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Costa E, Thrasivoulou C, Becker DL, Deprest JA, David AL, Chowdhury TT. Cx43 regulates mechanotransduction mechanisms in human preterm amniotic membrane defects. Prenat Diagn 2023; 43:1284-1295. [PMID: 37649228 DOI: 10.1002/pd.6429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The effects of mechanical stimulation in preterm amniotic membrane (AM) defects were explored. METHODS Preterm AM was collected from women undergoing planned preterm caesarean section (CS) due to fetal growth restriction or emergency CS after spontaneous preterm prelabour rupture of the membranes (sPPROM). AM explants near the cervix or placenta were subjected to trauma and/or mechanical stimulation with the Cx43 antisense. Markers for nuclear morphology (DAPI), myofibroblasts (αSMA), migration (Cx43), inflammation (PGE2 ) and repair (collagen, elastin and transforming growth factor β [TGFβ1 ]) were examined by confocal microscopy, second harmonic generation, qPCR and biochemical assays. RESULTS In preterm AM defects, myofibroblast nuclei were highly deformed and contractile and expressed αSMA and Cx43. Mechanical stimulation increased collagen fibre polarisation and the effects on matrix markers were dependent on tissue region, disease state, gestational age and the number of fetuses. PGE2 levels were broadly similar but reduced after co-treatment with Cx43 antisense in late sPPROM AM defects. TGFβ1 and Cx43 gene expression were significantly increased after trauma and mechanical stimulation but this response dependent on gestational age. CONCLUSION Mechanical stimulation affects Cx43 signalling and cell/collagen mechanics in preterm AM defects. Establishing how Cx43 regulates mechanosignalling could be an approach to repair tissue integrity after trauma.
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Affiliation(s)
- Eleni Costa
- Centre for Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | | | - David L Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jan A Deprest
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building, London, UK
| | - Anna L David
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building, London, UK
| | - Tina T Chowdhury
- Centre for Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, UK
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Characterization of Cryopreserved Canine Amniotic Membrane. MEMBRANES 2021; 11:membranes11110824. [PMID: 34832052 PMCID: PMC8624976 DOI: 10.3390/membranes11110824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
Amniotic membrane is an effective corneal reconstruction material in veterinary surgery. Cryopreserved amniotic membrane is widely used in practice. Properties of cryopreserved canine amniotic membranes are currently not well studied. This study aimed to compare three properties between canine amniotic membranes cryopreserved for 7 days and 30 days, including tensile strength, transparency, and cell viability. After their respective cryopreservation time, stress-strain curves of the cryopreserved membranes' tensile strength were assessed using a universal testing machine. Both groups produced J-shaped stress-strain curves with statistically comparable parameters, including maximum stress, strain, and Young's modulus. The percentage of cell viability was observed by trypan blue staining under a light microscope. Membrane transparency was tested with a spectrophotometer. Transparency tests showed high levels of light transmission and low haze, with no statistical difference between groups. Cell viability was statistically lower in the 30-day cryopreserved group. Tensile strength and transparency of cryopreserved CAM were not significantly impeded for up to 30 days. For CAM to be used as an alternative corneal transplant material in veterinary and regenerative medicine, further research on cell biology, biomechanical properties of the membrane, and cell viability should be conducted.
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Amberg B, DeKoninck P, Kashyap A, Rodgers K, Zahra V, Hooper S, Crossley K, Hodges R. The effects of cold, dry and heated, humidified amniotic insufflation on sheep fetal membranes. Placenta 2021; 114:1-7. [PMID: 34418749 DOI: 10.1016/j.placenta.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Uterine distension with pressurised carbon dioxide (CO2) (amniotic insufflation) is used clinically to improve visibility during keyhole fetal surgery. However, there are concerns that amniotic insufflation with unconditioned (cold, dry) CO2 damages the fetal membranes which leads to post-operative preterm prelabour rupture of membranes (iatrogenic PPROM). We assessed whether heating and humidifying the insufflated CO2 could reduce fetal membrane damage in sheep. METHODS Thirteen pregnant ewes at 103-106 days gestation underwent amniotic insufflation with cold, dry (22 °C, 0-5% humidity, n = 6) or heated, humidified (40 °C, 95-100% humidity, n = 7) CO2 at 15 mmHg for 180 min. Twelve non-insufflated amniotic sacs acted as controls. Fetal membrane sections were collected after insufflation and analysed for molecular and histological markers of cell damage (caspase 3 and high mobility group box 1 [HMGB1]), inflammation (interleukin 1-alpha [IL1-alpha], IL8 and vascular cell adhesion molecule [VCAM]) and collagen weakening (matrix metalloprotease 9 [MMP9]). RESULTS Exposure to cold, dry CO2 increased mRNA levels of caspase 3, HMGB1, IL1-alpha, IL8, VCAM and MMP9 and increased amniotic epithelial caspase 3 and HMGB1 cell counts relative to controls. Exposure to heated, humidified CO2 also increased IL8 levels relative to controls however, HMGB1, IL1-alpha and VCAM mRNA levels and amniotic epithelial HMGB1 cell counts were significantly lower than the cold, dry group. DISCUSSION Amniotic insufflation with cold, dry CO2 damaged the amniotic epithelium and induced fetal membrane inflammation. Heated, humidified insufflation partially mitigated this damage and inflammation in sheep and may prove an important step in reducing the risk of iatrogenic PPROM following keyhole fetal surgery.
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Affiliation(s)
- Benjamin Amberg
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Philip DeKoninck
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia; Department of Obstetrics and Gynaecology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Aidan Kashyap
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Karyn Rodgers
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Valarie Zahra
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Stuart Hooper
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Kelly Crossley
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Ryan Hodges
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia; The Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
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Amberg BJ, Hodges RJ, Rodgers KA, Crossley KJ, Hooper SB, DeKoninck PLJ. Why Do the Fetal Membranes Rupture Early after Fetoscopy? A Review. Fetal Diagn Ther 2021; 48:493-503. [PMID: 34404043 DOI: 10.1159/000517151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/03/2021] [Indexed: 11/19/2022]
Abstract
Iatrogenic preterm premature rupture of the fetal membranes (iPPROM) remains the Achilles' heel of keyhole fetal surgery (fetoscopy) despite significant efforts in preclinical models to develop new therapies. This limited success is partially due to incomplete understanding why the fetal membranes rupture early after fetoscopy and notable differences in membrane physiology between humans and domestic species. In this review, we summarize aspects of fetoscopy that may contribute to iPPROM, the previous efforts to develop new therapies, and limitations of preclinical models commonly used in fetal membrane research.
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Affiliation(s)
- Benjamin J Amberg
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia, .,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia,
| | - Ryan J Hodges
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Karyn A Rodgers
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Kelly J Crossley
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Stuart B Hooper
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
| | - Philip L J DeKoninck
- The Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Dadkhah A, Hashemi A. Does preconditioning lower the rupture resistance of chorioamniotic membrane? ACTA ACUST UNITED AC 2021; 65:643-652. [PMID: 32432560 DOI: 10.1515/bmt-2019-0337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/04/2020] [Indexed: 11/15/2022]
Abstract
Premature rupture of fetal membrane occurs in about 3% of all pregnancies. The physical integrity of chorioamnion (CA) membrane should be retained until delivery for a healthy pregnancy. To explore the effect of pre-conditioning and probe size on the mechanical properties of human chorioamniotic sac, the mechanical properties of 17 human chorioamniotic membranes, collected from cesarean delivery, were examined using biaxial puncture tests with and without preconditioning by different probe sizes. For preconditioned samples, the mean ± std. of ultimate rupture stress was calculated to be 1.73 ± 0.13, 1.61 ± 0.29 and 1.78 ± 0.26 MPa for the probe sizes of 3, 5 and 7 mm, respectively. For samples with no preconditioning, these values were calculated to be 2.38 ± 0.29, 2.36 ± 0.37, and 2.59 ± 0.43 MPa for the above-mentioned probe sizes. The force to probe diameter for samples with no preconditioning was in the range of 1087-1301 N/m for the three probe diameters, well in the range of 850-1580 N/m reported by previous studies. Our results show that the preconditioned samples had significantly lower ultimate puncture force and ultimate stress compared to non-preconditioned samples. In addition, a correlation between the probe size and the magnitude of puncture force was observed, while the stress values were not significantly affected by changing probe size.
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Affiliation(s)
- Arash Dadkhah
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA
| | - Ata Hashemi
- Biomechanics Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
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McCoy AM, Arrington J, Yau PM. Effect of Preparation Method on the Protein Profile of Equine Amnion Dressings. J Proteome Res 2019; 18:2676-2685. [PMID: 31117638 DOI: 10.1021/acs.jproteome.9b00240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The protein content of amnion is thought to be the primary contributor to its efficacy as a biological dressing for wounds. Protein elution into antibiotic processing media has been reported, but the effect of antiseptic-based processing methods is unknown. Amniotic membranes were collected from eight healthy mares. Samples were collected after removal of gross debris. Tissues were subsequently divided and processed with either 0.05% chlorhexidine or 2% iodine/0.25% acetic acid. After protein extraction and trypsin digestion, the proteins were labeled with 8-plex iTRAQ tags, combined, and analyzed by high-resolution liquid chromatography-mass spectrometry. The MaxQuant-Perseus software suite was used to identify and quantify sample proteins, with functional annotation performed in PANTHER. There were 220 unique proteins identified, of which 144 were found in all individuals and across all conditions, several with a known role in wound healing. Contrary to expectations, processing did not significantly alter the protein content of the amnion tissue. Limitations include the small sample size and single time point. These results suggest that either processing method is acceptable for use in the preparation of equine amnion dressings. The role of expressed proteins in the biological activity of amnion dressings remains to be elucidated.
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Affiliation(s)
- Annette M McCoy
- Department of Veterinary Clinical Medicine , University of Illinois Urbana-Champaign , 1008 West Hazelwood Drive , Urbana , Illinois 61802 , United States
| | - Justine Arrington
- Protein Sciences Facility, Roy J. Carver Biotechnology Center , University of Illinois Urbana-Champaign , 505 South Matthews Avenue , Urbana , Illinois 61801 , United States
| | - Peter M Yau
- Protein Sciences Facility, Roy J. Carver Biotechnology Center , University of Illinois Urbana-Champaign , 505 South Matthews Avenue , Urbana , Illinois 61801 , United States
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Chowdhury B, David AL, Thrasivoulou C, Becker DL, Bader DL, Chowdhury TT. Tensile strain increased COX-2 expression and PGE2 release leading to weakening of the human amniotic membrane. Placenta 2014; 35:1057-64. [PMID: 25280972 DOI: 10.1016/j.placenta.2014.09.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/14/2014] [Accepted: 09/11/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There is evidence that premature rupture of the fetal membrane at term/preterm is a result of stretch and tissue weakening due to enhanced prostaglandin E2 (PGE2) production. However, the effect of tensile strain on inflammatory mediators and the stretch sensitive protein connexin-43 (Cx43) has not been examined. We determined whether the inflammatory environment influenced tissue composition and response of the tissue to tensile strain. METHODS Human amniotic membranes isolated from the cervix (CAM) or placenta regions (PAM) were examined by second harmonic generation to identify collagen orientation and subjected to tensile testing to failure. In separate experiments, specimens were subjected to cyclic tensile strain (2%, 1 Hz) for 24 h. Specimens were examined for Cx43 by immunofluorescence confocal microscopy and expression of COX-2 and Cx43 by RT-qPCR. PGE2, collagen, elastin and glycosaminoglycan (GAG) levels were analysed by biochemical assay. RESULTS Values for tensile strength were significantly higher in PAM than CAM with mechanical parameters dependent on collagen orientation. Gene expression for Cx43 and COX-2 was enhanced by tensile strain leading to increased PGE2 release and GAG levels in PAM and CAM when compared to unstrained controls. In contrast, collagen and elastin content was reduced by tensile strain in PAM and CAM. DISCUSSION Fibre orientation has a significant effect on amniotic strength. Tensile strain increased Cx43/COX-2 expression and PGE2 release resulting in tissue softening mediated by enhanced GAG levels and a reduction in collagen/elastin content. CONCLUSION A combination of inflammatory and mechanical factors may disrupt amniotic membrane biomechanics and matrix composition.
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Affiliation(s)
- B Chowdhury
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - A L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - C Thrasivoulou
- Department of Cell and Developmental Biology, UCL, Gower Street, London WC1E 6BT, UK
| | - D L Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11, Mandalay Road, Singapore
| | - D L Bader
- Institute of Bioengineering, School of Engineering and Material Science, Queen Mary University of London, Mile End Road, London E1 4NS, UK; Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - T T Chowdhury
- Institute of Bioengineering, School of Engineering and Material Science, Queen Mary University of London, Mile End Road, London E1 4NS, UK.
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Faturechi R, Hashemi A, Fatouraee N. Do mechanical properties of human fetal membrane depend on strain rate? J Obstet Gynaecol Res 2014; 41:84-91. [PMID: 25160512 DOI: 10.1111/jog.12498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 05/01/2014] [Indexed: 11/28/2022]
Abstract
AIM The objective of this study was to examine the effect of strain rate on the mechanical properties of human fetal membranes. METHODS Different strain rates were employed to quantify the stress-strain relation of the chorioamnion membrane. The mechanical properties of nine human amnion membranes, four collected from cesarean delivery and five collected from normal vaginal delivery, were examined in uniaxial tension tests under strain rates of 0.1, 1 and 10%/min. RESULTS Statistical analysis revealed significant (P < 0.05) correlation between the change in strain rate and the elastic modulus as well as failure strain of amnion samples. The rupture stress, though, did not show dependency on strain rates. CONCLUSION Human chorioamnion is strongly viscoelastic. By increasing the rate of the test, the stiffness of amnion increases considerably.
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Affiliation(s)
- Rahim Faturechi
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
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Mauri A, Perrini M, Mateos JM, Maake C, Ochsenbein-Koelble N, Zimmermann R, Ehrbar M, Mazza E. Second harmonic generation microscopy of fetal membranes under deformation: normal and altered morphology. Placenta 2013; 34:1020-6. [PMID: 24070621 DOI: 10.1016/j.placenta.2013.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/02/2013] [Accepted: 09/05/2013] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Insight into the microstructure of fetal membrane and its response to deformation is important for understanding causes of preterm premature rupture of the membrane. However, the microstructure of fetal membranes under deformation has not been visualized yet. Second harmonic generation microscopy, combined with an in-situ stretching device, can provide this valuable information. METHODS Eight fetal membranes were marked over the cervix with methylene blue during elective caesarean section. One sample per membrane of reflected tissue, between the placenta and the cervical region, was cyclically stretched with a custom built inflation device. Samples were mounted on an in-situ stretching device and imaged with a multiphoton microscope at different deformation levels. Microstructural parameters such as thickness and collagen orientation were determined. Image entropy was evaluated for the spongy layer. RESULTS The spongy layer consistently shows an altered collagen structure in the cervical and cycled tissue compared with the reflected membrane, corresponding to a significantly higher image entropy. An increased thickness of collagenous layers was found in cervical and stretched samples in comparison to the reflected tissue. Significant collagen fibre alignment was found to occur already at moderate deformation in all samples. CONCLUSIONS For the first time, second harmonic generation microscopy has been used to visualize the microstructure of fetal membranes. Repeated mechanical loading was shown to affect the integrity of the amnion-chorion interface which might indicate an increased risk of premature rupture of fetal membrane. Moreover, mechanical loading might contribute to morphological alterations of the fetal membrane over the cervical region.
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Affiliation(s)
- A Mauri
- Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland.
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