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Luteal phase concentrations of a progestagen-associated endometrial protein (PEP) in the serum of cycling women with adequate or inadequate endometrium.

We previously demonstrated that the human endometrium synthesizes and secretes a specific protein designated "Progestagen-associated Endometrial Protein" or PEP. This work was undertaken to determine luteal phase levels of PEP in serum of cycling women with histologic evidence of adequate endometrium (endometrium in phase) or inadequate endometrium (endometrium out of phase by 3-4 days). The results provide a normative curve with 95% confidence limits for serum PEP concentrations vs normalized cycle day in women with adequate endometrium (judged by histologic endometrial dating), and indicate that the PEP concentration increases exponentially after day 22, with a mean doubling time of 2.95 +/- 1.60 (mean +/- SD) days (based on serial data from 13 women). More importantly, the proportion of serum PEP values falling outside of the 95% confidence limits was significantly greater (p less than 0.001) in women with inadequate endometrium (83%) than in women with adequate endometrium (16%). Therefore, determination of PEP in serum, rather than the more invasive endometrial biopsy examination, may serve as a method of choice for evaluating endometrial adequacy in infertile women.

Endometrium↗

Immunohistological localization of the human endometrial secretory protein pregnancy-associated endometrial alpha 1-globulin, an insulin-like growth factor-binding protein, during the menstrual cycle.

Pregnancy-associated endometrial alpha 1-globulin (alpha 1-PEG), a 29,000 mol wt insulin-like growth factor-binding protein, is the major secretory protein of the human endometrium from the latter half of the first trimester to the end of pregnancy. It is also produced and secreted by nonpregnant endometrial tissue, especially during the late secretory phase of the menstrual cycle. We studied the localization of this protein in the endometrium during different phases of the cycle using immunohistochemistry with monoclonal antibodies. Immunostaining was first observed in the midsecretory phase and was most consistently detected during the late secretory phase, during which it was principally associated with stromal cell populations. These cells were localized initially surrounding spiral arteries and subsequently also in the subluminal epithelial region of the endometrium. These results suggest that alpha 1-PEG synthesis is principally associated with the process of stromal cell differentiation. i.e. predecidualization. However, the presence of alpha 1-PEG was not directly correlated with the presence of mature predecidual cells, suggesting that its synthesis is not an inherent feature of this cell.

Adult↗

De novo synthesis of placental protein-14 (PP14) and not PP12 by monolayer cultures of glandular epithelium of gestational endometrium.

Nine monolayer cell cultures of glandular epithelium from gestational endometrium were established from six apparently healthy women undergoing elective termination of pregnancy (7-11 weeks gestation). Radiolabel incorporation studies showed increasing incorporation of [35S]methionine into proteins present in supernatant and cytosol fractions over 48 h. The secreted proteins represented approximately 20% of the total incorporation of methionine into cytosolic proteins. De novo synthesis and secretion of placental protein-14 (PP14) and not PP12 was identified by a novel combination of line immunoelectrophoresis and autoradiography. All monolayer cultures demonstrated the presence of radiolabeled PP14, but not PP12, in the culture supernatants. These observations suggest that the glandular epithelial cells are the major site of synthesis and secretion of PP14 in human gestational endometrium.

Antibodies↗

Progesterone and human chorionic gonadotropin do not stimulate placental proteins 12 and 14 or prolactin production by human decidual tissue in vitro.

To investigate the regulation of the synthesis and secretion of placental proteins-12 (PP12) and -14 (PP14) and PRL, explants and enriched preparations of stromal cells and gland cells obtained from 10 human early pregnancy decidua were preincubated in medium for 24 h (baseline), followed by incubation in medium with or without progesterone (0.02-32 mumol/L), hCG (10 and 100 ng/ml), or cAMP (0.25-1 mmol/L) in an atmosphere of 5% CO2-95% air at 37 C for another 96-120 h. Media were changed each 24 h, and PP12, PP14, and PRL levels were determined by RIA. Decidual explants, as well as their isolated cells produced detectable levels of PP12, PP14, and PRL in vitro. The gland cells synthesized and secreted about 30 times more PP14 than did stromal cells. After 96-120 h of incubation, the production of each protein by control cultures was increased 81-167% compared to the baseline (not significant). The secretion of these proteins in medium supplemented with progesterone or hCG was not significantly different from that in the control groups. 8-Bromo-cAMP significantly increased the secretion of PRL and PP12, but not PP14, by stromal cells compared to control values. We conclude that 1) PP14 is mainly produced by decidual gland cells; 2) progesterone at the concentrations used in our study does not stimulate production of PP12, PP14, and PRL in decidualized endometrium in vitro; 3) hCG does not stimulate the production of PP12 and PP14 in decidualized endometrium; and 4) 8-bromo-cAMP stimulates decidual stromal cell secretion of PRL and PP12.

8-Bromo Cyclic Adenosine Monophosphate↗

Role of the ovary in the synthesis of placental protein-14.

Women with absent ovarian function provide an opportunity to investigate the ovarian contribution to secretion of placental proteins (PP), such as PP14, in early pregnancy. We present data on serum PP14 levels in 12 women (median age, 30.5 yr; range, 26-37 yr) with premature ovarian failure (POF) who conceived after ovum donation and embryo transfer with exogenous sex steroid support using transdermal (n = 5) or oral (n = 7) estradiol and vaginal (n = 8) or im (n = 4) progesterone. The women were closely monitored throughout early pregnancy, with measurement of serum levels of estradiol (E2), progesterone (P4), and PP14. Levels of E2 and P4 were entirely normal. Levels of PP14 were significantly subnormal (P = 0.008) in all 12 agonadal women compared with levels of PP14 in a control group of women with normal ovarian function between 6-12 weeks gestation. Basal and peak levels for subjects with absent ovarian function were 40 and 124 micrograms/L, respectively. For each week between 6-12 weeks of pregnancy, the mean serum levels of PP14 for women with normal ovarian function were between 706-940 micrograms/L. These observations support the concept that PP14 arises from the ovary in early pregnancy or that factors under the control of the maternal ovary are involved in its production by the endometrium.

Adult↗

Human decidua synthesizes placental protein 14 (PP14) in vitro.

Human decidua was found to synthesize and secrete placental protein 14 (PP14). The presence of PP14 in tissue explants of decidua, foetal membranes and placenta from term pregnancy was demonstrated by radioimmunoassay. The PP14 content in decidua (1300 +/- 410 ng/100 mg tissue) was higher than in chorion (570 +/- 120 ng/100 mg; P less than 0.01), amnion (240 +/- 100 ng/100 mg; P less than 0.001) or placenta (300 +/- 130 ng/100 mg; P less than 0.001). Three to 36 times more PP14 was released into culture medium by decidual explants compared with the other tissues, and cycloheximide decreased this release by 39%. Placental tissues released hardly any PP14. Decidual synthesis of PP14 was demonstrated by incorporation of [35S]methionine into immunoprecipitable PP14 in tissue culture.

Autoradiography↗

A progestagen-dependent endometrial protein in human amniotic fluid.

A protein was detected in human amniotic fluid that had properties identical to those of the progestagen-dependent endometrial protein. The concentration of the amniotic fluid protein was maximal during Weeks 15-18 of pregnancy and then declined rapidly. The protein was not detected in immature and mature placentae, ovary, Fallopian tube, myometrium and cervix. We conclude that a specific protein synthesized by the human uterine decidua is transported to the amniotic sac.

Adult↗

Localization of alpha-uterine protein in human endometrium.

Immunoperoxidase staining was used to investigate the origin of human alpha-uterine protein (AUP). Specific staining was observed in the glandular epithelium of the endometrium during the secretory phase of the menstrual cycle and during pregnancy, and in a patient on an oestrogen-progestagen contraceptive pill. The pattern of staining strongly suggests that AUP is secreted into the uterine lumen. The location and concentration of AUP in the uterus may explain the relative concentrations of AUP in amniotic fluid and maternal serum.

Amnion↗

N-terminal sequence analysis of human placental protein 14, purified in high yield from decidual cytosol.

Human placental protein 14 (PP14) has been purified in high yield from first trimester decidual cytosol. High-performance liquid chromatography on anion exchange, gel filtration and reverse-phase chromatography were used. The protein obtained is approximately 97% pure with an overall recovery of about 50% from the original tissue extract. The first 24 amino acids of the N-terminal were found to be Met-Asp-Ile-Pro-Gln-Thr-Lys-Gln-Asp-Leu-Glu-Leu-Pro-Lys-Leu-Ala-Gly-Thr-Glu-His - Glu-Met-Ala-Met. PP14 has been characterized in this study to be a dimeric glycoprotein of Mr 60,000, with homologous subunits having an Mr of 28,000.

Amino Acid Sequence↗

Immunohistological localization of human pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), a glycosylated beta-lactoglobulin homologue, in the decidua and placenta during pregnancy.

Monoclonal and polyclonal antibodies to pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), a glycosylated human beta-lactoglobulin homologue, were used in an immunohistological technique to determine the cellular localization of this protein in the decidua and placental tissues during pregnancy. During the first trimester the protein was principally localized to the glandular epithelium of the decidua spongiosa region of the endometrium with only weak staining associated with glands of the decidualized decidua compacta region. No significant cellular staining was detected in the decidua capsularis. At term in the decidua of the amniochorion and the placental bed weak staining for alpha 2-PEG was only associated with the epithelium of attenuated glands. No significant staining was detected in the placenta during pregnancy. These results suggest that the epithelium of glands associated with non-decidualized stroma represents the primary source of alpha 2-PEG during the first trimester and that a function of the decidua spongiosa in early pregnancy may be related to production of alpha 2-PEG. The decline in production of alpha 2-PEG during pregnancy is suggested to result from involution of the decidua spongiosa and at term the attenuated glands of the decidua represents the source of alpha 2-PEG.

Decidua↗

Localization of progesterone-associated endometrial protein mRNA by in-situ hybridization in human pregnancy decidua, endometriosis and borderline endometrioid adenoma.

Progesterone-associated endometrial protein (PAEP) has been isolated from human decidualized endometrium. In-situ hybridization histochemistry was employed to determine the cellular localization of PAEP mRNA in decidua during pregnancy. PAEP mRNA was found to be expressed in the glandular epithelium of decidua spongiosa throughout pregnancy. Substantial variations in the amount of PAEP mRNA during the course of pregnancy were observed, and it was most abundant at the end of the first trimester. We also found that the PAEP gene was expressed in endometriosis and in a borderline endometrioid adenoma. As in decidual tissues, PAEP mRNA in endometriosis was abundant in the glandular compartment.

Adenoma↗

Major secretory protein of human decidualized endometrium in pregnancy is an insulin-like growth factor-binding protein.

Pregnancy-associated endometrial alpha 1-globulin (alpha 1-PEG) is quantitatively the major secretory protein product, synthesized and secreted in vitro, of the human decidualized endometrium during pregnancy. This protein has been purified from cytosolic extracts of this tissue and has now been characterized as a 32 kDa somatomedin/insulin-like growth factor (IGF)-binding protein. Immunoreactive alpha 1-PEG isolated from amniotic fluid exhibited identical physiochemical properties and IGF-I-binding characteristics. In cytosolic extracts of pregnancy endometrium, in incubation medium of this tissue and in amniotic fluid, the 32 kDa protein represented the major alpha 1-PEG immunoreactive protein and major IGF-I-binding component. Purified alpha 1-PEG and incubation medium of pregnancy endometrium competed for IGF-I with placental membrane IGF receptors in vitro. The implications of the endometrial source of IGF-I-binding protein are discussed with reference to the origin of the amniotic fluid and serum small Mr IGF-binding protein and to the suggested paracrine effect upon trophoblast proliferation.

Affinity Labels↗

Human 'pregnancy-associated endometrial alpha 1-globulin', an insulin-like growth factor-binding protein: immunohistological localization in the decidua and placenta during pregnancy employing monoclonal antibodies.

We have previously shown that pregnancy-associated endometrial alpha 1-globulin, a small molecular weight insulin-like growth factor-binding protein (IGF-BP), is quantitatively the major secretory protein product of the decidualized endometrium during human pregnancy. In the present study, employing monoclonal antibodies raised against this protein in an immunohistological technique, the cellular localization of the protein has been examined in the decidua and placenta during pregnancy. During the first trimester the protein was principally associated with the decidual cell in the decidualized decidua compacta region of the endometrium with both cytoplasmic and extracellular matrix-associated staining patterns being detected. No extensive staining was observed in the placenta. At term the protein was localized in similar cells in the placental bed and endometrium associated with the amniochorion but not in the placenta. These studies suggest that the decidual cell represents the major source of IGF-BP during pregnancy and have relevance to the origin of amniotic fluid IGF-BP and the paracrine role of the decidual cell in the control of trophoblast growth.

Antibodies, Monoclonal↗

Is ovarian relaxin a stimulus to placental protein 14 secretion in pregnancy?

The objective of this study was to investigate whether relaxin might be involved in placental protein 14 (PP14) secretion by measuring serum levels of PP14 during labour and post partum in normal women with a term pregnancy given vaginal human recombinant relaxin (rhRlx) gel for induction of labour. A randomized double-blind controlled trial was conducted on 11 women with a singleton pregnancy at term admitted for induction of labour. Comparison of serum PP14 and relaxin concentrations in the control and treated groups of subjects revealed that there was an increase in serum relaxin concentrations in women receiving 3 mg or 6 mg relaxin. There was no difference in serum PP14 levels between the control and treatment groups. These findings do not support the hypothesis that relaxin is involved in the control of PP14 secretion. However, the failure of any response might be a consequence of the very small increase in systemic levels of relaxin produced by topical vaginal administration of rhRlx. Furthermore, these measurements were made in late pregnancy and hence may not relate to the events in early pregnancy, when serum levels of PP14 are maximal.

Adult↗

Is decidua affected in gestational hypertension? Indication by elevated PP14 levels.

The serum concentration of placental protein 14 (PP14) was measured by radioimmunoassay in 129 apparently healthy pregnant women at 33-40 weeks, and the results were compared with those of 40 women with gestational hypertension either with or without proteinuria at similar weeks. In normal pregnancy, maternal serum PP14 levels decreased towards term. Therefore, the results were expressed as multiples of the normal median for each week. In gestational hypertension, the values were higher than normal (p less than 0.001): they were above the normal median in 32 (80%) cases (p less than 0.005), and above the normal 90th percentile in 15 (38%) cases (p less than 0.001). The presence or absence of proteinuria did not affect the result. Since recent findings suggest that PP14 is synthesized by late pregnancy decidua and not by the placenta, our results suggest that decidua may be affected in gestational hypertension.

Adolescent↗

Placental proteins (PP 5, PP 12 and PP 14) in ovarian tumors. A preliminary report.

Using a specific radio-immunoassay, the placental proteins PP 12, PP 14 and PP 5 were studied in serum for 2 patients with ovarian cancer and 7 with benign ovarian tumor. Elevated levels of PP 14, found in one endometroid ovarian cancer, decreased during successful treatment. PP 14 could also be found in the blood of nude mice grafted with this tumor. One patient with serous kystadenocarcinoma had a slightly elevated level of PP 14 at diagnosis, increasing as the tumor progressed. PP 14 was demonstrated histochemically in both the original tumor and the grafted. Ascitic fluid was rich in PP 14. Elevated levels of the proteins PP 12 and PP 5 were not found in these patients, however. In seven benign ovarian tumours, low PP 14 serum levels were found. The conclusion drawn from this study is that PP 14 can constitute a tumor marker in ovarian cancer.

Adult↗

Placental proteins 12 and 14 in pre-eclampsia.

The concentrations of circulating placental protein 12 (PP12) and placental protein 14 (PP14) were measured in 41 patients with pre-eclampsia and in 17 control subjects. The levels of PP12 were significantly elevated in patients with severe preeclampsia, whereas PP14 levels were unaffected. There was a negative correlation between the levels of both PP12 and PP14 and birthweight. PP12 and PP14 appear therefore to have different control mechanisms and, possibly, different cellular origins within the decidua.

Birth Weight↗