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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

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Volume 45, Issue 2


Anti-inflammatory Elafin in human fetal membranes

Cecilia Stalberg
  • Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
  • University of Gothenburg, Gothenburg, Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nathalia Noda
  • Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
  • Department of Pathology, Botucatu Medical School, UNESP – Univ. Estadual Paulista, Botucatu, Sao Paulo, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jossimara Polettini
  • Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
  • Department of Pathology, Botucatu Medical School, UNESP – Univ. Estadual Paulista, Botucatu, Sao Paulo, Brazil
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Bo Jacobsson
  • Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg, Sweden
  • Department of Genetics and Bioinformatics, Area of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
  • Other articles by this author:
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/ Ramkumar Menon
  • Corresponding author
  • Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-08-31 | DOI: https://doi.org/10.1515/jpm-2016-0139



Elafin is a low molecular weight protein with antileukoproteinase, anti-inflammatory, antibacterial and immunomodulating properties. The profile of Elafin in fetal membranes is not well characterized. This study determined the changes in Elafin expression and concentration in human fetal membrane from patients with preterm prelabor rupture of membranes (PPROM) and in vitro in response to intra-amniotic polymicrobial pathogens.


Elafin messenger RNA (mRNA) expressions were studied in fetal membranes from PPROM, normal term as well as in normal term not in labor membranes in an organ explant system treated (24 h) with lipopolysaccharide (LPS), using quantitative reverse transcription-polymerase chain reaction (RT-PCR). Enzyme-linked immunosorbent assay (ELISA) measured Elafin concentrations in culture supernatants from tissues treated with LPS and polybacterial combinations of heat-inactivated Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Gardnerella vaginalis (GV).


Elafin mRNA expression in fetal membranes from women with PPROM was significantly higher compared to women who delivered at term after normal pregnancy (5.09±3.50 vs. 11.71±2.21; P<0.05). In vitro, LPS-stimulated membranes showed a significantly increased Elafin m-RNA expression (P<0.05). However, the protein levels after LPS stimulation was not changed. Similarly, polymicrobial-treated fetal membranes also showed no changes in Elafin protein concentrations compared to untreated controls.


Higher Elafin expression in PPROM fetal membranes suggests a host response to an inflammatory pathology. However, lack of Elafin response to LPS and polymicrobial treatment is indicative of the minimal anti-inflammatory impact of this molecule in fetal membranes.

Keywords: Amnion; bacteria; chorion; inflammation; pathway; PI3; polymicrobial infection; PPROM; preterm birth; risk


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About the article

Corresponding author: Ramkumar Menon, MS, PhD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Perinatal Research, The University of Texas Medical Branch at Galveston, 301 University Blvd, MRB 11-158, Galveston, TX 77555, USA, Tel.: +409-772-7596, Fax: +409-747-0475

Received: 2016-04-19

Accepted: 2016-07-22

Published Online: 2016-08-31

Published in Print: 2017-02-01

The authors stated that there are no conflicts of interest regarding the publication of this article.

Citation Information: Journal of Perinatal Medicine, Volume 45, Issue 2, Pages 237–244, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0139.

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