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Suarez AC, Gimenez CJ, Russell SR, Wang M, Munson JM, Myers KM, Miller KS, Abramowitch SD, De Vita R. Pregnancy-induced remodeling of the murine reproductive tract: a longitudinal in vivo magnetic resonance imaging study. Sci Rep 2024; 14:586. [PMID: 38182631 PMCID: PMC10770079 DOI: 10.1038/s41598-023-50437-1] [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: 08/31/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
Mammalian pregnancy requires gradual yet extreme remodeling of the reproductive organs to support the growth of the embryos and their birth. After delivery, the reproductive organs return to their non-pregnant state. As pregnancy has traditionally been understudied, there are many unknowns pertaining to the mechanisms behind this remarkable remodeling and repair process which, when not successful, can lead to pregnancy-related complications such as maternal trauma, pre-term birth, and pelvic floor disorders. This study presents the first longitudinal imaging data that focuses on revealing anatomical alterations of the vagina, cervix, and uterine horns during pregnancy and postpartum using the mouse model. By utilizing advanced magnetic resonance imaging (MRI) technology, T1-weighted and T2-weighted images of the reproductive organs of three mice in their in vivo environment were collected at five time points: non-pregnant, mid-pregnant (gestation day: 9-10), late pregnant (gestation day: 16-17), postpartum (24-72 h after delivery) and three weeks postpartum. Measurements of the vagina, cervix, and uterine horns were taken by analyzing MRI segmentations of these organs. The cross-sectional diameter, length, and volume of the vagina increased in late pregnancy and then returned to non-pregnant values three weeks after delivery. The cross-sectional diameter of the cervix decreased at mid-pregnancy before increasing in late pregnancy. The volume of the cervix peaked at late pregnancy before shortening by 24-72 h postpartum. As expected, the uterus increased in cross-sectional diameter, length, and volume during pregnancy. The uterine horns decreased in size postpartum, ultimately returning to their average non-pregnant size three weeks postpartum. The newly developed methods for acquiring longitudinal in vivo MRI scans of the murine reproductive system can be extended to future studies that evaluate functional and morphological alterations of this system due to pathologies, interventions, and treatments.
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Affiliation(s)
- Aileen C Suarez
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger Street, Blacksburg, VA, 24061, USA
| | - Clara J Gimenez
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger Street, Blacksburg, VA, 24061, USA
| | - Serena R Russell
- Department of Mechanical Engineering, Columbia University, 234 S W. Mudd, New York, NY, 10027, USA
| | - Maosen Wang
- Fralin Biomedical Research Institute, Virginia Tech, 4 Riverside Circle,, Roanoke, VA, 24016, USA
| | - Jennifer M Munson
- Fralin Biomedical Research Institute, Virginia Tech, 4 Riverside Circle,, Roanoke, VA, 24016, USA
| | - Kristin M Myers
- Department of Mechanical Engineering, Columbia University, 234 S W. Mudd, New York, NY, 10027, USA
| | - Kristin S Miller
- Department of Mechanical Engineering, The University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX, 75080, USA
| | - Steven D Abramowitch
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA
| | - Raffaella De Vita
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, 325 Stanger Street, Blacksburg, VA, 24061, USA.
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2
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Yoshida K. Bioengineering and the cervix: The past, current, and future for addressing preterm birth. Curr Res Physiol 2023; 6:100107. [PMID: 38107784 PMCID: PMC10724223 DOI: 10.1016/j.crphys.2023.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/23/2023] [Accepted: 09/20/2023] [Indexed: 12/19/2023] Open
Abstract
The uterine cervix plays two important but opposing roles during pregnancy - as a mechanical barrier that maintains the fetus for nine months and as a compliant structure that dilates to allow for the delivery of a baby. In some pregnancies, however, the cervix softens and dilates prematurely, leading to preterm birth. Bioengineers have addressed and continue to address the lack of reduction in preterm birth rates by developing novel technologies to diagnose, prevent, and understand premature cervical remodeling. This article highlights these existing and emerging technologies and concludes with open areas of research related to the cervix and preterm birth that bioengineers are currently well-positioned to address.
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Affiliation(s)
- Kyoko Yoshida
- Department of Biomedical Engineering, University of Minnesota, 7-105 Nils Hasselmo Hall, 312 Church Street SE, Minneapolis, MN, 55455, USA
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3
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Pittokopitou S, Mavrogianni D, Pergialiotis V, Pappa KI, Antsaklis P, Theodora M, Sindos M, Papapanagiotou A, Domali A, Stavros S, Drakakis P, Daskalakis G. Expression of Stemness Markers in the Cervical Smear of Patients with Cervical Insufficiency. Cells 2023; 12:cells12081183. [PMID: 37190092 DOI: 10.3390/cells12081183] [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: 02/03/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
The presence of stem cells has been previously described in human precancerous and malignant cervical cultures. Previous studies have shown a direct interplay of the stem cell niche, which is present in practically every tissue with the extracellular matrix. In the present study, we sought to determine the expression of stemness markers in cytological specimens collected from the ectocervix among women with cervical insufficiency during the second trimester of pregnancy and women with normal cervical length. A prospective cohort of 59 women was enrolled of whom 41 were diagnosed with cervical insufficiency. The expression of OCT-4 and NANOG was higher in the cervical insufficiency group compared to the control group (-5.03 (-6.27, -3.72) vs. -5.81 (-7.67, -5.02) p = 0.040 for OCT4) and (-7.47 (-8.78, -6.27) vs. -8.5 (-10.75, -7.14), p = 0.035 for NANOG. Differences in the DAZL gene were not significantly different (5.94 (4.82, 7.14) vs. 6.98 (5.87, 7.43) p = 0.097). Pearson correlation analysis indicated the existence of a moderate correlation of OCT-4 and Nanog with cervical length. Considering this information, the enhanced activity of stemness biomarkers among pregnant women diagnosed with cervical insufficiency may be predisposed to cervical insufficiency, and its predictive accuracy remains to be noted in larger population sizes.
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Affiliation(s)
- Savvia Pittokopitou
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Despina Mavrogianni
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Kalliopi I Pappa
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Marianna Theodora
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Michail Sindos
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Angeliki Papapanagiotou
- Department of Biological Chemistry, Medical School, National and Kapodistrial University of Athens, 11528 Athens, Greece
| | - Aikaterini Domali
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Sofoklis Stavros
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Peter Drakakis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
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4
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Kuba K, Kirby MA, Hughes F, Yellon SM. Reassessing the Bishop score in clinical practice for induction of labor leading to vaginal delivery and for evaluation of cervix ripening. PLACENTA AND REPRODUCTIVE MEDICINE 2023; 2:8. [PMID: 37712009 PMCID: PMC10500565 DOI: 10.54844/prm.2023.0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Kfier Kuba
- Department of Obstetrics and Gynecology, Division of
Maternal-Fetal Medicine, Northwell Health - Long Island Jewish Medical Center, New
Hyde Park 11040, NY, USA
| | - Michael A. Kirby
- Longo Center for Perinatal Biology, Departments of Basic
Sciences (Division of Physiology), Pediatrics, Gynecology and Obstetrics, Loma Linda
University School of Medicine, Loma Linda 92350, CA, USA
- Departments of Pathology and Human Anatomy, and Pediatrics,
Loma Linda University School of Medicine, Loma Linda 92350, CA, USA
| | - Francine Hughes
- Department of Obstetrics & Gynecology and
Women’s Health, Division of Maternal-Fetal Medicine, Montefiore Medical
Center/Albert Einstein College of Medicine, Bronx 10461, NY, USA
| | - Steven M. Yellon
- Longo Center for Perinatal Biology, Departments of Basic
Sciences (Division of Physiology), Pediatrics, Gynecology and Obstetrics, Loma Linda
University School of Medicine, Loma Linda 92350, CA, USA
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Tripathy S, Nallasamy S, Mahendroo M. Progesterone and its receptor signaling in cervical remodeling: Mechanisms of physiological actions and therapeutic implications. J Steroid Biochem Mol Biol 2022; 223:106137. [PMID: 35690241 PMCID: PMC9509468 DOI: 10.1016/j.jsbmb.2022.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/26/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
The remodeling of the cervix from a closed rigid structure to one that can open sufficiently for passage of a term infant is achieved by a complex series of molecular events that in large part are regulated by the steroid hormones progesterone and estrogen. Among hormonal influences, progesterone exerts a dominant role for most of pregnancy to initiate a loss of tissue strength yet maintain competence in a phase termed softening. Equally important are the molecular events that abrogate progesterone function in late pregnancy to allow a loss of tissue competence and strength during cervical ripening and dilation. In this review, we focus on current understanding by which progesterone receptor signaling for the majority of pregnancy followed by a loss/shift in progesterone receptor action at the end of pregnancy, collectively ensure cervical remodeling as necessary for successful parturition.
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Affiliation(s)
- Sudeshna Tripathy
- Division of Basic Research, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Cecil H. and Ida Green Center for Reproductive Biology Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Shanmugasundaram Nallasamy
- Division of Basic Research, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Cecil H. and Ida Green Center for Reproductive Biology Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Mala Mahendroo
- Division of Basic Research, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Cecil H. and Ida Green Center for Reproductive Biology Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
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6
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Durcan C, Hossain M, Chagnon G, Perić D, Karam G, Bsiesy L, Girard E. Experimental investigations of the human oesophagus: anisotropic properties of the embalmed mucosa–submucosa layer under large deformation. Biomech Model Mechanobiol 2022; 21:1685-1702. [PMID: 36030514 PMCID: PMC9420190 DOI: 10.1007/s10237-022-01613-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022]
Abstract
Mechanical characterisation of the layer-specific, viscoelastic properties of the human oesophagus is crucial in furthering the development of devices emerging in the field, such as robotic endoscopic biopsy devices, as well as in enhancing the realism, and therefore effectiveness, of surgical simulations. In this study, the viscoelastic and stress-softening behaviour of the passive human oesophagus was investigated through ex vivo cyclic mechanical tests. Due to restrictions placed on the laboratory as a result of COVID-19, only oesophagi from cadavers fixed in formalin were allowed for testing. Three oesophagi in total were separated into their two main layers and the mucosa–submucosa layer was investigated. A series of uniaxial tensile tests were conducted in the form of increasing stretch level cyclic tests at two different strain rates: 1% s\documentclass[12pt]{minimal}
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\begin{document}$$^{-1}$$\end{document}-1. Rectangular samples in both the longitudinal and circumferential directions were tested to observe any anisotropy. Histological analysis was also performed through a variety of staining methods. Overall, the longitudinal direction was found to be much stiffer than the circumferential direction. Stress-softening was observed in both directions, as well as permanent set and hysteresis. Strain rate-dependent behaviour was also apparent in the two directions, with an increase in strain rate resulting in an increase in stiffness. This strain rate dependency was more pronounced in the longitudinal direction than the circumferential direction. Finally, the results were discussed in regard to the histological content of the layer, and the behaviour was modelled and validated using a visco-hyperelastic matrix-fibre model.
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Affiliation(s)
- Ciara Durcan
- Zienkiewicz Centre for Computational Engineering, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN UK
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Mokarram Hossain
- Zienkiewicz Centre for Computational Engineering, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN UK
| | - Grégory Chagnon
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Djordje Perić
- Zienkiewicz Centre for Computational Engineering, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN UK
| | - Georges Karam
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Lara Bsiesy
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Edouard Girard
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
- Laboratoire d’Anatomie des Alpes Françaises, Université Grenoble Alpes, Grenoble, France
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7
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Lee N, Shi L, Colon Caraballo M, Nallasamy S, Mahendroo M, Myers K. Mechanical Response of Mouse Cervices Lacking Decorin and Biglycan During Pregnancy. J Biomech Eng 2022; 144:1139857. [PMID: 35348624 DOI: 10.1115/1.4054199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Indexed: 11/08/2022]
Abstract
Cervical remodeling is critical for a healthy pregnancy. The proper regulation of extracellular matrix (ECM) turnover leads to remodeling throughout gestation, transforming the tissue from a stiff material to a compliant, extensible, viscoelastic tissue prepared for delivery. Small leucine rich proteoglycans (SLRPs) are known to regulate structural fiber assembly in the cervical ECM and overall tissue material properties. To quantify the SLRPs' mechanical role in the cervix, whole cervix specimens from non-pregnant and late pregnant knockout mice of SLRPs, decorin and biglycan, were subjected to cyclic load-unload, ramp-hold, and load-to-failure mechanical tests. Further, a fiber composite material model, accounting for collagen fiber bundle waviness, was developed to describe the three-dimensional large deformation equilibrium behavior of the cervix. In nonpregnant tissue, SLRP KO cervices have the same equilibrium material properties as wild-type tissue. In contrast, the load-to-failure and ramp-hold tests reveal SLRPs impact rupture and time-dependent relaxation behavior. Loss of decorin in NP cervices results in inferior rupture properties. While remodeling recovers cervical strength, the SLRP-deficient tissue has diminished ability to dissipate stress during a ramp-hold. In mice with a combined loss of decorin and biglycan, the pregnant cervix loses its extensibility, compliance, and viscoelasticity. Taken together, these results suggest decorin and biglycan are necessary for key compliance and viscoelastic material property features of a healthy remodeled pregnant cervix.
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Affiliation(s)
- Nicole Lee
- Department of Mechanical Engineering, Columbia University, New York, New York
| | - Lei Shi
- Department of Mechanical Engineering, Columbia University, New York, New York
| | - Mariano Colon Caraballo
- Department of Obstetrics and Gynecology, Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Shanmugasundaram Nallasamy
- Department of Obstetrics and Gynecology, Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Mala Mahendroo
- Department of Obstetrics and Gynecology, Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Kristin Myers
- Department of Mechanical Engineering, Columbia University, New York, New York
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8
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Colon-Caraballo M, Lee N, Nallasamy S, Myers K, Hudson D, Iozzo RV, Mahendroo M. Novel regulatory roles of small leucine-rich proteoglycans in remodeling of the uterine cervix in pregnancy. Matrix Biol 2022; 105:53-71. [PMID: 34863915 PMCID: PMC9446484 DOI: 10.1016/j.matbio.2021.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/03/2023]
Abstract
The cervix undergoes rapid and dramatic shifts in collagen and elastic fiber structure to achieve its disparate physiological roles of competence during pregnancy and compliance during birth. An understanding of the structure-function relationships of collagen and elastic fibers to maintain extracellular matrix (ECM) homeostasis requires an understanding of the mechanisms executed by non-structural ECM molecules. Small-leucine rich proteoglycans (SLRPs) play key functions in biology by affecting collagen fibrillogenesis and regulating enzyme and growth factor bioactivities. In the current study, we evaluated collagen and elastic fiber structure-function relationships in mouse cervices using mice with genetic ablation of decorin and/or biglycan genes as representative of Class I SLRPs, and lumican gene representative of Class II SLRP. We identified structural defects in collagen fibril and elastic fiber organization in nonpregnant mice lacking decorin, or biglycan or lumican with variable resolution of defects noted during pregnancy. The severity of collagen and elastic fiber defects was greater in nonpregnant mice lacking both decorin and biglycan and defects were maintained throughout pregnancy. Loss of biglycan alone reduced tissue extensibility in nonpregnant mice while loss of both decorin and biglycan manifested in decreased rupture stretch in late pregnancy. Collagen cross-link density was similar in the Class I SLRP null mice as compared to wild-type nonpregnant and pregnant controls. A broader range in collagen fibril diameter along with an increase in mean fibril spacing was observed in the mutant mice compared to wild-type controls. Collectively, these findings uncover functional redundancy and hierarchical roles of Class I and Class II SLRPs as key regulators of cervical ECM remodeling in pregnancy. These results expand our understating of the critical role SLRPs play to maintain ECM homeostasis in the cervix.
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Affiliation(s)
- Mariano Colon-Caraballo
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Nicole Lee
- Department of Mechanical Engineering, Columbia University New York, New York 10027
| | - Shanmugasundaram Nallasamy
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Burlington, Vermont 05405
| | - Kristin Myers
- Department of Mechanical Engineering, Columbia University New York, New York 10027
| | - David Hudson
- Department of Orthopaedics and Sports Medicine, University of Washington Seattle, Washington 98165
| | - Renato V. Iozzo
- Department of Pathology, Anatomy, and Cell Biology and the Translational Cellular Oncology Program, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania 19107
| | - Mala Mahendroo
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390,Correspondence to: Mala Mahendroo, Ph.D, Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas 75390.
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9
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Jayyosi C, Lee N, Madhukaran SP, Nallasamy S, Mahendroo M, Myers K. The swelling behavior of the mouse cervix: Changing kinetics with osmolarity and the role of hyaluronan in pregnancy. Acta Biomater 2021; 135:414-424. [PMID: 34411755 DOI: 10.1016/j.actbio.2021.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022]
Abstract
The cervical remodeling process during pregnancy is characterized by progressive compositional and structural changes in the tissues extra-cellular matrix (ECM). Appropriately timed remodeling is critical for healthy gestation and prevention of premature cervical softening leading to preterm birth (PTB). Modification of the ECM glycosaminoglycans (GAGs) content with advancing pregnancy, especially the non-sulfated GAG hyaluronan (HA), is a fundamental change associated with cervical remodeling. While GAGs have numerous physiological roles, the mechanical consequence of evolving GAG content on cervical structure-function behavior remains an open question. Additionally, an understanding of cervical swelling properties, postulated to be regulated in part by GAGs, is required for the appropriate definition of a reference configuration for mechanical tests and to enhance biological understanding. To investigate cervical swelling, osmotic loading tests are conducted on isolated wild type mouse cervices throughout pregnancy. These tests are performed in various osmolarity solutions to assess the influence of the media on swelling kinetics. A genetically altered strain of mice with depletion of cervical HA is also tested to elucidate the contribution of HA to tissue swelling. Results show ex vivo cervical swelling is significant with volume changes ranging from 20 to 100% after 3h of free swelling. The swelling kinetics depend highly on osmolarity of the media and is altered with advancing pregnancy. The contribution of HA to swelling is only significant in hypo-osmotic solution when HA cervical content is high at the end of pregnancy. In summary, it is critical to account for swelling deformation mechanisms after excision in mechanical experiments. STATEMENT OF SIGNIFICANCE: The cervical extracellular matrix (ECM) undergoes drastic changes to fulfill the functional change of the cervix during pregnancy. Inappropriate timing for this transformation can result in preterm birth, a severe clinical challenge. One of the fundamental changes of the cervical ECM is the significant modification of the glycosaminoglycan content, especially hyaluronan (HA), which is thought to contribute significantly to the swelling and mechanical properties of the cervix. This study aims to measure the swelling kinetics of cervical tissue during pregnancy and to investigate the role of HA in these swelling tendencies. Results show the significant swelling of cervical tissue, which evolves as pregnancy progresses, highlighting a key material property feature of the remodeled cervix. Using a mouse strain with a cervical HA depletion, this work shows HA contributes to the swelling trends of late-term cervical tissue, in a hypo-osmotic solution.
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Affiliation(s)
- C Jayyosi
- Department of Mechanical Engineering, Columbia University, New York, NY, 10027, USA
| | - N Lee
- Department of Mechanical Engineering, Columbia University, New York, NY, 10027, USA
| | - S P Madhukaran
- Department of Obstetrics and Gynecology and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - S Nallasamy
- Department of Obstetrics and Gynecology and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - M Mahendroo
- Department of Obstetrics and Gynecology and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA
| | - K Myers
- Department of Mechanical Engineering, Columbia University, New York, NY, 10027, USA.
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10
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Acuna A, Jimenez JM, Deneke N, Rothenberger SM, Libring S, Solorio L, Rayz VL, Davis CS, Calve S. Design and validation of a modular micro-robotic system for the mechanical characterization of soft tissues. Acta Biomater 2021; 134:466-476. [PMID: 34303012 PMCID: PMC8542608 DOI: 10.1016/j.actbio.2021.07.035] [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: 01/07/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
The mechanical properties of tissues are critical design parameters for biomaterials and regenerative therapies seeking to restore functionality after disease or injury. Characterizing the mechanical properties of native tissues and extracellular matrix throughout embryonic development helps us understand the microenvironments that promote growth and remodeling, activities critical for biomaterials to support. The mechanical characterization of small, soft materials like the embryonic tissues of the mouse, an established mammalian model for development, is challenging due to difficulties in handling minute geometries and resolving forces of low magnitude. While uniaxial tensile testing is the physiologically relevant modality to characterize tissues that are loaded in tension in vivo, there are no commercially available instruments that can simultaneously measure sufficiently low tensile force magnitudes, directly measure sample deformation, keep samples hydrated throughout testing, and effectively grip minute geometries to test small tissues. To address this gap, we developed a micromanipulator and spring system that can mechanically characterize small, soft materials under tension. We demonstrate the capability of this system to measure the force contribution of soft materials, silicone, fibronectin sheets, and fibrin gels with a 5 nN - 50 µN force resolution and perform a variety of mechanical tests. Additionally, we investigated murine embryonic tendon mechanics, demonstrating the instrument can measure differences in mechanics of small, soft tissues as a function of developmental stage. This system can be further utilized to mechanically characterize soft biomaterials and small tissues and provide physiologically relevant parameters for designing scaffolds that seek to emulate native tissue mechanics. STATEMENT OF SIGNIFICANCE: The mechanical properties of cellular microenvironments are critical parameters that contribute to the modulation of tissue growth and remodeling. The field of tissue engineering endeavors to recapitulate these microenvironments in order to construct tissues de novo. Therefore, it is crucial to uncover the mechanical properties of the cellular microenvironment during tissue formation. Here, we present a system capable of acquiring microscale forces and optically measuring sample deformation to calculate the stress-strain response of soft, embryonic tissues under tension, and easily adaptable to accommodate biomaterials of various sizes and stiffnesses. Altogether, this modular system enables researchers to probe the unknown mechanical properties of soft tissues throughout development to inform the engineering of physiologically relevant microenvironments.
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Affiliation(s)
- Andrea Acuna
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States
| | - Julian M Jimenez
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States
| | - Naomi Deneke
- School of Materials Engineering, Purdue University, Neil Armstrong Hall of Engineering, 701 West Stadium Avenue, West Lafayette, IN 47907, United States
| | - Sean M Rothenberger
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States
| | - Sarah Libring
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States
| | - Luis Solorio
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States; Purdue Center for Cancer Research, Purdue University, 201 South Street, West Lafayette, IN 47906, United States
| | - Vitaliy L Rayz
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States
| | - Chelsea S Davis
- School of Materials Engineering, Purdue University, Neil Armstrong Hall of Engineering, 701 West Stadium Avenue, West Lafayette, IN 47907, United States
| | - Sarah Calve
- Weldon School of Biomedical Engineering, Purdue University, 206 South Martin Jischke Drive, West Lafayette, IN 47907, United States; Paul M. Rady Department of Mechanical Engineering, University of Colorado - Boulder, 1111 Engineering Center, 427 UCB, Boulder, CO 80309, United States.
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11
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Nallasamy S, Palacios HH, Setlem R, Caraballo MC, Li K, Cao E, Shankaran M, Hellerstein M, Mahendroo M. Transcriptome and proteome dynamics of cervical remodeling in the mouse during pregnancy. Biol Reprod 2021; 105:1257-1271. [PMID: 34309663 DOI: 10.1093/biolre/ioab144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022] Open
Abstract
During gestation, the female reproductive tract must maintain pregnancy while concurrently preparing for parturition. Here, we explore the transitions in gene expression and protein turnover (fractional synthesis rates [FSR]) by which the cervix implements a transition from rigid to compliant. Shifts in gene transcription to achieve immune tolerance and alter epithelial cell programs begin in early pregnancy. Subsequently, in mid-to-late pregnancy transcriptional programs emerge that promote structural reorganization of the extracellular matrix (ECM). Stable isotope labeling revealed a striking slowdown of overall FSRs across the proteome on gestation day 6 that reverses in mid-to-late pregnancy. An exception was soluble fibrillar collagens and proteins of collagen assembly, which exhibit high turnover in non-pregnant cervix compared to other tissues and FSRs that continue throughout pregnancy. This finding provides a mechanism to explain how cross-linked collagen is replaced by newly synthesized, less-cross-linked collagens, which allows increased tissue compliance during parturition. The rapid transition requires a reservoir of newly synthesized, less cross-linked collagens, which is assured by the high FSR of soluble collagens in the cervix. These findings suggest a previously unrecognized form of "metabolic flexibility" for ECM in the cervix that underlies rapid transformation in compliance to allow parturition.
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Affiliation(s)
- Shanmugasundaram Nallasamy
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Hector H Palacios
- Department of Nutritional Sciences & Toxicology, University of California Berkeley, Berkeley, CA
| | - Rohit Setlem
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Mariano Colon Caraballo
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Kelvin Li
- Department of Nutritional Sciences & Toxicology, University of California Berkeley, Berkeley, CA
| | - Edward Cao
- Department of Nutritional Sciences & Toxicology, University of California Berkeley, Berkeley, CA
| | - Mahalakshmi Shankaran
- Department of Nutritional Sciences & Toxicology, University of California Berkeley, Berkeley, CA
| | - Marc Hellerstein
- Department of Nutritional Sciences & Toxicology, University of California Berkeley, Berkeley, CA
| | - Mala Mahendroo
- Department of Ob/Gyn and Cecil H. and Ida Green Center for Reproductive Biological Science, The University of Texas Southwestern Medical Center, Dallas, TX
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12
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Zhang T, Guo S, Zhou H, Wu Z, Liu J, Qiu C, Deng G. Endometrial extracellular matrix rigidity and IFNτ ensure the establishment of early pregnancy through activation of YAP. Cell Prolif 2021; 54:e12976. [PMID: 33393124 PMCID: PMC7849163 DOI: 10.1111/cpr.12976] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background In mammals, early pregnancy is a critical vulnerable period during which complications may arise, including pregnancy failure. Establishment of a maternal endometrial acceptance phenotype is a prerequisite for semiheterogeneous embryo implantation, comprising the rate‐limiting step of early pregnancy. Methods Confocal fluorescence, immunohistochemistry and western blot for nuclear and cytoplasmic protein were used to examine the activation of yes‐associated protein (YAP) in uterine tissue and primary endometrial cells. The target binding between miR16a and YAP was verified by dual‐luciferase reporter gene assay. The mouse pregnancy model and pseudopregnancy model were used to investigate the role of YAP in the maternal uterus during early pregnancy in vivo. Results We showed that YAP translocates into the nucleus in the endometrium of cattle and mice during early pregnancy. Mechanistically, YAP acts as a mediator of ECM rigidity and cell density, which requires the actomyosin cytoskeleton and is partially dependent on the Hippo pathway. Furthermore, we found that the soluble factor IFNτ, which is a ruminant pregnancy recognition factor, also induced activation of YAP by reducing the expression of miR‐16a. Conclusions This study revealed that activation of YAP is necessary for early pregnancy in bovines because it induced cell proliferation and established an immunosuppressive local environment that allowed conceptus implantation into the uterine epithelium.
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Affiliation(s)
- Tao Zhang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Shuai Guo
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Han Zhou
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhimin Wu
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Junfeng Liu
- College of Animal Science, Tarim University, Alar, China
| | - Changwei Qiu
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Ganzhen Deng
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
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13
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Callejas A, Melchor J, Faris IH, Rus G. Hyperelastic Ex Vivo Cervical Tissue Mechanical Characterization. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4362. [PMID: 32764345 PMCID: PMC7472274 DOI: 10.3390/s20164362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/19/2020] [Accepted: 08/03/2020] [Indexed: 12/18/2022]
Abstract
This paper presents the results of the comparison between a proposed Fourth Order Elastic Constants (FOECs) nonlinear model defined in the sense of Landau's theory, and the two most contrasted hyperelastic models in the literature, Mooney-Rivlin, and Ogden models. A mechanical testing protocol is developed to investigate the large-strain response of ex vivo cervical tissue samples in uniaxial tension in its two principal anatomical locations, the epithelial and connective layers. The final aim of this work is to compare the reconstructed shear modulus of the epithelial and connective layers of cervical tissue. According to the obtained results, the nonlinear parameter A from the proposed FOEC model could be an important biomarker in cervical tissue diagnosis. In addition, the calculated shear modulus depended on the anatomical location of the cervical tissue (μepithelial = 1.29 ± 0.15 MPa, and μconnective = 3.60 ± 0.63 MPa).
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Affiliation(s)
- Antonio Callejas
- Department of Structural Mechanics, University of Granada, 18010 Granada, Spain; (I.H.F.); (G.R.)
- Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
| | - Juan Melchor
- Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
- Excellence Research Unit, “Modelling Nature” (MNat), University of Granada, 18010 Granada, Spain
- Department of Statistics and Operations Research, University of Granada, 18010 Granada, Spain
| | - Inas H. Faris
- Department of Structural Mechanics, University of Granada, 18010 Granada, Spain; (I.H.F.); (G.R.)
- Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
| | - Guillermo Rus
- Department of Structural Mechanics, University of Granada, 18010 Granada, Spain; (I.H.F.); (G.R.)
- Instituto de Investigación Biosanitaria, ibs.GRANADA, 18012 Granada, Spain;
- Excellence Research Unit, “Modelling Nature” (MNat), University of Granada, 18010 Granada, Spain
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14
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Gou K, Topol H, Demirkoparan H, Pence TJ. Stress-Swelling Finite Element Modeling of Cervical Response With Homeostatic Collagen Fiber Distributions. J Biomech Eng 2020; 142:1072289. [PMID: 31891375 DOI: 10.1115/1.4045810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Indexed: 01/01/2023]
Abstract
During pregnancy, the cervix experiences significant mechanical property change due to tissue swelling, and to ongoing changes in the collagen content. In this paper, we model how these two effects contribute to cervical deformation as the pressure load on top of the cervix increases. The cervix and its surrounding supporting ligaments are taken into consideration in the resulting mechanical analysis. The cervix itself is treated as a multilayered tube-like structure, with layer-specific collagen orientation. The cervical tissue in each layer is treated in terms of a collagen constituent that remodels with time within a ground substance matrix that experiences swelling. The load and swelling are taken to change sufficiently slowly so that the collagen properties at any instant can be regarded as being in a state of homeostasis. Among other things, the simulations show how the luminal cross-sectional area varies along its length as a function of pressure and swelling. In general, an increase in pressure causes an overall shortening of the lumen while an increase in swelling has the opposite effect.
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Affiliation(s)
- Kun Gou
- Department of Science and Mathematics, Texas A&M University-San Antonio, San Antonio, TX 78224
| | - Heiko Topol
- Carnegie Mellon University in Qatar, Education City, P.O. Box 24866, Doha, Qatar
| | - Hasan Demirkoparan
- Carnegie Mellon University in Qatar, Education City, P.O. Box 24866, Doha, Qatar
| | - Thomas J Pence
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824
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15
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Yao X, Li D, Park HC, Chen D, Guan H, Mahendroo M, Li X. Ultra-sensitive optical coherence elastography using a high-dynamic-range force loading scheme for cervical rigidity assessment. BIOMEDICAL OPTICS EXPRESS 2020; 11:688-698. [PMID: 32133219 PMCID: PMC7041475 DOI: 10.1364/boe.383720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/16/2019] [Accepted: 12/22/2019] [Indexed: 05/29/2023]
Abstract
An ultra-sensitive, wide-range force loading scheme is proposed for compression optical coherence elastography (OCE) that allows for the quantitative analysis of cervical tissue elasticity ex vivo. We designed a force loading apparatus featuring a water sink for minuscule incremental loading through a volume-controlled water droplet, from which the Young's modulus can be calculated by fitting the stress-strain curve. We validated the performance of the proposed OCE system on homogenous agar phantoms, showing the Young's modulus can be accurately estimated using this scheme. We then measured the Young's modulus of rodent cervical tissues acquired at different gestational ages, showing that the cervical rigidity of rodents was significantly dropped when entering the third trimester of pregnancy.
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Affiliation(s)
- Xinwen Yao
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
- SERI-NTU Advanced Ocular Engineering (STANCE), 50 Nanyang Drive #04-13, Singapore 637553, Singapore
- These authors contribute equally to this work
| | - Dawei Li
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
- These authors contribute equally to this work
| | - Hyeon-Cheol Park
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
| | - Defu Chen
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
| | - Honghua Guan
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
| | - Mala Mahendroo
- Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Xingde Li
- Department of Biomedical Engineering, 720 Rutland Ave, Baltimore, MD 21205, USA
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16
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Zierden HC, Ortiz Ortiz JI, Dimitrion P, Laney V, Bensouda S, Anders NM, Scardina M, Hoang T, Ronnett BM, Hanes J, Burd I, Mahendroo M, Ensign LM. Characterization of an Adapted Murine Model of Intrauterine Inflammation-Induced Preterm Birth. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 190:295-305. [PMID: 31837289 DOI: 10.1016/j.ajpath.2019.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/17/2022]
Abstract
Preterm birth (PTB) affects nearly 15 million infants each year. Of these PTBs, >25% are a result of inflammation or infection. Animal models have improved our understanding of the mechanisms leading to PTB. Prior work has described induction of intrauterine inflammation in mice with a single injection of lipopolysaccharide (LPS). Herein, we have improved the reproducibility and potency of LPS in the model using two injections distal to the cervix. An in vivo imaging system revealed more uniform distribution of Evans Blue Dye using a double distal injection (DDI) approach compared with a single proximal injection (SPI). Endotoxin concentrations in vaginal lavage fluid from SPI dams were significantly higher than from DDI dams. At equivalent LPS doses, DDI consistently induced more PTB than SPI, and DDI showed a linear dose-response, whereas SPI did not. Gene expression in myometrial tissue revealed increased levels of inflammatory markers in dams that received LPS DDI compared with LPS SPI. The SPI group showed more significant overexpression in cervical remodeling genes, likely due to the leakage of LPS from the uterine horns through the cervix. The more reliable PTB induction and uniform uterine exposure provided by this new model will be useful for further studying fetal outcomes and potential therapeutics for the prevention of inflammation-induced PTB.
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Affiliation(s)
- Hannah C Zierden
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Jairo I Ortiz Ortiz
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peter Dimitrion
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Victoria Laney
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Sabrine Bensouda
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nicole M Anders
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Morgan Scardina
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thuy Hoang
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brigitte M Ronnett
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Justin Hanes
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Irina Burd
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Mala Mahendroo
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Laura M Ensign
- The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University, Baltimore, Maryland.
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17
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Zhang Y, Raia N, Peterson A, Kaplan DL, House M. Injectable Silk-Based Hydrogel as an Alternative to Cervical Cerclage: A Rabbit Study. Tissue Eng Part A 2019; 26:379-386. [PMID: 31621512 DOI: 10.1089/ten.tea.2019.0210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Preterm birth is a common cause of morbidity and mortality in newborn infants. Cervical insufficiency (CI) is a significant cause of preterm birth. The treatment for CI is cerclage, which is a suture placed around the cervix to provide mechanical support. Cerclage, however, is associated with limited efficacy. Here we present an injectable, silk-based hydrogel as an alternative to cerclage. Objective: Pregnant rabbits were used as an animal model of pregnancy to study the mechanical properties, biocompatibility, and degradation of the hydrogel after cervical injection. Study Design: Silk hydrogel (200 μL volume) was injected into the cervix. Controls were either injected with saline or treated with cerclage (5-0 polyethylene terephthalate suture). To study the effect on mechanical properties, the cervix was tested in compression. Biodegradation of the hydrogel was followed over 6 weeks. For biocompatibility, expression levels of proinflammatory mediators were studied. Results: Hydrogel injection resulted in significant tissue augmentation-the cross-sectional area of the cervix increased 46.3 ± 3.0%. The modulus of the uninjected and hydrogel-injected tissues was 3.3 ± 0.7 and 3.2 ± 0.5 kPa at 5-10% strain, respectively (p = 0.8). Histology showed a mild inflammatory response surrounding the hydrogel. Biodegradation of the hydrogel showed 70% volume loss over 6 weeks. Hydrogel-injected tissue showed similar inflammatory response compared with cerclage. Conclusions: In pregnant rabbits, cervical injection of the silk-based hydrogel was biocompatible and naturally degraded. No adverse effects on timing of delivery and pup viability were seen. Silk-based hydrogels show promise for tissue augmentation during pregnancy. Impact Statement This research describes the use of injectable silk-based hydrogel for augmenting cervical tissue in vivo in a pregnant rabbit model. Further preclinical development of the methods and insights described in this article can lead to therapeutic use of this hydrogel as an alternative to cerclage in preterm birth due to cervical insufficiency.
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Affiliation(s)
- Yali Zhang
- Tufts Medical Center, Mother Infant Research Institute, Boston, Massachusetts
| | - Nicole Raia
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
| | - Ashley Peterson
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
| | - Michael House
- Tufts Medical Center, Mother Infant Research Institute, Boston, Massachusetts.,Department of Biomedical Engineering, Tufts University, Medford, Massachusetts.,Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts
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18
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Yoshida K, Jayyosi C, Lee N, Mahendroo M, Myers KM. Mechanics of cervical remodelling: insights from rodent models of pregnancy. Interface Focus 2019; 9:20190026. [PMID: 31485313 PMCID: PMC6710664 DOI: 10.1098/rsfs.2019.0026] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2019] [Indexed: 01/01/2023] Open
Abstract
The uterine cervix undergoes a complex remodelling process during pregnancy, characterized by dramatic changes in both extracellular matrix (ECM) structure and mechanical properties. Understanding the cervical remodelling process in a term or preterm birth will aid efforts for the prevention of preterm births (PTBs), which currently affect 14.8 million babies annually worldwide. Animal models of pregnancy, particularly rodents, continue to provide valuable insights into the cervical remodelling process, through the study of changes in ECM structure and mechanical properties at defined gestation time points. Currently, there is a lack of a collective, quantitative framework to relate the complex, nonlinear mechanical behaviour of the rodent cervix to changes in ECM structure. This review aims to fill this gap in knowledge by outlining the current understanding of cervical remodelling during pregnancy in rodent models in the context of solid biomechanics. Here we highlight the collective contribution of multiple mechanical studies which give evidence that cervical softening coincides with known ECM changes throughout pregnancy. Taken together, mechanical tests on tissue from pregnant rodents reveal the cervix's remarkable ability to soften dramatically during gestation to allow for a compliant tissue that can withstand damage and can dissipate mechanical loads.
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Affiliation(s)
- Kyoko Yoshida
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Charles Jayyosi
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Nicole Lee
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Mala Mahendroo
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristin M. Myers
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
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19
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Akintunde A, Robison KM, Capone D, Desrosiers L, Knoepp LR, Miller KS. Effects of elastase digestion on the murine vaginal wall biaxial mechanical response. J Biomech Eng 2018; 141:2716276. [PMID: 30453317 DOI: 10.1115/1.4042014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Indexed: 11/08/2022]
Abstract
Although the underlying mechanisms of pelvic organ prolapse (POP) remain unknown, disruption of elastic fiber metabolism within the vaginal wall extracellular matrix has been highly implicated. It has been hypothesized that elastic fiber fragmentation correlates to decreased structural integrity and increased risk of prolapse; however, the mechanisms by which elastic fiber damage may contribute to prolapse are poorly understood. Further, the role of elastic fibers in normal vaginal wall mechanics has not been fully ascertained. Therefore, the objective of this study is to investigate the contribution of elastic fibers to murine vaginal wall mechanics. Vaginal tissue from C57BL/6 female mice were mechanically tested using biaxial extension-inflation protocols before and after intraluminal exposure to elastase. Elastase digestion induced marked changes in the vaginal geometry, and biaxial mechanical properties, suggesting that elastic fibers may play an important role in vaginal wall mechanical function. Additionally, a constitutive model that considered two diagonal families of collagen fibers with a slight preference towards the circumferential direction described the data reasonably well before and after digestion. The present findings may be important to determine the underlying structural and mechanical mechanisms of POP, and aid in the development of growth and remodeling models for improved assessment and prediction of changes in structure-function relationships with prolapse development. Keywords: vaginal wall, women's health, mechanical testing, pelvic floor disorders, elastic fibers Disclosures: none.
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Affiliation(s)
- Akinjide Akintunde
- Department of Biomedical Engineering, Lindy Boggs Center Suite 500, Tulane University, New Orleans, LA 70118 USA
| | - Kathryn M Robison
- ASME Member, Department of Biomedical Engineering, Lindy Boggs Center Suite 500, Tulane University, New Orleans, LA 70118 USA
| | - Daniel Capone
- Department of Biomedical Engineering, Lindy Boggs Center Suite 500, Tulane University, New Orleans, LA 70118 USA
| | - Laurephile Desrosiers
- Department of Female Pelvic Medicine & Reconstructive Surgery, UQ Ochsner Clinical School, 1514 Jefferson Highway, New Orleans, LA 70121
| | - Leise R Knoepp
- Department of Female Pelvic Medicine & Reconstructive Surgery, UQ Ochsner Clinical School, 1514 Jefferson Highway, New Orleans, LA 70121
| | - Kristin S Miller
- ASME Member, Department of Biomedical Engineering, Lindy Boggs Center Suite 500, Tulane University, New Orleans, LA 70118 USA
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