Expression And Meaning Of Nuclear Factor Kappa B (NF-κB), Cyclooxygenase-2 (COX-2) And Matrix Metalloproteinase-9 (MMP-9) In Premature Rupture Of Membrane

Objective:This investigation was designed to research the changes of NF-κB, COX-2 and MMP-9 in premature rupture of membrane and analyze the relationship among NF-κB,COX-2 and MMP-9,so as to help us find a new way to prevent and treat with premature rupture of membrane.Materials and Methods:1. Materials. The study population consisted of patients from the Affiliated Hospital of Yang Zhou University from November 2006 to May 2007.Subjects were divided into two groups:(1)The PROM group which was constituted with follow two parts.①The preterm PROM part(n=12,average maternal age was 28.33±2.57 years old, average gestational age was 33.99±3.69 weeks).②The term PROM part(n=20, average maternal age was 28.20±3.38 years old, average gestational age was 39.14±0.83 weeks).(2)The normal group(n=20,average maternal age was 27.30±1.56 years old, average gestational age was 39.99±1.06 weeks).The two groups did not differ in maternal age and gestational age. All cases were eligible for inclusion with a singleton live fetus in cephalic presentation and primiara vaginally. They had no any of disorders of pregnancy and inducements of PROM, such as trauma, sexual intercourse, and et al.2. Methods. (1)A piece of membrane(2cm×2cm) was immediately collected after labor, formalin-fixed at least 24 hours, paraffin-embedded, HE stain. After diagnosing chorioamnionitis, all cases were divided into two groups: chorioamnionitis group and non-chorioamnionitis group. (2)The expression of NF-κB, COX-2 and MMP-9 in fetal membranes was evaluated by immunohistochemical method.(3)The expression of NF-κB, COX-2 and MMP-9 in fetal membranes was done by western blot method (choose 10 cases randomly from each part).Statistical analysis was performed with SPSS10.0 software, using t-test, analysis of variance and linear correlation analysis. Statistically significant level was considered as"alpha equals 0.05".Results:1. After HE stain, the infection rate in the PROM group was 46.88% (15/32), in the tPROM part 35.00% (7/20) and the pPROM part 66.67% (8/12).In the normal group, the infection rate was 10.00%(2/20).2. The protein expression of NF-κB, COX-2 and MMP-9 in fetal membranes was significantly higher in the PROM group than that in the normal group(p<0.05). The expression of NF-κB,COX-2 and MMP-9 in the chorioamnionitis group was significantly higher than that in the non-chorioamnionitis group(p<0.05).There were significantly positive correlations among NF-κB,COX-2 and MMP-9(p<0.01).Conclusion:The high expression of NF-κB, COX-2 and MMP-9 may play an important role in the pathogenesis of premature rupture of membrane. The expression of COX-2, MMP-9 was significantly positive correlations with the expression of NF-κB. We presume that the expression of COX-2, MMP-9 was regulated by NF-κB. The activation of NF-κB may be a key point in the origination of PROM. The inhibitor of NF-κB probably becomes a new way to prevent and treat with premature rupture of membrane.