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Kowsar R, Sadeghi K, Hashemzadeh F, Miyamoto A. Ovarian sex steroid and epithelial control of immune responses in the uterus and oviduct: human and animal models†. Biol Reprod 2024; 110:230-245. [PMID: 38038990 PMCID: PMC10873282 DOI: 10.1093/biolre/ioad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/08/2023] [Accepted: 11/30/2023] [Indexed: 12/02/2023] Open
Abstract
The female reproductive tract (FRT), including the uterus and oviduct (Fallopian tube), is responsible for maintaining an optimal microenvironment for reproductive processes, such as gamete activation and transportation, sperm capacitation, fertilization, and early embryonic and fetal development. The mucosal surface of the FRT may be exposed to pathogens and sexually transmitted microorganisms due to the opening of the cervix during mating. Pathogens and endotoxins may also reach the oviduct through the peritoneal fluid. To maintain an optimum reproductive environment while recognizing and killing pathogenic bacterial and viral agents, the oviduct and uterus should be equipped with an efficient and rigorously controlled immune system. Ovarian sex steroids can affect epithelial cells and underlying stromal cells, which have been shown to mediate innate and adaptive immune responses. This, in turn, protects against potential infections while maintaining an optimal milieu for reproductive events, highlighting the homeostatic involvement of ovarian sex steroids and reproductive epithelial cells. This article will discuss how ovarian sex steroids affect the immune reactions elicited by the epithelial cells of the non-pregnant uterus and oviduct in the bovine, murine, and human species. Finally, we propose that there are regional and species-specific differences in the immune responses in FRT.
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Affiliation(s)
- Rasoul Kowsar
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, Iran
| | | | - Farzad Hashemzadeh
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, Iran
| | - Akio Miyamoto
- Global Agromedicine Research Center, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
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Abuelo A, Mann S, Contreras GA. Metabolic Factors at the Crossroads of Periparturient Immunity and Inflammation. Vet Clin North Am Food Anim Pract 2023; 39:203-218. [PMID: 37032303 DOI: 10.1016/j.cvfa.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Abstract
Periparturient cows have the highest risk for disease and culling in the adult dairy herd. This risk is compounded by the multiple physiological changes of metabolism and immune function occurring around calving that alter the cow's inflammatory response. In this article, the authors summarize the current knowledge on immunometabolism in the periparturient cow, discussing major changes in immune and metabolic function around parturition that will facilitate the assessment of periparturient cow management programs.
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Affiliation(s)
- Angel Abuelo
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, East Lansing, MI 48824, USA
| | - Sabine Mann
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, 240 Farrier Road, Box 47, Ithaca, NY 14853, USA.
| | - Genaro Andres Contreras
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, East Lansing, MI 48824, USA
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Lee S, Yoo I, Cheon Y, Hong M, Jeon BY, Ka H. Antimicrobial peptides β-defensin family: Expression and regulation in the endometrium during the estrous cycle and pregnancy in pigs. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2023; 139:104596. [PMID: 36442607 DOI: 10.1016/j.dci.2022.104596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/16/2023]
Abstract
Members of the β-defensin (DEFB) family, which are antimicrobial peptides and humoral components of the innate immune system, protect the surfaces of various host tissues by killing a broad range of microorganisms and are involved in immunomodulatory actions. The expression of these DEFB members changed during the estrous cycle and pregnancy in a stage-specific manner. The expression of DEFBs was also detected in conceptus and chorioallantoic tissues during pregnancy. DEFB1 and DEFB3 proteins and DEFB2 mRNA were localized primarily to endometrial epithelial cells during early pregnancy. Increasing doses of progesterone upregulated DEFB2 and EP2C expression in endometrial explant tissues. These results showed that members of the DEFB family were expressed stage-specifically at the maternal-conceptus interface in pigs, suggesting that the DEFB family plays important roles at the maternal-conceptus interface in regulation of innate immunity by protection of the maternal endometrial and conceptus tissues from pathogens to preserve fertility in pigs.
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Affiliation(s)
- Soohyung Lee
- Division of Biological Science and Technology, Yonsei University, Wonju, 26493, Republic of Korea
| | - Inkyu Yoo
- Division of Biological Science and Technology, Yonsei University, Wonju, 26493, Republic of Korea
| | - Yugyeong Cheon
- Division of Biological Science and Technology, Yonsei University, Wonju, 26493, Republic of Korea
| | - Minsun Hong
- Division of Biological Science and Technology, Yonsei University, Wonju, 26493, Republic of Korea
| | - Bo-Young Jeon
- Department of Biomedical Laboratory Science, Yonsei University, Wonju, 26493, Republic of Korea
| | - Hakhyun Ka
- Division of Biological Science and Technology, Yonsei University, Wonju, 26493, Republic of Korea.
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Karabulut S, Korkmaz O, Erdem Altun C, Keskin I. A Histopathological Evaluation of Ovarian Hyperstimulation Syndrome on Reproductive and Vital Organs and the Role of the VEGF-PKA Pathway in a Mouse Model. Cells Tissues Organs 2021; 210:218-238. [PMID: 34320509 DOI: 10.1159/000517424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/14/2021] [Indexed: 11/19/2022] Open
Abstract
Ovarian hyperstimulation syndrome (OHSS) is one of the most common and iatrogenic complications of in vitro fertilization therapy, which is an exaggerated response to excess hormones resulting in the development of a large number of maturing follicles. Although the complications of and reasons for the condition are well known, the overall histopathological effects on systemic organs and the extent of the damage have not been fully elucidated. Besides, the mechanism that underlies the situation is not very well known. The aim of the present work was to analyse the histopathological effects of OHSS on reproductive (uterus and ovary) and vital organs (liver and kidney) and the possible role of the VEGF-PKA pathway in triggering the condition. Balb/c mice were used to establish an OHSS model. The OHSS group were injected with overdose PMSG while the normal responder group were injected with an optimal dose. Histopathological evaluation was utilised in the liver, kidney, ovary, and uterus stained with hematoxylin and eosin, Masson's trichrome, and periodic acid-Schiff stain. The expression profiles of VEGF (vascular endothelial growth factor), PKA (protein kinase A), and p-PKA (an activated form of PKA) were detected with immunohistochemistry and Western blotting. OHSS was demonstrated to have a negative histopathological effect on all of the organs analysed. These effects were associated with an overall increase in the expression levels of VEGF, PKA, and p-PKA. OHSS has a serious histopathological negative effect on the systemic and reproductive organs and is proven to affect overall health, and thus should be considered a dangerous complication during ART techniques. The activation of the VEGF-PKA pathway, which is indicated by the expression levels of VEGF, PKA, and p-PKA, is demonstrated to accompany this complication, which should be further elucidated to understand the mechanisms underlying the condition.
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Affiliation(s)
- Seda Karabulut
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Health Science and Technologies Research Institute (SABITA), Istanbul, Turkey
| | - Oya Korkmaz
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Health Science and Technologies Research Institute (SABITA), Istanbul, Turkey
| | - Ceren Erdem Altun
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ilknur Keskin
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Health Science and Technologies Research Institute (SABITA), Istanbul, Turkey
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Zheng ZH, Han Y, You SY, Chen Z, Zheng XD. Improvement in post-partum uterine involution in rats treated with Apios americana. J Zhejiang Univ Sci B 2019; 20:576-587. [PMID: 31168971 DOI: 10.1631/jzus.b1800475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Apios americana, a plant used as a staple ingredient of native American diets, has various properties, including anti-cancer, anti-hyperglycemic, hypotensive, and anti-inflammatory activity. In Japan, Apios is used as a post-natal medication. After parturition, women undergo a period of recovery as they return to pre-pregnancy conditions. However, few health products that aid post-partum recovery are on the market. We explored whether Apios can accelerate the post-partum recovery process, in particular the involution of the uterus. METHODS Female rats kept in individual cages were mated with two male rats, with the exception of the control group (female rats without mating, on basal diet; n=6). After delivery, rats were divided into five groups based on their diet: basal diet (model; n=6); basal diet+oral intake at 5.4 g/kg of Chanfukang granules (a Chinese patent medicine preparation for post-partum lochia) (positive; n=6); basal diet containing 10% Apios powder (low; n=6); basal diet containing 20% Apios powder (medium; n=6); basal diet containing 40% Apios powder (high; n=6). Five days later, uteri and spleens were weighed. Uterus and spleen indices for each rat were calculated by dividing visceral weight by the total weight. Hormone and cytokine concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Histological analysis of uteri was completed using hematoxylin and eosin (H&E) staining. Expression of matrix metalloproteinases and inhibitors in uteri was measured by western blotting. RESULTS Our results showed that Apios treatment reduced the post-partum uterus index and regulated the hormone concentrations. Moreover, we found that the process of uterine involution was accelerated, based on morphological changes in the uterus. In addition, our results indicated that Apios alleviated the inflammatory response induced by the involution process. Transforming growth factor β was also found to be regulated by Apios. There were significant downregulation of matrix metalloproteinases and upregulation of their inhibitors by Apios, which suggested that Apios increased the rate of the collagen clearance process. CONCLUSIONS These results, based on experimental observations at the molecular and protein levels, verified our hypothesis that Apios can improve uterine involution, and demonstrated the potential application of Apios in post-partum care.
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Affiliation(s)
- Zi-Huan Zheng
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Ying Han
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310022, China
| | - Shi-Ying You
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Zuo Chen
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Xiao-Dong Zheng
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.,National Engineering Laboratory of Intelligent Food Technology and Equipment, Hangzhou 310058, China.,Zhejiang Key Laboratory for Agro-Food Processing, Hangzhou 310058, China.,Fuli Institute of Food Science, Hangzhou 310058, China
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Meade KG, O'Farrelly C. β-Defensins: Farming the Microbiome for Homeostasis and Health. Front Immunol 2019; 9:3072. [PMID: 30761155 PMCID: PMC6362941 DOI: 10.3389/fimmu.2018.03072] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Diverse commensal populations are now regarded as key to physiological homeostasis and protection against disease. Although bacteria are the most abundant component of microbiomes, and the most intensively studied, the microbiome also consists of viral, fungal, archael, and protozoan communities, about which comparatively little is known. Host-defense peptides (HDPs), originally described as antimicrobial, now have renewed significance as curators of the pervasive microbial loads required to maintain homeostasis and manage microbiome diversity. Harnessing HDP biology to transition away from non-selective, antibiotic-mediated treatments for clearance of microbes is a new paradigm, particularly in veterinary medicine. One family of evolutionarily conserved HDPs, β-defensins which are produced in diverse combinations by epithelial and immune cell populations, are multifunctional cationic peptides which manage the cross-talk between host and microbes and maintain a healthy yet dynamic equilibrium across mucosal systems. They are therefore key gatekeepers to the oral, respiratory, reproductive and enteric tissues, preventing pathogen-associated inflammation and disease and maintaining physiological normality. Expansions in the number of genes encoding these natural antibiotics have been described in the genomes of some species, the functional significance of which has only recently being appreciated. β-defensin expression has been documented pre-birth and disruptions in their regulation may play a role in maladaptive neonatal immune programming, thereby contributing to subsequent disease susceptibility. Here we review recent evidence supporting a critical role for β-defensins as farmers of the pervasive and complex prokaryotic ecosystems that occupy all body surfaces and cavities. We also share some new perspectives on the role of β-defensins as sensors of homeostasis and the immune vanguard particularly at sites of immunological privilege where inflammation is attenuated.
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Affiliation(s)
- Kieran G. Meade
- Animal and Bioscience Research Centre, Teagasc, Grange, Ireland
| | - Cliona O'Farrelly
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Alan E, Liman N. Toll-like receptor expression patterns in the rat uterus during post partum involution. Reprod Fertil Dev 2017; 30:330-348. [PMID: 28701256 DOI: 10.1071/rd16431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 06/12/2017] [Indexed: 11/23/2022] Open
Abstract
Toll-like receptors (TLRs) belong to a family of pathogen recognition receptors and play critical roles in detecting and responding to invading pathogens. TLR expression could be significant because, in the uterus, the reproductive tract is an important site of exposure to and infection by pathogens during the post partum involution period. To clarify the expression and localisation patterns of TLRs in the rat uterus on Days 1, 3, 5 and 10 post partum (PP1, PP3, PP5 and PP10 respectively), immunohistochemistry and western blotting were used to analyse TLR1-7, TLR9 and TLR10. The immunohistochemistry results indicated that TLR1-7, TLR9 and TLR10 were localised in both the cytoplasm and nuclei of luminal and glandular epithelium, stromal fibroblasts and myometrial cells in the rat uterus. In the luminal epithelium, TLR4-7 were also found in lateral membranes, whereas TLR10 was present in apical membranes. Western blot analysis revealed that the expression of TLR proteins increased with the number of days post partum, reaching a maximum on PP10, although levels did not differ significantly from those on PP1 (P>0.05). These findings confirm that TLR1-7, TLR9 and TLR10 are constitutively expressed in uterine cells and that localisation pattern of TLRs in the endometrium varies with structural changes in the uterus on different days of involution. These results suggest that TLRs may play a role in uterine repair and remodelling during physiological involution.
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Affiliation(s)
- Emel Alan
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Erciyes University, Kayseri 38039, Turkey
| | - Narin Liman
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Erciyes University, Kayseri 38039, Turkey
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Hong Y, Zhang B, Yu L, Duan SS. Cell membrane integrity and revascularization: The possible functional mechanism of ischemic preconditioning for skeletal muscle protection against ischemic-reperfusion injury. Acta Histochem 2017; 119:309-314. [PMID: 28291543 DOI: 10.1016/j.acthis.2017.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this paper was to evaluate whether ischemic preconditioning (IPC) could make protective effects against skeletal muscle injuries induced by ischemic-reperfusion (I/R). METHODS Eighteen rats were randomly divided into three groups of 6 subjects each: control group, I/R group, and IPC group. Thigh root ischemia of rats in the I/R group was induced by 3h ischemia and 24h reperfusion. IPC was applied by 3 periods of 15min ischemia/15min reperfusion prior to ischemia. Morphological changes in skeletal muscle cells induced by I/R and IPC were observed by hematoxylin and eosin (HE) staining and electron microscopy. In addition, angiogenesis was evaluated by immunolabeling of CD31. RESULTS IPC could prevented morphological alternations induced by ischemia, including myofilament, cell membrane, cell matrix, nucleus, mitochondria, and sarcoplasmic reticulum damage in skeletal muscle cells. The CD31 immunolabeling showed that neovascularization was observed in the IPC group but not in the I/R group. IPC could protect skeletal muscle cells from necrosis, apoptosis, and morphological damages induced by I/R injury. CONCLUSION Revascularization may play a key role in the mechanism underlying the protective effects of IPC in vivo.
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Alan E, Liman N. Involution dependent changes in distribution and localization of bax, survivin, caspase-3, and calpain-1 in the rat endometrium. Microsc Res Tech 2016; 79:285-97. [DOI: 10.1002/jemt.22629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/06/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Emel Alan
- Department of Histology and Embryology, Faculty of Veterinary Medicine; University of Erciyes; Kayseri Turkey
| | - Narin Liman
- Department of Histology and Embryology, Faculty of Veterinary Medicine; University of Erciyes; Kayseri Turkey
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Alan E, Lİman N, Sağsöz H. Immunohistochemical localization of epidermal growth factor system in the lung of the Japanese quail (Coturnix coturnix japonica) during the post-hatching period. Microsc Res Tech 2015; 78:807-22. [PMID: 26179370 DOI: 10.1002/jemt.22544] [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: 01/29/2015] [Revised: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 11/09/2022]
Abstract
The purpose of this study is to determine the possible changes in the localization of the four Epidermal Growth Factor Receptors and three ligands in quail lungs from the first day of hatching until the 125th after hatching using immunohistochemical methods. Immunohistochemical results demonstrated that four EGFRs and their ligands are chiefly located in the cytoplasm of cells. Additionally, ErbB4, AREG, and NRG1 are localized to the nucleus and nucleolus, but EGF is present in the nucleolus. ErbB2 was also found in the cell membrane. In the epithelium of secondary bronchi, the goblet cells only exhibited ErbB1 and ErbB2, whereas the basal and ciliated cells exhibited EGFRs and ligands immunoreactivity. The atrial granular cells displayed moderate levels of ErbB1-ErbB3 and EGF and strong levels of ErbB4, AREG, and NRG1 immunoreactivity. While the squamous atrial cells and squamous respiratory cells of air capillaries and endothelial cells of blood capillaries exhibited moderate to strong ErbB2, ErbB4, AREG, and NRG1 immunoreactivity, they had negative or weak ErbB1, ErbB3, and EGF immunoreactivity. The expression levels of ErbB2-ErbB4, EGF, AREG, and NRG1 were also detected in fibroblasts. Although ErbB2 was highly expressed in the bronchial and vascular smooth muscle cells, weak expression of ErbB1, ErbB3, AREG and EGF and moderate expression of ErbB4 and NRG1 were observed. Macrophages were only negative for ErbB1. In conclusion, these data indicate that the EGFR-system is functionally active at hatching, which supports the hypothesis that the members of EGFR-system play several cell-specific roles in quail lung growth after hatching.
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Affiliation(s)
- Emel Alan
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Erciyes, Kayseri, Turkey
| | - Narİn Lİman
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Erciyes, Kayseri, Turkey
| | - Hakan Sağsöz
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Dicle, Diyarbakır, Turkey
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Sağsöz H, Liman N, Alan E. Expression of vascular endothelial growth factor receptors and their ligands in rat uterus during the postpartum involution period. Biotech Histochem 2015; 90:361-74. [DOI: 10.3109/10520295.2015.1007482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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The profile of the epidermal growth factor system in rat endometrium during postpartum involution period. Vet Res Commun 2015; 39:115-35. [DOI: 10.1007/s11259-015-9633-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 02/20/2015] [Indexed: 01/18/2023]
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Cao M, Chan RWS, Yeung WSB. Label-retaining stromal cells in mouse endometrium awaken for expansion and repair after parturition. Stem Cells Dev 2014; 24:768-80. [PMID: 25386902 DOI: 10.1089/scd.2014.0225] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Human and mouse endometrium undergo dramatic cellular reorganization during pregnancy and postpartum. Somatic stem cells maintain homeostasis of the tissue by providing a cell reservoir for regeneration. We hypothesized that endometrial cells with quiescent properties (stem/progenitor cells) were involved in the regeneration of the endometrial tissue. Given that stem cells divide infrequently, they can retain the DNA synthesis label [bromodeoxyuridine (BrdU)] after a prolonged chase period. In this study, prepubertal mice were pulsed with BrdU and after a 6-week chase a small population of label-retaining stromal cells (LRSC) was located primarily beneath the luminal epithelium, adjacent to blood vessels, and near the endometrial-myometrial junction. Marker analyses suggested that they were of mesenchymal origin expressing CD44(+), CD90(+), CD140b(+), CD146(+), and Sca-1(+). During pregnancy, nonproliferating LRSC predominately resided at the interimplantation/placental loci of the gestational endometrium. Immediately after parturition, a significant portion of the LRSC underwent proliferation (BrdU(+)/Ki-67(+)) and expressed total and active β-catenin. The β-catenin expression in the LRSC was transiently elevated at postpartum day (PPD) 1. The proliferation of LRSC resulted in a significant decline in the proportion of LRSC in the postpartum uterus. The LRSC returned to dormancy at PPD7, and the percentage of LRSC remained stable thereafter until 11 weeks. This study demonstrated that LRSC can respond efficiently to physiological stimuli upon initiation of uterine involution and return to its quiescent state after postpartum repair.
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Affiliation(s)
- Mingzhu Cao
- 1 Department of Obstetrics and Gynaecology, University of Hong Kong , Pokfulam, Hong Kong, SAR, China
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