Immunoreactive parathyroid hormone-related protein: its association with preterm labor

Objective: Parathyroid hormone-related protein (PTHrP) is a 141 amino acid protein which contains a 1–36 N-terminal domain resembling parathyroid hormone which has smooth muscle relaxant activity and a mid (67–86) domain which reportedly alters placental calcium transport. Using specific antibodies to these regions of PTHrP, the objective of this study was to determine changes in the levels and localization of the peptides in placenta and membranes that might be indicative of their biological activity and role during term and preterm labor. Study design: Placenta and fetal membranes were collected from patients with preterm delivery (PTL) ( n = 16), term cesarean section in the absence of labor ( n = 10) and term vaginal delivery ( n = 5). Immunohistochemistry was performed with specific antisera visualized by the avidin-biotin peroxidase method and the staining intensity was quantified with an image analysis system MCID. Results: Immunoreactive (ir)-PTHrP(1–34) and ir-PTHrP(67–86) were localized to the amnionic epithelium chorionic trophoblasts, decidual cells and placental syncytiotrophoblast. Intense immunostaining was observed for ir-PTHrP(67–86) but not for ir-PTHrP(1–34) in the endothelial lining of the villous capillaries. Ir-PTHrP(134) staining was lower in placenta and fetal membranes of PTL patients compared with term cesarean section in the absence of labor ( P < 0.05 Mann-Whitney test). In contrast, there was no difference in ir-PTHrP [67–86] staining intensity between delivery categories. Conclusion: These results showing differential localization of PTHrP(1–34) and PTHrP(67–86) suggest cell specific processing of PTHrP precursor in the human placenta. Moreover, the changes in ir-PTHrP(1–34) but not ir-PTHrP(67–86) with labor are indicative of a particular role for this peptide in the delivery process.