Hod. Critchley et al., Role of inflammatory mediators in human endometrium during progesterone withdrawal and early pregnancy, J CLIN END, 84(1), 1999, pp. 240-248
The role of progesterone (P-4) in the regulation of inflammatory mediators
interleukin-8 (IL-8), monocyte chemoattractant protein-1, and cyclooxygenas
e-2 (COX-2) and in the recruitment of leukocyte subpopulations in the endom
etrium has been examined, by employing a model of P-4 withdrawal and mainte
nance in vivo. Messenger RNA and protein expression have been investigated
in endometrial biopsies: 1) during the midsecretory phase (LH+8 to 10); dur
ing the maintained luteal phase (P-4 administered vaginally for 4 days from
LH+8) and biopsies collected 2) 24 h and 3) 48 h post withdrawal of P-4; a
nd 4) during pseudo pregnancy (Lifespan of corpus luteum extended by 7 days
with CG; (decidua collected from women with 5) an ectopic gestation and 6)
from women undergoing first-trimester termination of pregnancy). CD56+ lar
ge granular lymphocytes remain the major leukocyte subtype, both 24 and 48
h after P-4 withdrawal, and in decidua (CG supported or ectopic). Higher nu
mbers (P < 0.05) of macrophages (CD68+) were present in endometrium 48 h po
st P-4 withdrawal and in pseudo pregnant endometrium, compared with normal
decidua. Significantly more macrophages (P < 0.01) were present in decidua
from an ectopic pregnancy. A significant elevation of IL-8 (P < 0.01) and C
OX-2 (P < 0.05) messenger RNA was detected 48 h post P-4 withdrawal. Eviden
ce is provided for up-regulation of IL-8 and COX-2 in response to P-4 withd
rawal.