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Title: Regulation of inflammatory mediators by antigestagens at the uteroplacental interface
Author: Elliott, Catherine L.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1998
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This thesis describes a randomised placebo-controlled clinical trial to assess the effectiveness of mifepristone in causing cervical ripening in women at term. This showed that the administration of 200 mg mifepristone to primigravid pregnant women with unfavourable cervices at term significantly improved cervical ripening as compared with placebo (p=0.01), whereas the improvement following the administration of 50mg mifepristone to comparable women was just below the level of significance. The role of antigestagens in the regulation of inflammatory mediators in uterine tissues is as yet unclear. Laboratory studies were performed to investigate the effects of antigestagens on the production of IL-8 and other mediators by placenta, decidua and cervix. These studies found that placenta and decidua obtained in the third trimester and cervical tissue from the first trimester all produced IL-8. In the third trimester IL-8 was demonstrated in placenta and decidua by immunohistochemistry and shown to be localised to perivascular regions, which is in keeping with its putative role in neutrophil migration into uterine tissues. The production of IL-8 by placental explants was significantly increased (p<0.05) in samples collected after spontaneous vaginal delivery as compared with those from pre-labour caesareans. Culture of placental explants with antigestagens produced a variable, but generally increased effect on IL-8 production. For example, onapristone caused a significant increase in IL-8 production by explants from spontaneously delivered placentae. The effects of progesterone, dexamethasone and mifepristone on production of IL-8 by decidual explants was examined.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available