Published online Jul 16, 2016. doi: 10.12998/wjcc.v4.i7.165
Peer-review started: February 18, 2016
First decision: March 25, 2016
Revised: May 10, 2016
Accepted: May 17, 2016
Article in press: May 27, 2016
Published online: July 16, 2016
Processing time: 146 Days and 12.4 Hours
The activities of corticotropin-releasing factor (CRF) and related peptides are mediated a number of receptors with seven transmembrane domains that are coupled to the Gs and Gq proteins. These receptors are known as CRF-Rs. In vitro studies have evidenced that urocortin (UCN) and CRF provoke an increase in the contractility of the uterus which is induced by endometrial prostaglandin F2a. Furthermore, through trophoblasts, it stimulates the secretion of adrenocorticotropic hormone (ACTH) and prostaglandin PGE2 and has a vasodilatory effect on the placenta. While it is well known that the placenta produces considerable quantities of CRF, several studies have, however, excluded that the placenta can generate significant quantities of UCN. In the short term, the human fetal adrenal gland produces more cortisol and dehydroepiandrosterone sulfate. The gestational tissues express UCN3 and UCN2 mRNA in cytotrophoblast and syncytiotrophoblast cells, while UCN2 is only to be found in the maternal and fetal vessels and amniotic cells. Nevertheless, gestational tissues express UCN2 and UCN3 differentially and do not stimulate placental ACTH secretion. In term pregnancies, maternal plasma levels of CRF and UCN are lower than at the beginning of pregnancy and are correlated to labor onset. Conversely, they do not decrease in post-term pregnancies. This evidence would seem to indicate that the fine-regulated expression of these neuropeptides is important in determining the duration of human gestation. In this scenario, low concentrations of UCN in the amniotic fluid at mid-term may be considered a sign of predisposition to preterm birth.
Core tip: Low concentrations of urocortin (UCN) in the amniotic fluid may be a sign of predisposition to preterm birth, since it correlates with a pro-inflammatory state. UCN is present at higher serum concentrations in women with endometriomas. Therefore, the measurement of UCN could be useful in distinguishing between endometriosis and other benign ovarian cysts. The therapeutic treatment with UCN decreases serum levels of proinflammatory cytokines in several experimental situations, so it is plausible that the same effects may occur in different obstetric and gynecological diseases in which inflammation plays a key role in the onset and progression of the disease.