Decidualisation of cervical stromal cells.

Objective: Control of cervical function is poorly understood. The major structural component of the cervix is collagen and peri-partum cervical changes are largely due to the action of collagenase, either released by resident cells or derived from an influx of neutrophils. More importantly, the cell type that initiates the changes in the cervix is unknown although the resident fibroblast is a possible contender. Little is known about the state of the cervical fibroblast during pregnancy. Decidualisation of the endometrium is essential for implantation and pregnancy. In man, pre-decidual and decidual transformation of endometrial stroma occurs under the influence of progesterone. Decidualisation can also be induced in vitro in endometrial fibroblast-like stromal cells where the process is also dependent on elevated intracellular cAMP levels.

Study Design: Cultured human cervical fibroblasts were treated with progestin (medroxyprogesterone acetate) and cAMP elevating agents for 6 and 10 days.

Results: After 6 days they expressed and released IGFBP-1 and prolactin (PRL) and underwent morphological changes by 10 days. In addition, there was an increase in progesterone receptor and prostaglandin E type 2 receptor mRNA (but not type 4).

Conclusion: The propensity of cervical stromal cells to decidualise suggests that these differentiated cells may be a better model with which to study the initiation of labour.