Role of progesterone and progestin therapy in threatened abortion and preterm labour

Front Biosci. 2008 Jan 1:13:1981-90. doi: 10.2741/2817.

Abstract

Progesterone (P) has been widely used in an attempt to prevent threatened miscarriage, recurrent miscarriage and pre-term labour. Successful pregnancy depends on maternal tolerance of the fetal "semi-allograft". Along with its endocrine effects, P also acts as an "immunosteroid", by controlling the bias towards a pregnancy protective immune milieu. A protein called progesterone-induced blocking factor (PIBF), by inducing a Th2 dominant cytokine production mediates the immunological effects of progesterone. Progesterone plays a role in uterine homing of NK cells and up-regulates HLA-G gene expression, the ligand for various NK inhibitory receptors. At high concentrations, progesterone is a potent inducer of Th2-type cytokines as well as of LIF and M-CSF production by T cells. The possible mechanisms by which progesterone contributes to the maintenance of early and late pregnancy are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abortion, Threatened / metabolism*
  • Animals
  • Cytokines / metabolism
  • Female
  • Humans
  • Inflammation
  • Killer Cells, Natural / metabolism
  • Monocytes / metabolism
  • Obstetric Labor, Premature / metabolism*
  • Oxidative Stress
  • Pregnancy
  • Progesterone / metabolism
  • Progesterone / physiology*
  • Progestins / therapeutic use*
  • Prostaglandins / metabolism

Substances

  • Cytokines
  • Progestins
  • Prostaglandins
  • Progesterone