The Investigation Of Relationship Between Intercellular Adhesion Molecule-1 And Premature Rupture Of Membrane

Objectives : To understand the relationship between intercellular adhesion molecule-1 (ICAM-1) and premature rupture of membrane(PROM),we detect the levels of soluble intercellular adhesion molecule-1(sICAM-1) in serum and ICAM-1 in fetal membranes of pregnant women .Methods : The antecubital venous blood, amniochorion (fetal membranes) samples were collected from 41 nulliparous women undergoing cesarean delivery before the onset of labor, including 15 cases of tPROM, 10 cases of pPROM and 16 cases of term intact membranes as controls. We excluded women with other pregnancy complications, clinical infections and /or undergoing antibiotic treatment. (1) Location and half-quantity of ICAM-1 in fetal membranes were documented with immunohistochemistry. (2) Fetal membranes histology after hematoryline and eosin (HE) staining were performed to identify as the chorioamnionitis and the no chorioamnionitis group. (3) The enzyme-linked immunosorbent assay (ELISA) assayed the levels of sICAM-1 in serum in order to show whether there are differences among the sICAM-1 concentrations of each group. Results were analyzed by using F test, q test, t test, chi-square, Continuity Correction chi-square and linear correlation. For these analyses, P<0.05 was considered statistically significant.Result:1 Protein expression levels of ICAM-1 in fetal membranes of tPROM and pPROM were higher than the levels of control groups[tPROM:(17.28±2.84)×10^-2, P<0.05; pPROM:(17.81±1.73)×10^-2, P<0.05;control: (10.14±3.52)×10^-2], but there were no differences of ICAM-1 in fetal membranes between tPROM and pPROM(P>0.05). ICAM-1 in fetal membranes mainly located in the leukocytes, amniotic epithelial cells ,fibroblasts and chorionic trophoblasts.2 Fetal membranes histology indicated: The rate of pregnant women with chorioamnionitis in PROM groups was greater than that of groups (tPROM: 55.33% ,P<0.05; pPROM:60%, P<0.05; control:12.5%), but there were no significant differences between the and groups(P>0.05).3 Protein expression levels of ICAM-1 in fetal membranes with chorioamnionitis were significantly higher than that with no chorioamnionitis.[(18.97±2.84)×10^-2; (11.85±3.69)×10^-2; P<0.01]. 4 The median serum concentrations of sICAM-1 in patients with PROM were significantly higher than that in controls (tPROM: 82.13±43.46,P<0.05; pPROM: 91.60±48.17, P<0.05; controls: 33.06±21.66,), whereas there were no significant differences in the median serum concentrations of sICAM-1 between the tPROM and pPROM groups (P>0.05) . 5 The median serum concentrations of sICAM-1 with chorioamnionitis were significantly higher than that with no chorioamnionitis(110.24±36.75;36.48±19.21;P<0.01).6 The levels of sICAM-1 in serum and the expression of ICAM-1 in fetal membranes have pertinence in the same experiment group(tPROM :r=0.66,P<0.01;pPROM:r=0.73,P<0.05;r=0.59,P<0.05;control:r=0.59,P<0.05).Conclusion:1 The expression levels of ICAM-1 in fetal membranes of the two PROM groups(ICAM-1 mainly located in the leukocytes, amniotic epithelial cells, fibroblasts, chorionic trophoblasts) are higher than that of control groups, so we can speculate : Fetal membranes can expresse ICAM-1, which so much ICAM-1 is expressed by amniochorion resulted in the cells'dysfunction of fetal membranes and aggravation of fetal membranes'inflamma- tion.2 The levels of sICAM-1 in serum of the two PROM groups are higher than that of control groups, so we can speculate: Pregnant women with PROM have the changes of maternal endothelia cell function; sICAM-1 is a valuable biomarker for PROM with chorioamnionitis.3 The rate of chorioamnionitis in the two PROM groups are higher than that of control groups; ICAM-1 in fetal membranes and sICAM-1 in serum have differences between the groups who have inflammation in fetal membranes and the groups who have no inflammation in fetal membranes, we think sICAM-1and ICAM-1 have osculation relationship with chorioamnionitis, they participate in the inflammation in fetal membranes.4 That the levels of sICAM-1 in serum and the expression of ICAM-1 in fetal membranes have pertinence in the same experiment group suggest that levels of sICAM-1 in serum can reflect the levels of ICAM-1 in fetal membranes.5 The levels of sICAM-1 in serum, the expression of ICAM-1 in fetal membranes and the rate of chorioamnionitis were no significant differences between the tPROM and pPROM groups. We think: tPROM and pPROM have the same or kindred pathological mechanism changes; ICAM-1 may be one factor of the pathogenesis of PROM.