Pretreatment of human amnion-chorion with vitamins C and E prevents hypochlorous acid-induced damage

OBJECTIVE: Preterm premature rupture of fetal membranes has been associated with infection, cigarette smoking, and bleeding. Hypochlorous acid (a reac tive oxygen species) is central to the body's response to infection, yet it may damage surrounding tissue while destroying pathogens. We examined in v itro the tissue-damaging actions of hypochlorous acid on the amnion-chorion and the protective role provided by pretreatment with vitamins C and E. STUDY DESIGN: Amnion-chorion samples were obtained from 4 term pregnancies, cut into segments, and divided into 6 exposure groups. Half were treated i n advance with vitamins C and E (Trolox C) and half were treated with buffe r solution alone. After rinsing, amnion-chorion samples were exposed to hyp ochlorous acid at 1 or 10 mmol/L for 4 hours. Histologic and immunocytochem ical evaluations were conducted with antibodies for collagen I and IV. RESULTS: Extensive damage to amniotic epithelium and collagen I but not col lagen IV resulted from hypochlorous acid exposure and was dose related. Pre treatment with vitamins C and E prevented this damage in all cases. CONCLUSION: Hypochlorous acid damages the amniotic epithelium and collagen I in the amnion-chorion. The protection against hypochlorous acid-induced d amage provided by antioxidant therapy (vitamins C and E) is of therapeutic significance.