CERVICAL DILATATION - INDUCTION BY ANTIGESTAGENS VIA ADHESION MOLECULES - AN IN-VITRO EXAMINATION IN ENDOTHELIAL-CELL CULTURES

Cervical ripening at term resembles an inflammatory reaction with inva sion of activated granulocytes into the cervical stroma. Our objective was to investigate the influence of the antigestagen onapristone alon e and in combination with other substances associated with cervical ri pening on the expression of the inflammation-associated adhesion molec ules ELAM-1 ICAM-1 and VCAM-1. Human endothelial cell cultures were st imulated with onapristone (200 ng/ml), TNF-alpha(100 U/ml), IL-8 (20 n g/ml) and PGE(2) (3 ng/ml) separately and in combination (n = 6), The expression of adhesion molecules was determined qualitatively and quan titatively by immunofluorescence staining and flow cytometry with stat istical evaluation by Kolmogorov-Smirnov analysis. Onapristone upregul ated slightly the expression of ELAM-1 (19%), The costimulation of ona pristone and TNF-alpha provoked an additive expression of VCAM-1 (64%) beyond the effect of TNF-alpha alone, while the costimulation of onap ristone and PGE(2) as well as the combination with IL-8 did not result in an additional stimulatory effect. All results were statistically s ignificant (p < 0.001). This result supports our hypothesis that onapr istone may lead to an increased adhesion of granulocytes to the capill ary endothelium thereby initiating cervical ripening.