamnionitis or unchorioamnionitis was diagnosed with HE, anddetermining the results between the expressions of MIF and MMP-9. theRelationship of the expressions between MIF and MMP-9 in PROM andchorioamnionitis was investigated.Results: 1. the expressions at different level of MIF and MMP-9 locating in theendochylema of the amnio-endothelial cells and basal membrane cellsin each group were found.2. The expression of MIF in embryolemma of the full term PROM cesareansection delivery group (PROM) is higher than that of the full termcesarean section delivery group (control group 1) obviously, and theirdifferent is significant in statistics (p＜0.05).3. The expression of MMP-9 in embryolemma of the full term PROMcesarean section delivery group (PROM) is higher than that of the fullterm cesarean section delivery group (control group 1) obviously, andtheir different is significant in statistics (p＜0.05).4. The expression of MIF in embryolemma of the pro-full term PROMvaginal delivery group (PPROM) is higher than that of the full termvaginal delivery group (control group 2) obviously, and their different issignificant in statistics (p＜0.05).5. The expression of MMP-9 in embryolemma of the pro-full term PROMvaginal delivery group (PPROM) is higher than that of the full termvaginal delivery group (control group 2) obviously, and their different issignificant in statistics (p＜0.05).6. The expressions of MIF and MMP-9 in embryolemma of midrange and serious chorioamnionitis groups are higher than those ofunchorioamnionitis and light chorioamnionitis groups obviously, andtheir different is significant in statistics (p＜0.05).7. There is statistic positive relationship between MIF and MMP-9 inembryolemma of all the selected puerperants.Conclusion: 1. As a kind of wide-effected ante-inflammatory factors, theexpression of MIF is at a high level in embryolemma of PROMpatients. This suggests that MIF plays a very important role in thepathogeny of PROM, and MIF also provides a new theoretic basicto the etiology of PROM.2. The expression of MMP-9 is high in patients with PROM, itsuggests that the increased activity of MMP-9 can promote thedegradation of collagen in embryolemma greatly, consequentlyinduce the disequilibrium of MMP/TIMP. This may be theimportant physiological foundation of the rupture of membranes.3. By controlling AP-1 or NF-_KB, MIF can promote the expressionof MMP-9 indirectly and increase its activity, which causes thedegradation of collagen in embryolemma greatly, and thenconsequently induces the disequilibrium of MMP/TIMP, soPROM happens, and they are of dependability.4. PROM and chorioamnionitis have the relationship of the reasonfor each other, the relationship between pro-full term PROMand inflammation is more closer than that of PROM andchorioamnionitis. The expressions of MIF and MMP-9 are highin midrange and serious chorioamnionitis, this suggests thatMIF and MMP-9 play important roles in the inflammatorymechanism of chorioamnionitis. MIF and MMP-9 provide a new target to the early diagnosis of chorioamnionitis.