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Niels Uldbjerg - One of the best experts on this subject based on the ideXlab platform.
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The Cervical Mucus plug: Structured review of the literature
Acta obstetricia et gynecologica Scandinavica, 2009Co-Authors: Naja Becher, Merete Hein, Kristina M. Adams Waldorf, Niels UldbjergAbstract:The Cervical Mucus plug is a large, complex structure within the Cervical canal that is shed shortly before or during labor. We propose that the Cervical Mucus plug fulfills critical 'gate-keeper' functions based on its physical and immunologic properties, which help prevent ascending infection and preterm labor. The viscoelastic properties of the Cervical Mucus plug are determined by mucins (large glycoproteins), which can inhibit viral replication and exclude larger molecules and bacteria by preventing their diffusion through the plug. Furthermore, the innate and adaptive immunological properties of the Cervical Mucus plug are well suited for arresting bacterial infection by stimulating a robust inflammatory response. A possible association between an impaired gate-keeper function of the Cervical Mucus plug and preterm birth is discussed.
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Immunoglobulin levels and phagocytes in the Cervical Mucus plug at term of pregnancy.
Acta obstetricia et gynecologica Scandinavica, 2005Co-Authors: Merete Hein, Rikke Bek Helmig, Niels Uldbjerg, Astrid Christine Petersen, Jesper ReinholdtAbstract:Background. To characterize the potential for adaptive immune protection in Cervical Mucus plugs with respect to immunoglobulin isotypes and effector cells (phagocytes). Methods. Thirty-one Cervical Mucus plugs were collected from healthy women in labor at term. The Cervical Mucus plugs were allocated either to analysis of immunoglobulins by enzyme-linked immunosorbent assay (ELISA), gel chromatography and Western blotting ( n = 20) or to microscopical, including immunocytochemical, analyses. The levels of immunoglobulin in the plugs were compared to the levels in 10 samples of ovulatory Cervical Mucus from nonpregnant women. Results. In the Cervical Mucus plugs, levels of immunoglobulin G (IgG) [median 3270 µg/mL (100-14 500)] and IgA [540 (22-2820)], but not IgM [30.5 (1.0-160)], were significantly elevated compared to Cervical Mucus from nonpregnant women ( p < 0.02 for IgG and IgA). The IgG : IgA ratio in the plugs was also elevated ( p < 0.02). The proportion of secretory immunoglobulin A (SIgA) rela...
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Antimicrobial factors in the Cervical Mucus plug.
American journal of obstetrics and gynecology, 2002Co-Authors: Merete Hein, Erika V. Valore, Rikke Bek Helmig, Niels Uldbjerg, Tomas GanzAbstract:Abstract Objective: The Cervical Mucus plug is positioned between the microbe-rich vagina and the normally sterile uterine cavity, which suggests a host defense function, but few relevant data are available. We analyzed the composition and antimicrobial activity of Cervical Mucus plugs. Study Design: Cervical Mucus plugs were collected from healthy women at delivery. Groups of plugs were randomly selected for electrolyte analysis, antimicrobial activity assays against group B Streptococcus, Escherichia coli, Candida albicans, and assays of known antimicrobial polypeptides. Results: Both intact Cervical Mucus plugs and their aqueous extracts exhibited antimicrobial activity against aerobic microbes, in the order of potency: group B Streptococcus > E coli > C albicans . Semiquantitative Western blotting of extracts showed that secretory leukoprotease inhibitor, lysozyme, lactoferrin, and neutrophil defensins were present at concentrations that were sufficient for antimicrobial activity. Conclusion: The Cervical Mucus plug is not only a mechanical but also a chemical barrier to infection that ascends from the vagina. (Am J Obstet Gynecol 2002;187:137-44.)
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An in vitro study of antibacterial properties of the Cervical Mucus plug in pregnancy.
American journal of obstetrics and gynecology, 2001Co-Authors: Merete Hein, Rikke Bek Helmig, Tomas Ganz, Henrik Carl Schønheyder, Niels UldbjergAbstract:Abstract Objective: To evaluate whether Cervical Mucus plugs are antibacterial in vitro. Study Design: Cervical Mucus plugs from 56 healthy women in labor were studied by 2 different antimicrobial assays: (1) analysis of the inhibition by the Cervical Mucus plug of several gram-positive and gram-negative bacteria by overlaying the Cervical Mucus plug onto an agar plate with imbedded bacteria, and (2) determination of the antibacterial property of the Cervical Mucus plug material by radial diffusion assay with group B Streptococcus and Escherichia coli. Results: In the agar overlay assay, there was complete inhibition of clinical isolates of Staphylococcus saprophyticus, E coli, and Pseudomonas aeruginosa and patient-variable partial-to-complete inhibition of Enterococcus faecium, Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae. In the radial diffusion assay, Cervical Mucus plugs had activity toward group B Streptococcus equivalent to 0.075 μg/mL of gentamicin and toward E coli equivalent to 0.5 μg/mL of gentamicin. Conclusion: A low-molecular substance with antibacterial activity in the Cervical Mucus plug may protect the fetus against ascending infections. (Am J Obstet Gynecol 2001;185:586-92.)
Merete Hein - One of the best experts on this subject based on the ideXlab platform.
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The Cervical Mucus plug: Structured review of the literature
Acta obstetricia et gynecologica Scandinavica, 2009Co-Authors: Naja Becher, Merete Hein, Kristina M. Adams Waldorf, Niels UldbjergAbstract:The Cervical Mucus plug is a large, complex structure within the Cervical canal that is shed shortly before or during labor. We propose that the Cervical Mucus plug fulfills critical 'gate-keeper' functions based on its physical and immunologic properties, which help prevent ascending infection and preterm labor. The viscoelastic properties of the Cervical Mucus plug are determined by mucins (large glycoproteins), which can inhibit viral replication and exclude larger molecules and bacteria by preventing their diffusion through the plug. Furthermore, the innate and adaptive immunological properties of the Cervical Mucus plug are well suited for arresting bacterial infection by stimulating a robust inflammatory response. A possible association between an impaired gate-keeper function of the Cervical Mucus plug and preterm birth is discussed.
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Immunoglobulin levels and phagocytes in the Cervical Mucus plug at term of pregnancy.
Acta obstetricia et gynecologica Scandinavica, 2005Co-Authors: Merete Hein, Rikke Bek Helmig, Niels Uldbjerg, Astrid Christine Petersen, Jesper ReinholdtAbstract:Background. To characterize the potential for adaptive immune protection in Cervical Mucus plugs with respect to immunoglobulin isotypes and effector cells (phagocytes). Methods. Thirty-one Cervical Mucus plugs were collected from healthy women in labor at term. The Cervical Mucus plugs were allocated either to analysis of immunoglobulins by enzyme-linked immunosorbent assay (ELISA), gel chromatography and Western blotting ( n = 20) or to microscopical, including immunocytochemical, analyses. The levels of immunoglobulin in the plugs were compared to the levels in 10 samples of ovulatory Cervical Mucus from nonpregnant women. Results. In the Cervical Mucus plugs, levels of immunoglobulin G (IgG) [median 3270 µg/mL (100-14 500)] and IgA [540 (22-2820)], but not IgM [30.5 (1.0-160)], were significantly elevated compared to Cervical Mucus from nonpregnant women ( p < 0.02 for IgG and IgA). The IgG : IgA ratio in the plugs was also elevated ( p < 0.02). The proportion of secretory immunoglobulin A (SIgA) rela...
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Antimicrobial factors in the Cervical Mucus plug.
American journal of obstetrics and gynecology, 2002Co-Authors: Merete Hein, Erika V. Valore, Rikke Bek Helmig, Niels Uldbjerg, Tomas GanzAbstract:Abstract Objective: The Cervical Mucus plug is positioned between the microbe-rich vagina and the normally sterile uterine cavity, which suggests a host defense function, but few relevant data are available. We analyzed the composition and antimicrobial activity of Cervical Mucus plugs. Study Design: Cervical Mucus plugs were collected from healthy women at delivery. Groups of plugs were randomly selected for electrolyte analysis, antimicrobial activity assays against group B Streptococcus, Escherichia coli, Candida albicans, and assays of known antimicrobial polypeptides. Results: Both intact Cervical Mucus plugs and their aqueous extracts exhibited antimicrobial activity against aerobic microbes, in the order of potency: group B Streptococcus > E coli > C albicans . Semiquantitative Western blotting of extracts showed that secretory leukoprotease inhibitor, lysozyme, lactoferrin, and neutrophil defensins were present at concentrations that were sufficient for antimicrobial activity. Conclusion: The Cervical Mucus plug is not only a mechanical but also a chemical barrier to infection that ascends from the vagina. (Am J Obstet Gynecol 2002;187:137-44.)
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An in vitro study of antibacterial properties of the Cervical Mucus plug in pregnancy.
American journal of obstetrics and gynecology, 2001Co-Authors: Merete Hein, Rikke Bek Helmig, Tomas Ganz, Henrik Carl Schønheyder, Niels UldbjergAbstract:Abstract Objective: To evaluate whether Cervical Mucus plugs are antibacterial in vitro. Study Design: Cervical Mucus plugs from 56 healthy women in labor were studied by 2 different antimicrobial assays: (1) analysis of the inhibition by the Cervical Mucus plug of several gram-positive and gram-negative bacteria by overlaying the Cervical Mucus plug onto an agar plate with imbedded bacteria, and (2) determination of the antibacterial property of the Cervical Mucus plug material by radial diffusion assay with group B Streptococcus and Escherichia coli. Results: In the agar overlay assay, there was complete inhibition of clinical isolates of Staphylococcus saprophyticus, E coli, and Pseudomonas aeruginosa and patient-variable partial-to-complete inhibition of Enterococcus faecium, Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae. In the radial diffusion assay, Cervical Mucus plugs had activity toward group B Streptococcus equivalent to 0.075 μg/mL of gentamicin and toward E coli equivalent to 0.5 μg/mL of gentamicin. Conclusion: A low-molecular substance with antibacterial activity in the Cervical Mucus plug may protect the fetus against ascending infections. (Am J Obstet Gynecol 2001;185:586-92.)
Zhen-qun Zheng - One of the best experts on this subject based on the ideXlab platform.
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Early Pregnancy Factor in Cervical Mucus of Pregnant Women
American Journal of Reproductive Immunology, 2004Co-Authors: Shu-juan Cheng, Zhen-qun ZhengAbstract:Problem: This study was carried out to determine the presence of early pregnancy factor (EPF) activity in Cervical Mucus of pregnant women and explore the relationship between EPF activity in sera suggested it and in Cervical Mucus. Method of study: Cervical Mucus and sera were collected from 60 pregnant women in different terms and 25 non-pregnant women, respectively. EPF activity was detected by rosette inhibition assay. Results: EPF activity did exist in Cervical Mucus of pregnant women and was similar both in Cervical Mucus and sera. Conclusions: We report here for the first time the EPF activity in Cervical Mucus of pregnant women. The parallel change observed in sera suggested it might be another useful index in evaluating embryo viability.
S. Gopalan - One of the best experts on this subject based on the ideXlab platform.
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Effect of two anti-estrogens, clomiphene citrate and tamoxifen, on Cervical Mucus and sperm-Cervical Mucus interaction.
International journal of fertility and women's medicine, 1997Co-Authors: V. Annapurna, L. K. Dhaliwal, S. GopalanAbstract:OBJECTIVE To compare the effect of two ovulation-inducing agents, clomiphene citrate and tamoxifen, on Cervical Mucus and sperm-Cervical Mucus interaction. SUBJECTS AND SETTING Forty couples with unexplained infertility attending infertility clinic. METHODS Cervical Mucus scoring and postcoital test done using the Moghissi system in a spontaneous cycle (control cycle) and with clomiphene citrate or tamoxifen (study cycles). RESULTS Clomiphene citrate significantly decreased Cervical Mucus production, whereas tamoxifen significantly improved the total score. CONCLUSION Tamoxifen is a better drug than clomiphene for ovulation induction in women with poor Cervical Mucus quality.
William H. Kutteh - One of the best experts on this subject based on the ideXlab platform.
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quantification of immunoglobulins and cytokines in human Cervical Mucus during each trimester of pregnancy
American Journal of Obstetrics and Gynecology, 2001Co-Authors: William H. Kutteh, Rodney D FranklinAbstract:Abstract Objectives: Our aims were to determine immunoglobulin and cytokine levels in Cervical Mucus obtained from women during each trimester of pregnancy and to compare these levels with those reported in normally menstruating women and in women taking oral contraceptives. Study Design: Cervical Mucus samples were collected at specified intervals from 36 pregnant women. An enzyme-linked immunosorbent assay was used to quantitate the presence of immunoglobulins A and G and interleukins 1β, 6, and 10 in Cervical Mucus. Results: Immunoglobulin A in Cervical Mucus remained stable during each trimester of pregnancy (26 mg/dL). Cervical Mucus immunoglobulin G decreased from a first-trimester high of 44.4 mg/dL to lower levels in the second and third trimesters. Levels of interleukin 1β increased significantly from the first trimester (4261 pg/mL) to 12,899 pg/mL in the second trimester ( P Conclusion: These data suggest a possible correlation of reproductive hormones and immunologic factors in the female reproductive tract during pregnancy. (Am J Obstet Gynecol 2001;184:865-74.)
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Cervical Mucus anti-sperm antibodies: treatment with intrauterine insemination.
American journal of reproductive immunology (New York N.Y. : 1989), 1996Co-Authors: William H. Kutteh, William Byrd, Linda Blankenship, Carol C. Kutteh, Bruce R. CarrAbstract:PROBLEM : To determine (1) the incidence of Cervical Mucus anti-sperm antibodies in infertile women, and (2) the results of treatment by intrauterine insemination. METHOD : Cervical Mucus was collected the morning after urinary LH surge occurred from 153 consecutive women being treated for unexplained infertility with intrauterine insemination. Immunobead testing for IgG, IgA, IgA1, and IgA2 was performed with only actively mottle sperm being counted. RESULTS : Overall, 23/153 (15.0%) of Cervical Mucus samples were positive for anti-sperm antibodies : 9/23 (39.1%) were only IgA-positive (62% IgA1-positive, 38% IgA2-positive), 11/23 (47.8%) were only IgG-positive, and 3/23 (13.0%) were positive for both IgA and IgG. Insemination resulted in a pregnancy in 6/23 (26.1%) of women with Cervical Mucus anti-sperm antibodies after 1-3 cycles. CONCLUSIONS : Testing for Cervical Mucus anti-sperm antibodies should be performed in cases of unexplained infertility, and intrauterine insemination may be an effective treatment, resulting in pregnancies in over one-fourth of couples.