BJOG: An International Journal of Obstetrics and Gynaecology 2015-12-01

Evidence of an immunosuppressive effect of progesterone upon in vitro secretion of proinflammatory and prodegradative factors in a model of choriodecidual infection.

M Pineda-Torres, P Flores-Espinosa, A Espejel-Nunez, G Estrada-Gutierrez, A Flores-Pliego, R Maida-Claros, V Zaga-Clavellina

Index: BJOG 122 , 1798-807, (2015)

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Abstract

To evaluate whether progesterone (P4) is able to modulate the secretion of tumour necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8, IL-10 and matrix metalloproteinase-9 (MMP-9) after choriodecidual stimulation with lipopolysaccharide (LPS).Chorioamnionitis-elicited preterm delivery is associated with an uncontrolled secretion of proinflammatory cytokines that may induce MMPs, which modify the fine immunological and structural equilibrium at the fetal-maternal interface.Instituto Nacional de Perinatología 'Isidro Espinosa de los Reyes', Mexico City.Twelve human fetal membranes at term from healthy patients were placed in a two-chamber culture system.Choriodecidual and amniotic regions were preincubated with 1.0, 0.1, or 0.01 μmol/l P4 for 24 hours; after which the choriodecidual region was costimulated with 1000 ng/ml of LPS for 24 hours.Descriptive statistics were obtained for each variable. Data distribution was tested for normality using Kolmogorov-Smirnoff and Shapiro-Wilk tests. When distribution was normal, Student's t test was used to analyse for differences among groups. Mann-Whitney's U test was used when data were not normally distributed.Pretreatment with 1.0 μmol/l P4 significantly blunted the secretion of TNF-α, IL-1β, IL-6, IL-8 and IL-10. MMP-9 was inhibited with 0.1 μmol/l P4. Mifepristone (RU486) blocked the immunosuppressive effect of P4, suggesting a P4 effect mediated by its receptor.These results offer evidence to support the concept that P4 can protect the fetal-placental unit through a compensatory mechanism that partially limits the secretion of proinflammatory and prodegradative modulators.© 2014 Royal College of Obstetricians and Gynaecologists.