Eine ständig steigende Nachfrage nach einer auf pflanzlichen Stoffen basierenden Hormonersatztherapie für menopausale Beschwerden, macht eine verstärkte Untersuchung sogenannter Phytoöstrogene erforderlich. Bei den hier untersuchten Substanzen handelt es sich um die chemisch synthetisierten Flavanone 6-(1,1-Dimethylallyl)Naringenin (6DMAN) und 8-Prenylnaringenin (8PN), die ursprünglich in Pflanzen identifiziert wurden. 7-Oxyprenylnaringenin-4'-Azetat (7OPN) ist ein weiteres Mitglied dieser Stoffgruppe, zu dem jedoch bisher noch praktisch keine Daten vorlagen. Ebenfalls in die Untersuchungen einbezogen wurde ein isopropanolischer Extrakt aus dem Rhizom von Cimicifuga racemosa (L.) Nutt. (iCR), der schon seit langer Zeit erfolgreich zur Bekämpfung menopausaler Beschwerden eingesetzt wird, dessen Wirkmechanismus jedoch unbekannt ist und zu dem bisher noch wenige molekulare Daten bezüglich der Wirkung auf einzelne Zielorgane, insbesondere nach einer Behandlung über einen längeren Zeitraum vorliegen. Die durchgeführten Untersuchungen betrafen zum Einen den Uterus als eines der Hauptzielorgane weiblicher Sexualhormone und zum Anderen die Vena cava, repräsentativ für das Gefäßsystem. Als Modellorganismus wurden Ratten gewählt. Dabei wurde die Genexpression Östrogen (E2)-regulierter Gene auf mRNA-Ebene mittels Real-Time-PCR bestimmt. Die Wirkung von 7OPN wurde in einem in vitro-System (MVLN-Zellen) und im Uterus getestet. Zusätzlich wurden humane Nabelschnurvenen-Endothelzellen als in vitro-Modell für das Gefäßsystem eingesetzt. Mit ihnen wurde die Wirkung der Testsubstanzen auf Angiogenese und Differenzierung getestet. Die durch die E2 hervorgerufenen Effekte entsprachen weitestgehend den Erwartungen. Es konnte sowohl eine Zunahme des Uterusgewichts der Ratten als auch eine Regulation der Expression von Proliferationsmarkern und E2-abhängig regulierten Genen im Uterus auf mRNA-Ebene festgestellt werden. Auch im Gefäßsystem konnte sowohl eine Regulation E2-abhängig exprimierter Gene beobachtet werden, als auch ein proliferationsfördernde und differentiationsfördernde Wirkung auf venöse Endothelzellen in vitro. Die untersuchten Flavanone zeigten einen von den vorhandenen funktionalen Gruppen abhängigen Effekt auf die E2-regulierten Prozesse und Gene. Während es sich bei 8PN um eine rein östrogen wirkende Substanz zu handeln scheint, wirkt 6DMAN offenbar als selektiver Östrogenrezeptor-Modulator (SERM) und zeigt für einen Einsatz in der HRT sehr interessante Eigenschaften, da weder ein uterotrophe Wirkung in vivo, noch eine angiogene Wirkung in vitro beobachtet werden konnte, während gleichzeitig eine östrogene, potentiell kardioprotektive Wirkung auf die Genexpression im Gefäßsystem gezeigt werden konnte. Auch 7OPN zeigt ein differenziertes Wirkmuster. Ein in vitro-Reportergentest in einer stabil transfizierten Brustkrebszellinie deutete auf eine in Abhängigkeit von der Konzentration E2-antagonistische oder agonistische Wirkung hin. Die Genexpressionsstudien im Uterus der Versuchstiere nach dreitägiger Behandlung zeigten, daß die Wirkung von 7OPN jedoch auch abhängig vom untersuchten Gen ist. Da auch dieses Flavanon keine uterotrophe Wirkung zu besitzen scheint, ist 7OPN ebenfalls eine interessante Zielsubstanz weiterer Untersuchungen im Hinblick auf die Anwendung in der HRT. Für den in einem Arzneimittel enthaltenen Extrakt iCR konnte in einem 17-tägigen Tierversuch keine östrogene Wirkung auf Uterus und Gefäßsystem gezeigt werden. Während eine Anwendung dieses Extrakts zur Behandlung menopausaler Beschwerden im Lichte dieser Ergebnisse und langjähriger praktischer Erfahrungen zwar sicher erscheint, bleibt der Wirkmechanismus von iCR weiterhin unbekannt.

Endometriosis is a reproductive disease affecting women in their prime reproductive years characterized by the presence of endometrial glands and stroma in ectopic locations. Animal models have been proven to be indispensable not only for the study of the disease but also to develop better non-invasive diagnostic imaging modalities. A major limitation with the diagnosis of endometriosis is the lack of a specific and sensitive non-invasive diagnostic test. Our objective was to develop a domestic animal model of endometriosis suitable for serial diagnostic imaging procedures and assessment of therapies. Two major studies were conducted to achieve this objective. First study involved in vitro whole tissue-explant culture and surgical induction of endometriosis in dog, pig and sheep to choose the most suitable model. For in vitro co-culture, dog, pig and sheep endometrium was placed on visceral peritoneum for 24 to 72 h to assess the degree of attachment and adhesion characteristics of endometrium (epithelium, glandular and stromal cells). Surgical induction of endometriosis was tested in dog, sheep (n=5 each) and pig (n=4) using autologous endometrial (n=4 grafts per animal) and fat grafts sutured to visceral (urinary bladder surface in dog and pig, uterus in sheep) and parietal (abdominal wall) peritoneum. Sham surgeries were performed in control group animals (dog and sheep n=5, pig n=3) using fat grafts alone. Animals were euthanized between 80-110 days post-surgery. Size, gross characteristics and histopathologic features of endometriotic lesions were recorded. During in vitro explant culture, surface epithelial, stromal and glandular cells of endometrium were capable of attaching to visceral peritoneum within 24 hours with and without an intact layer of mesothelial lining in dog, pig and sheep. The proportion of successful endometrial attachments were greater at 24h compared to 72h (15/18 vs. 7/18, p=0.008; data combined among species) with intermediate attachment at 48h (12/15). Following surgical induction, there was no difference (p>0.05) in proportion of successful tissue grafts placed on serosal surface of visceral vs. parietal peritoneum in dog (10/10 vs. 10/10), pig (7/8 vs. 8/8) or sheep (7/10 vs. 8/10). A variety of outcomes (endometriotic cysts with sero-sangunous fluid, solid lesions, vesicles, absence of lesions) were found. The proportion of cystic lesions was greater (p<0.01) in dog (19/20 grafts) than in pig (8/16) and sheep (5/20). Further, the area of endometriotic lesions at euthanasia was larger (0.89 ± 0.11 cm2) compared to that at the time of surgery (0.50 ± 0.09 cm2) in dog, whereas, the size of lesions decreased by half or more (p<0.05) in pig and sheep. Combined among grafting sites (visceral and parietal peritoneum) and species, a greater proportion (p=0.015) of surgical sites had adhesions in treatment (12/14) versus control group animals (5/13). The wall of majority of endometrial cysts in dogs were characterized by simple cuboidal/columnar epithelium, endometrial glands (normal, dilated and cystic), subepithelial capillary network and presence of stromal and smooth muscle cells. Hemorrhage and/or hemosiderin-laden macrophages were observed in the cystic lesions in dog. Development of a greater proportion of growing lesions in the form of endometriotic cysts in dogs compared to sheep and pig led us to conclude dog as a better suitable domestic animal model for endometriosis than sheep and pig. Second study involved assessing the usefulness and limitations of ultrasonography, magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in detecting cystic endometriotic lesions in dog and sheep. Surgical induction of endometriois was performed in dogs (n=5) and sheep (n=5) using autologous endometrial grafts (n=4 grafts per animal) and fat grafts sutured to visceral peritoneum (urinary bladder in dogs, uterus in sheep) and parietal peritoneum (ventral abdominal wall). Weekly ultrasonography was performed from Week 1-9 post-surgery and day of euthanasia (Week 14-15). T1 and T2 weighted weighted MRI images (n=2 each for dog and sheep) and PET-CT (n=3 dog, n=1 sheep) using 18F-fluorodeoxyglucose (18F-FDG) as radiolabel was performed between Week 13-15 post-surgery in dog and sheep. Gray-scale B-mode ultrasonography was able to detect endometriotic cysts (0.25-1.75cm) on urinary bladder and abdominal wall in dogs; endometrial grafts Week 1 post-surgery appeared as a homogenous, hypoechoic masses, following which they grew larger with evidence of cyst formation by Week 5. Cysts were undetectable from Week 10-13, whereas they appeared as homogenous masses with a hypoechoic fluid-filled cavity with diffuse hyperechoic echoes and low vascularisation (Color-Doppler imaging) by Week 14-15. In sheep, endometrial grafts were detected as hypoechoic masses Week 1 post-surgery that became smaller until no detectable lesions were visible beyond Week 6-7. Cysts in dogs and sheep appeared hyperintense on T2 and hypointense on T1 weighted images. 18F -FDG PET-CT did not show hypermetabolic activity in endometriotic cysts in dogs and sheep. In conclusion, MRI appeared to provide the most definitive diagnostic images of endometriotic cysts in dogs and sheep, particularly for lesions in sheep which were not evident by ultrasonography. However, ultrasonography was sufficient to characterize most endometriotic cysts in dogs. Further research needs to be carried out to develop specific PET tracers for endometriosis.

The mare experiences a transient innate immune response to breeding, the resolution of which is crucial for optimal fertility. The majority of mares are able to modulate this inflammation in a timely fashion, but a subpopulation exists which fail to do so and are considered susceptible to persistent breeding-induced endometritis (PBIE). Seminal plasma has been shown to modulate aspects of this inflammation. Recently, two seminal plasma proteins have garnered interest for their immune modulating properties: cysteine-rich secretory protein-3 (CRISP-3) and lactoferrin. These proteins have been found to alter the binding between sperm and neutrophils based on sperm viability in vitro, but minimal work has evaluated their effect on endometrial mRNA expression of cytokines and inflammation in response to breeding. Experiments were performed to analyze the expression of equine CRISP-3. Found to be primarily synthesized in the ampulla of the vas deferens and to a lesser extent in the vesicular gland, CRISP-3 expression was only seen in the postpubertal stallion. Due to the effect of sperm viability on protein function in vitro, varying sperm populations were analyzed for their effect on gene expression in the uterus. It was determined that viable sperm suppressed the gene expression of the inflammatory modulating cytokine interleukin-6 (IL-6) in comparison to dead sperm. Next, the effect of CRISP-3 and lactoferrin on endometrial gene expression in the normal and susceptible mare was investigated. Neither protein had a significant effect on the mRNA expression of inflammatory cytokines in the normal mares at six hours post-breeding. In contrast, lactoferrin was found to significantly suppress the expression of the pro-inflammatory cytokine tumor necrosis factor (TNF)-α in susceptible mares. Due to this, lactoferrin was further analyzed as an immunomodulant for the treatment of PBIE. Susceptible mares were infused with varying doses of lactoferrin at six hours post-breeding. Although not in a dose-dependent fashion, lactoferrin was found to decrease both fluid retention and neutrophil migration, in addition to suppressing the expression of the pro-inflammatory cytokine interferon gamma (IFNγ) and increasing the gene expression of the anti-inflammatory cytokine interleukin-1 receptor antagonist (IL-1RN). In conclusion, CRISP-3 expression occurs in secretory aspects of the male reproductive tract, and appears to be up regulated after sexual maturation. Viability of spermatozoa affects the immune response to breeding and should be taken into consideration for experimental design and interpretation of data. The seminal plasma proteins CRISP-3 and lactoferrin have minimal effect on endometrial gene expression in normal mares, but lactoferrin suppresses the expression of TNF in susceptible mares. Finally, lactoferrin was found to function as a potent anti-inflammatory for the persistent inflammation seen in susceptible mares when administered post-breeding. This protein should be further investigated as a potential therapeutic for the treatment of persistent breeding-induced endometritis.

INTRODUÇÃO: A prolactina é um hormônio polipeptídico, que possui reconhecida ação sistêmica, principalmente na fisiologia da reprodução, porém, seu desequilíbrio, em especial a hiperprolactinemia, é cada vez mais frequente na prática clínica. Apesar de ser um distúrbio relativamente comum, ainda existem dúvidas quanto aos efeitos moleculares da hiperprolactinemia no trato genital, particularmente no útero, e também na hipófise. O presente estudo teve por objetivo verificar os efeitos da hiperprolactinemia induzida pela metoclopramida na expressão gênica da prolactina e de seus receptores no útero e na hipófise de camundongo fêmea. MÉTODOS: Utilizaram-se 49 camundongos fêmeas (Wistar), randomicamente divididas em 7 grupos contendo 7 animais cada: 1) SS não ovariectomizadas que receberam solução salina (veículo); 2) M não ovariectomizadas tratadas com metoclopramida; 3) OSS ovariectomizadas tratadas com solução salina (veículo); 4) OM ovariectomizadas tratadas com metoclopramida; 5) OME ovariectomizadas tratadas com metoclopramida e 17-estradiol; 6) OMP ovariectomizadas tratadas com metoclopramida e progesterona micronizada; 7) OMEP ovariectomizadas tratadas com metoclopramida, 17-estradiol e progesterona micronizada. Após 50 dias os animais foram sacrificados sendo retirados o útero e a hipófise de cada animal para extração do ácido ribonucleico total, que foi utilizado para a síntese de ácido desoxirribonucleico complementar e avaliação da expressão gênica da prolactina e das diferentes isoformas de seus receptores, por reação em cadeia da polimerase em tempo real. RESULTADOS: Na hipófise, em animais não ovariectomizados, o tratamento com metoclopramida aumentou a expressão do gene que codifica a prolactina em relação ao tratamento apenas com o veículo. Nos animais castrados, a progesterona isoladamente ou associada ao estrogênio determinou o incremento do RNA mensageiro da prolactina em relação aos outros animais castrados que receberam outras combinações de tratamento. Este efeito foi semelhante ao da metoclopramida em animais com os ovários intactos. Em relação ao receptor de prolactina, o estrogênio e a progesterona, isoladamente, foram responsáveis pelo incremento da isoforma S2. No útero houve aumento na expressão de RNA mensageiro de prolactina após tratamento com metoclopramida ou com tratamento isolado ou combinado de estrogênio e progesterona. A ovariectomia determinou a redução da expressão das isoformas S1 e S2 do receptor de prolactina de todas as isoformas estudadas. Já o tratamento estroprogestativo determinou elevação da formas S3 e L do receptor, enquanto com a progesterona isoladamente causou apenas o incremento da forma L do receptor da prolactina no útero dos animais castrados. CONCLUSÕES: Nossos dados sugerem que o tratamento com metoclopramida altera de forma diferente a expressão de prolactina e de seus receptores quando se compara o resultado da hipófise em relação ao útero em camundongos fêmeas castrados e tratados com esteróides sexuais / INTRODUCTION: Prolactin is a polypeptide hormone with a recognized systemic action mainly on reproductive physiology. However, prolactin imbalance, particularly hyperprolactinemia, is increasingly more frequent in clinical practice. Although it is a comparatively common disorder, there are still doubts about the molecular effects of hyperprolactinemia on the genital tract especially in the uterus and the pituitary. The present study aimed at verifying the effects of metoclopramide-induced hyperprolactinemia on the gene expression of prolactin and its receptors in the uterus and pituitary of the female mouse. METHODS: Forty-nine female Wistar mice were randomized to 7 equal-sized groups as follows: 1) SS nonoophorectomized mice treated with saline solution (vehicle); 2) M nonoophorectomized mice treated with metoclopramide; 3) OSS oophorectomized mice treated with saline solution (vehicle); 4) OM oophorectomized mice treated with metoclopramide; 5) OME oophorectomized mice treated with metoclopramide and 17-estradiol; 6) OMP oophorectomized mice treated with metoclopramide and micronized progesterone; 7) OMEP oophorectomized mice treated with metoclopramide, 17-estradiol, and micronized progesterone. The animals were sacrificed 50 days after the end of the treatment, and the uterus and pituitary of each animal were removed for extraction of total ribonucleic acid, which was then used for synthesizing complementary deoxyribonucleic acid and for evaluating the gene expression of prolactin and the different isoforms of its receptors by the real-time polymerase chain reaction. RESULTS: In the pituitary of the nonoophorectomized mice, the treatment with metoclopramide against that with vehicle alone increased the expression of the prolactin-encoding gene. In the castrated animals, progesterone by itself or in conjunction with estrogen determined a raise in prolactin messenger RNA as opposed to the two other treatments with different combinations. This effect was similar to that produced by metoclopramide in animals with intact ovaries. Estrogen and progesterone, acting independently of each other, were responsible for the increase in the S2 isoform of the prolactin receptor. In the uterus, there was heightened expression of prolactin messenger RNA under the effect of the treatment with metoclopramide or with estrogen and/or progesterone. Oophorectomy caused a greater reduction in expression of the prolactin receptor S1 and S2 isoforms than in the other isoforms. However, the combined estrogen plus progesterone treatment led to an increase in the S3 and L forms of the receptor, while progesterone alone resulted solely in a higher expression of the L form of the prolactin receptor in the endometrium of the castrated mice. CONCLUSION: Our data suggest that metoclopramide treatment induces different changes in the expression of prolactin and its receptors according to whether the effect occurs in the pituitary or the uterus of castrated female mice treated with sex steroids

Orientador: José Ricardo de Arruda MIranda / Resumo: A contração uterina é um processo fisiológico espontâneo com impacto direto no ciclo menstrual/estral e na gestação. Disfunções na atividade uterina estão relacionadas com infertilidade, abortos e partos prematuros, sendo este último a maior causa de mortalidade e morbidade infantil no mundo. Sendo assim, se faz necessário o desenvolvimento de metodologias in vivo para monitorar o processo mecânico uterino. O objetivo deste trabalho foi aplicar a técnica de Biosusceptometria de Corrente Alternada para avaliação in vivo da atividade mecânica uterina em ratas prenhes. Foram utilizadas 40 ratas fêmeas Wistar prenhes com idade entre 10 e 15 semanas e com peso médio de 250 g. Através da Biosusceptometria de Corrente Alternada, 18 animais foram utilizados para avaliação da contratilidade uterina durante a prenhez e 8 foram usadas para avaliação da atividade uterina frente à ação da ocitocina. Na primeira etapa foi realizada uma cirurgia de fixação do marcador magnético em três posições da serosa uterina: próximo ao ovário; na região média entre o ovário e a cérvice; e próximo à cérvice. A atividade uterina foi monitorada nos dias 0, 7, 14, 20 e 21 de prenhez para cada posição do marcador. Na segunda etapa, foi realizado o implante do marcador magnético somente próximo à cérvice, e a atividade foi avaliada antes e depois da administração de ocitocina no dia 20 de prenhez. Os resultados obtidos foram perfis de contração para cada situação proposta, os quais apresentaram contrações ba... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Uterine contraction is a spontaneous physiologic process with direct impact on menstrual/estrous cycle and pregnancy. Uterine activity dysfunction are related with infertility, abortion and premature birth, in which the last is the major cause of childish mortality and morbidity in the world. Therefore, in vivo methods to assess the mechanical process of the uterus under real physiologic condition remains necessary to be developed. The aim of this study was to apply Alternate Current Biosusceptometry to assess in vivo mechanical uterine activity of pregnant rats. Forty Wistar female pregnant rats with 10 to 15 weeks age and weighing 250 g were used. Through Alternate Current Biosusceptometry, 30 animals were used for uterine contraction analysis during pregnancy and 10 were used to evaluate uterine contractility due to oxytocin action. On the first part, an implant surgery was performed to fix the magnetic marker on uterus serous at three different position: near ovary; middle distance between ovary and cervix, and near cervix. Uterine peristalsis were measured at days 0, 7, 14, 20 and 21 of pregnancy. On the second part, magnetic marker was implanted only on near cervix and uterine activity was evaluated before and after the oxytocin administration on day 20 of pregnancy. Contraction profiles were obtained as results to each proposed analysis, in which presented high frequency and low frequency basal contraction and intense contractions. During pregnancy evolution, was obser... (Complete abstract click electronic access below) / Doutor

Liu Yuet Man. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 165-191). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.iii / Abbreviations --- p.vi / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Incidences and Prevalence --- p.2 / Chapter 1.2 --- Anatomy of Uterus and its Support Mechanism --- p.3 / Chapter 1.3 --- Pathophysiology of Uterine Prolapse --- p.5 / Chapter 1.4 --- Classification of Uterine Prolapse --- p.6 / Chapter 1.5 --- Etiology of Uterine Prolapse --- p.7 / Chapter 1.6 --- Treatment of Uterine Prolapse --- p.12 / Chapter 1.6.1 --- Conservative Treatment --- p.12 / Chapter 1.6.2 --- Surgical Treatment --- p.13 / Chapter 1.7 --- Molecular Basis of Uterine Prolapse --- p.14 / Chapter 1.7.1 --- Collagen Metabolism --- p.15 / Chapter 1.7.2 --- Extracellular Matrix Metabolism --- p.16 / Chapter 1.7.3 --- Advanced Glycation End-products --- p.18 / Chapter 1.7.4 --- Estrogen and Estrogen Receptors --- p.19 / Chapter 1.8 --- Gene Expression Profiling of Uterine Prolapse --- p.22 / Chapter 1.9 --- Microarray Gene Expression Profiling Analysis --- p.24 / Chapter 1.9.1 --- Types of Microarray --- p.26 / Chapter 1.9.2 --- Comparison of Oligonucleotide and cDNA Arrays --- p.31 / Chapter 1.10 --- Quantitative Real-time PCR --- p.32 / Chapter 1.10.1 --- Principle of TaqMan Real-time PCR --- p.32 / Chapter 1.10.2 --- Other Types of Real-time PCR --- p.33 / Chapter 1.11 --- Project Aims --- p.34 / Chapter 1.12 --- Significance of Study --- p.35 / Chapter CHAPTER 2 --- MATERIALS AND METHODS --- p.37 / Chapter 2.1 --- Materials --- p.37 / Chapter 2.1.1 --- Patients --- p.37 / Chapter 2.1.2 --- Cardinal Ligament Specimen --- p.38 / Chapter 2.2 --- Methods --- p.39 / Chapter 2.2.1 --- Homogenization of Cardinal Ligament Tissues --- p.39 / Chapter 2.2.2 --- Total RNA extraction --- p.39 / Chapter 2.2.3 --- Oligonucleotide Microarray --- p.41 / Chapter 2.2.3.1 --- Two-cycle cDNA Synthesis --- p.41 / Chapter 2.2.3.2 --- Cleanup of Double-stranded cDNA --- p.45 / Chapter 2.2.3.3 --- Synthesis of Biotin-labeled cRNA --- p.45 / Chapter 2.2.3.4 --- Cleanup and Quantification of Biotin-labeled cRNA --- p.46 / Chapter 2.2.3.5 --- Fragmenting the cRNA for Target Preparation --- p.47 / Chapter 2.2.3.6 --- Target Hybridization --- p.47 / Chapter 2.2.3.7 --- "Array Washing, Staining and Scanning" --- p.48 / Chapter 2.2.3.8 --- Statistical Analysis of Microarray Data --- p.49 / Chapter 2.2.4 --- Quantitative Real-time Polymerase Chain Reaction --- p.52 / Chapter 2.2.4.1 --- Primers and Probes --- p.52 / Chapter 2.2.4.2 --- Reverse Transcription --- p.53 / Chapter 2.2.4.3 --- Plate Setup --- p.53 / Chapter 2.2.4.4 --- Real-time PCR Reaction Mixture Setup --- p.54 / Chapter 2.2.4.5 --- Statistical Analysis of Real-time PCR Data --- p.54 / Chapter CHAPTER 3 --- RESULTS --- p.56 / Chapter 3.1 --- Microarray Gene Expression Data Analysis --- p.57 / Chapter 3.1.1 --- Unsupervised Gene Selection --- p.57 / Chapter 3.1.2 --- Supervised Gene Selection --- p.59 / Chapter 3.1.2.1 --- Gene Expression Profiles Distinguish Cardinal Ligament with Uterine Prolapse from Control and Identify Differentially Expressed Genes --- p.59 / Chapter 3.1.2.2 --- Gene Expression Profiles Distinguish Cardinal Ligament with Different Degrees of Uterine Prolapse from Control and Identify Differentially Expressed Genes --- p.72 / Chapter 3.1.2.3 --- Gene Expression Profiles Distinguish Cardinal Ligament with Third-degree Prolapse from First-degree Prolapse and Identify Differentially Expressed Genes --- p.92 / Chapter 3.2 --- Validation of Microarray Data by Quantitative Real-time PCR --- p.96 / Chapter 3.2.1 --- Fold Change of Candidate Genes --- p.97 / Chapter 3.2.2 --- Correlation Between Microarray and Quantitative Real-time PCR Results --- p.102 / Chapter CHAPTER 4 --- DISCUSSIONS --- p.103 / Chapter 4.1 --- Global Gene Expression Profiling using Oligonucleotide Microarray --- p.103 / Chapter 4.1.1 --- Advantages of using Affymetrix GeneChipR Microarray for Gene Expression Profiling --- p.103 / Chapter 4.1.2 --- Microarray analysis software --- p.105 / Chapter 4.1.2.1 --- DNA-Chip Analyzer Software --- p.105 / Chapter 4.1.2.2 --- Comparison of Statistical Methods for Analysis of A ffymetrix GeneChipRMicroarray Data --- p.108 / Chapter 4.2 --- Validation of Microarray Data --- p.111 / Chapter 4.2.1 --- Advantages of using Quantitative Real-time PCR for mRNA Quantification --- p.111 / Chapter 4.3 --- Microarray Gene Expression Data Analysis --- p.115 / Chapter 4.3.1 --- Unsupervised Gene Selection --- p.115 / Chapter 4.3.2 --- Supervised Gene Selection --- p.115 / Chapter 4.3.2.1 --- Gene Expression Profiles Distinguish Cardinal Ligament with Uterine Prolapse from Control and Identify Differentially Expressed Genes --- p.115 / Chapter 4.3.2.2 --- Gene Expression Profiles Distinguish Cardinal Ligament with Different Degrees of Uterine Prolapse from Control and Identify Differentially Expressed Genes --- p.118 / Chapter 4.3.2.3 --- Gene Expression Profiles Distinguish Cardinal Ligament with Third-degree Prolapse from First-degree Prolapse and Identify Differentially Expressed Genes --- p.120 / Chapter 4.4 --- Potential Genes for Further Studies in Uterine Prolapse --- p.120 / Chapter 4.5 --- Implications of This Study --- p.157 / Chapter 4.6 --- Limitations of This Study --- p.160 / Chapter CHAPTER 5 --- CONCLUSIONS --- p.162 / Chapter CHAPTER 6 --- FUTURE PROSPECT --- p.164 / REFERENCES --- p.165

L’hormone anti-Müllerienne (AMH) est un membre de la famille TGF-β impliquée dans la différenciation du tractus reproductif mâle. Elle est aussi exprimée par les cellules de la granulosa de l’ovaire adulte. Cependant, son rôle physiologique chez la femelle n’a pas encore été entièrement établi. Mon projet de thèse a pour objectif d’élucider le(s) rôle(s) de l’AMH dans le tractus reproductif femelle. L’AMH transduit ses effets par l’intermédiaire de deux récepteurs transmembranaires sérine/thréonine kinase : un récepteur de type II qui lui est spécifique (AMHR-II) et un récepteur de type I (ActR-IA, BMPR-IA, BMPR-IB) qu’elle partage avec les BMPs. Après fixation de l’hormone sur le récepteur de type II, celui-ci recrute et phosphoryle le récepteur de type I. Ce dernier phosphoryle à son tour les Smads spécifiques (Smad1, 5 et 8) qui s’associent à la Smad commune, Smad4. L’ensemble transloque dans le noyau et en association avec des facteurs de transcription régule les gènes cibles de l’hormone. L'utilisation de souris KO conditionnelles pour les récepteurs Acvr1 et Bmpr1a et d'une technique de siRNA dirigés contre chacun des trois récepteurs de type I a permis de mettre en évidence que le récepteur BMPR-IA est un acteur essentiel de la voie de signalisation de l'AMH dans les cellules de la granulosa. Pour déterminer la ou les Smad(s) impliquées, une technique de gènes rapporteurs, Smad-Gal4/UAS-luciférase, a été utilisée. Nous avons pu montrer que les Smad1 et 5 sont importantes pour la transduction du signal de l'AMH dans les cellules de la granulosa. Récemment des corécepteurs aux BMPs, les Repulsive Guidance Molecule (RGMs), ont été mis en évidence. L’AMH partageant sa voie de signalisation avec les BMPs, nous avons cherché à déterminer si ces corécepteurs pouvaient également intervenir dans la voie de signalisation de l’AMH. Il existe 3 types de RGMs: RGMa, RGMb et RGMc. Nous avons montré en q-PCR que seul RGMb est exprimé dans les cellules de la granulosa alors que les 3 RGMs sont exprimés dans l’ovaire. L'utilisation de siRNA dirigés contre RGMb a permis de montrer que ce récepteur n'est pas nécessaire à la transduction du signal de l'AMH. Actuellement, seuls deux gènes cibles de l’AMH sont connus dans les cellules de la granulosa : l’aromatase et le récepteur LH. Nous avons réalisé des analyses de puces à ADN (ou micro-array) pour décrire de nouveaux gènes cibles de l'AMH. L'analyse des puces a permis de décrire de nouveaux gènes régulés par cette hormone tels qu’Ovgp1 ou Kcnj2. La dernière partie de mon projet visait à déterminer un rôle potentiel de l'AMH dans l'utérus. En effet, le récepteur de cette hormone est exprimé dans le myomètre utérin de souris permettant de supposer qu’elle peut agir sur cet organe. Nous avons pu mettre en évidence une expression faible du gène de l’Amh dans l’utérus. En revanche, l’expression et la localisation de la protéine restent encore à définir. Une expérience de PCR-array a permis de montrer que de nombreux gènes sont différentiellement exprimés entre l’utérus Wt et l’utérus KO Amh. Ceci indique que l’AMH jouerait un rôle sur la régulation de la fonction utérine qu’elle soit exprimée ou non dans cet organe. / Anti-Müllerian hormone (AMH) is a member of the TGF-ß superfamily. AMH is well known for its role in Müllerian duct regression in male fetuses. Postnatally, AMH is secreted by granulosa cells (GCs) of small growing follicles (preantral and small antral). However, despite the increasing interest of ovarian AMH in clinics, little is known on its mechanism of action and its role in female reproductive tract. My PhD project focuses on the identification of AMH function in the female reproductive tract.AMH signals through a type II transmembrane serine/threonine kinase receptor (AMHR-II) which forms a complex with a type I serine/threonine kinase receptor (ActR-IA, BMPR-IA, BMPR-IB). The type II receptor phosphorylates serine and threonine residues of type I receptor. Once activated, the type I receptor phosphorylates the receptor-regulated Smads (R-Smad1/5/8) which interact with a common partner Smad4. The Smad complex accumulates into the nucleus and regulates target gene expression. This canonical signalling pathway is regulated at different levels, in particular by co-receptors which amplify or antagonize TGF-ß family members action. The type I receptors and R-Smads involved in AMH effects on post-natal GCs remain unknown. In addition, to date, no co-receptor has been found for AMH. To define the involvement of the different type I receptors, we used siRNA technology to inactivate Acvr1, Bmpr1a and Bmpr1b in GC. In parallele, we analysed GC extracted from conditional mutant mice for Acvr1 and Bmpr1a. We found that BMPR-IA is the most important type I receptor for AMH to transduce its signal in GC. A Smad-Gal4/UAS-luciferase reporter gene technology allowed us to show that Smad1 and 5 are involved in AMH signaling pathway. Recently, new BMPs coreceptors were found, RGMs for Repulsive Guidance Molecules. There are three RGMs : RGMa, b and c. Because AMH shares with BMPs its type I receptors and R-Smad proteins, we hypothesized that they also share the same co-receptors, the RGM. We showed that RGMb was the only one expressed in GC and after siRNA transfection we demonstrated that this coreceptor is not essential for AMH to transduce its signal.To date, only few AMH target genes have been identified. Aromatase (Cyp19a1) and LH receptor (Lhcgr) are down-regulated by AMH in rat and porcine GCs. We used micro-array technology (Affymetrix) by comparing Wt and knockout immature ovaries to find new AMH target genes. This experiment evidenced that Ovgp1 and Kcnj2 are two new potential AMH target genes in the ovary.The last part of my project was to define a potential role of AMH in murine uterus. Only one study showed that AMHR-II is expressed in the mouse myometrium. We showed that Amh gene is slightly expressed in uterus but the results are not confirmed at the protein level. Using PCR-array, we found a lot of differentially expressed genes between Wt and Amh KO uterus. Therefore, AMH could regulate uterine function through the modulation of different genes located in the myometrium.

Leung, Winnie. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 155-164). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgements --- p.v / Table of Contents --- p.vi / List of Figures --- p.x / Abbreviations --- p.xii / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Clinical management of Cancer --- p.2 / Chapter 1.2 --- Multidrug resistance --- p.8 / Chapter 1.3 --- Aim of study --- p.14 / Chapter Chapter 2 --- Identification of gene contributing to multidrug resistance in human uterine sarcoma cells --- p.16 / Chapter 2.1 --- Introduction --- p.17 / Chapter 2.2 --- Material and Methods / Chapter 2.2.1 --- Materials / Chapter 2.2.1.1 --- Cell lines --- p.20 / Chapter 2.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.20 / Chapter 2.2.1.3 --- Gene expression assay reagents --- p.22 / Chapter 2.2.1.4 --- Western blotting reagents --- p.24 / Chapter 2.2.1.5 --- MTT assay reagents --- p.29 / Chapter 2.2.1.6 --- Apoptosis analysis by flow cytometry reagents --- p.29 / Chapter 2.2.2 --- Metho --- p.ds / Chapter 2.2.2.1 --- Cell Culture --- p.31 / Chapter 2.2.2.2 --- MTT assay --- p.32 / Chapter 2.2.2.3 --- Gene expression essay (RT-PCR) --- p.33 / Chapter 2.2.2.4 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.37 / Chapter 2.2.2.5 --- Quantification of doxorubicin uptake by flow cytometry --- p.40 / Chapter 2.2.2.6 --- Apoptosis analysis by flow cytometry --- p.41 / Chapter 2.3 --- Results --- p.4 / Chapter 2.3.1 --- Cytotoxicity of doxorubicin on SA and DX5 cells --- p.43 / Chapter 2.3.2 --- mRNA expression of multidrug resistance related genes in SA and DX5 cells --- p.46 / Chapter 2.3.3 --- P-glycoprotein expression in SA and DX5 cells --- p.49 / Chapter 2.3.4 --- Doxorubicin (Dox) uptake by SA and DX5 cells --- p.51 / Chapter 2.3.5 --- Doxorubicin induced Apoptosis in SA and DX5 cells --- p.54 / Chapter 2.4 --- Discussion --- p.61 / Chapter 2.5 --- Conclusion --- p.65 / Chapter Chapter 3 --- Alternation in P-glycoprotein expression in DX5_Ninjl cells --- p.66 / Chapter 3.1 --- Introduction --- p.67 / Chapter 3.2 --- Materials and Methods / Chapter 3.2.1 --- Materials / Chapter 3.2.1.1 --- Cell lines --- p.70 / Chapter 3.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.70 / Chapter 3.2.1.3 --- Gene expression assay reagents --- p.70 / Chapter 3.2.1.4 --- Western blotting reagents --- p.72 / Chapter 3.2.1.5 --- Plasmid DNA extraction --- p.75 / Chapter 3.2.1.6 --- Transient transfection --- p.76 / Chapter 3.2.1.7 --- MTT reagents --- p.76 / Chapter 3.2.2 --- Methods / Chapter 3.2.2.1 --- Cell culture --- p.78 / Chapter 3.2.2.2 --- Gene expression essay (RT-PCR) --- p.79 / Chapter 3.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.81 / Chapter 3.2.2.4 --- DNA plasmid extraction --- p.83 / Chapter 3.2.2.5 --- Transient transfection --- p.84 / Chapter 3.2.2.6 --- MTT assay --- p.85 / Chapter 3.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.86 / Chapter 3.3 --- Results / Chapter 3.3.1 --- mRNA expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.87 / Chapter 3.3.2 --- The protein expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.89 / Chapter 3.3.3 --- Ninjurin1 (Ninj1) cDNA transfection in DX5 cells --- p.91 / Chapter 3.3.4 --- mRNA expression of MDR1 in Ninjurin1-transfected DX5 cells (DX5_Ninjl) --- p.93 / Chapter 3.3.5 --- P-glycoprotein expression in Ninjurin1-transfected DX5 cells --- p.95 / Chapter 3.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5_Ninjl cells" --- p.97 / Chapter 3.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_Ninjl cells" --- p.99 / Chapter 3.4 --- Discussion --- p.102 / Chapter 3.5 --- Conclusion --- p.105 / Chapter Chapter 4 --- Alternation in MDR1 expression in DX5一THBS1 cells --- p.106 / Chapter 4.1 --- Introduction --- p.107 / Chapter 4.2 --- Materials and Methods / Chapter 4.2.1 --- Materials / Chapter 4.2.1.1 --- Cell lines --- p.109 / Chapter 4.2.1.2 --- Cell culture medium； supplements and buffers --- p.109 / Chapter 4.2.1.3 --- Gene expression assay reagents --- p.109 / Chapter 4.2.1.4 --- Western blotting reagents --- p.111 / Chapter 4.2.1.5 --- Plasmid DNA extraction --- p.114 / Chapter 4.2.1.6 --- Transient transfection --- p.115 / Chapter 4.2.1.7 --- MTT reagents --- p.115 / Chapter 4.2.2 --- Methods / Chapter 4.2.2.1 --- Cell culture --- p.117 / Chapter 4.2.2.2 --- Gene expression essay (RT-PCR) --- p.118 / Chapter 4.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.120 / Chapter 4.2.2.4 --- DNA plasmid extraction --- p.123 / Chapter 4.2.2.5 --- Transient transfection --- p.123 / Chapter 4.2.2.6 --- MTT assay --- p.124 / Chapter 4.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.125 / Chapter 4.3 --- Results / Chapter 4.3.1 --- mRNA expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.126 / Chapter 4.3.2 --- The protein expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.128 / Chapter 4.3.3 --- Thrombospondinl (THBS1) cDNA transfection in DX5 cells --- p.130 / Chapter 4.3.4 --- mRNA expression of MDR1 in Thrombospondinl-transfected DX5 cells (DX5_THBS1) --- p.132 / Chapter 4.3.5 --- P-glycoprotein expression in Thrombospondinl-transfected DX5 cells --- p.134 / Chapter 4.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5一THBS1 cells" --- p.136 / Chapter 4.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_THBS1 cells" --- p.138 / Chapter 4.4 --- Discussion --- p.141 / Chapter 4.5 --- Conclusion --- p.145 / Chapter Chapter 5 --- General discussion --- p.146 / Chapter 5.1 --- Doxorubicin induced multidrug resistance in human uterin sarcoma cells via upregulation of P-glycoprotein --- p.147 / Chapter 5.2 --- The down-regulation of Ninjurin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.148 / Chapter 5.3 --- The down-regulation of Thrombospondin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.150 / Chapter 5.4 --- Conclusion and Future Perspective --- p.153 / Reference --- p.155

INTRODUÇÃO: A prolactina é um hormônio polipeptídico, que possui reconhecida ação sistêmica, principalmente na fisiologia da reprodução, porém, seu desequilíbrio, em especial a hiperprolactinemia, é cada vez mais frequente na prática clínica. Apesar de ser um distúrbio relativamente comum, ainda existem dúvidas quanto aos efeitos moleculares da hiperprolactinemia no trato genital, particularmente no útero, e também na hipófise. O presente estudo teve por objetivo verificar os efeitos da hiperprolactinemia induzida pela metoclopramida na expressão gênica da prolactina e de seus receptores no útero e na hipófise de camundongo fêmea. MÉTODOS: Utilizaram-se 49 camundongos fêmeas (Wistar), randomicamente divididas em 7 grupos contendo 7 animais cada: 1) SS não ovariectomizadas que receberam solução salina (veículo); 2) M não ovariectomizadas tratadas com metoclopramida; 3) OSS ovariectomizadas tratadas com solução salina (veículo); 4) OM ovariectomizadas tratadas com metoclopramida; 5) OME ovariectomizadas tratadas com metoclopramida e 17-estradiol; 6) OMP ovariectomizadas tratadas com metoclopramida e progesterona micronizada; 7) OMEP ovariectomizadas tratadas com metoclopramida, 17-estradiol e progesterona micronizada. Após 50 dias os animais foram sacrificados sendo retirados o útero e a hipófise de cada animal para extração do ácido ribonucleico total, que foi utilizado para a síntese de ácido desoxirribonucleico complementar e avaliação da expressão gênica da prolactina e das diferentes isoformas de seus receptores, por reação em cadeia da polimerase em tempo real. RESULTADOS: Na hipófise, em animais não ovariectomizados, o tratamento com metoclopramida aumentou a expressão do gene que codifica a prolactina em relação ao tratamento apenas com o veículo. Nos animais castrados, a progesterona isoladamente ou associada ao estrogênio determinou o incremento do RNA mensageiro da prolactina em relação aos outros animais castrados que receberam outras combinações de tratamento. Este efeito foi semelhante ao da metoclopramida em animais com os ovários intactos. Em relação ao receptor de prolactina, o estrogênio e a progesterona, isoladamente, foram responsáveis pelo incremento da isoforma S2. No útero houve aumento na expressão de RNA mensageiro de prolactina após tratamento com metoclopramida ou com tratamento isolado ou combinado de estrogênio e progesterona. A ovariectomia determinou a redução da expressão das isoformas S1 e S2 do receptor de prolactina de todas as isoformas estudadas. Já o tratamento estroprogestativo determinou elevação da formas S3 e L do receptor, enquanto com a progesterona isoladamente causou apenas o incremento da forma L do receptor da prolactina no útero dos animais castrados. CONCLUSÕES: Nossos dados sugerem que o tratamento com metoclopramida altera de forma diferente a expressão de prolactina e de seus receptores quando se compara o resultado da hipófise em relação ao útero em camundongos fêmeas castrados e tratados com esteróides sexuais / INTRODUCTION: Prolactin is a polypeptide hormone with a recognized systemic action mainly on reproductive physiology. However, prolactin imbalance, particularly hyperprolactinemia, is increasingly more frequent in clinical practice. Although it is a comparatively common disorder, there are still doubts about the molecular effects of hyperprolactinemia on the genital tract especially in the uterus and the pituitary. The present study aimed at verifying the effects of metoclopramide-induced hyperprolactinemia on the gene expression of prolactin and its receptors in the uterus and pituitary of the female mouse. METHODS: Forty-nine female Wistar mice were randomized to 7 equal-sized groups as follows: 1) SS nonoophorectomized mice treated with saline solution (vehicle); 2) M nonoophorectomized mice treated with metoclopramide; 3) OSS oophorectomized mice treated with saline solution (vehicle); 4) OM oophorectomized mice treated with metoclopramide; 5) OME oophorectomized mice treated with metoclopramide and 17-estradiol; 6) OMP oophorectomized mice treated with metoclopramide and micronized progesterone; 7) OMEP oophorectomized mice treated with metoclopramide, 17-estradiol, and micronized progesterone. The animals were sacrificed 50 days after the end of the treatment, and the uterus and pituitary of each animal were removed for extraction of total ribonucleic acid, which was then used for synthesizing complementary deoxyribonucleic acid and for evaluating the gene expression of prolactin and the different isoforms of its receptors by the real-time polymerase chain reaction. RESULTS: In the pituitary of the nonoophorectomized mice, the treatment with metoclopramide against that with vehicle alone increased the expression of the prolactin-encoding gene. In the castrated animals, progesterone by itself or in conjunction with estrogen determined a raise in prolactin messenger RNA as opposed to the two other treatments with different combinations. This effect was similar to that produced by metoclopramide in animals with intact ovaries. Estrogen and progesterone, acting independently of each other, were responsible for the increase in the S2 isoform of the prolactin receptor. In the uterus, there was heightened expression of prolactin messenger RNA under the effect of the treatment with metoclopramide or with estrogen and/or progesterone. Oophorectomy caused a greater reduction in expression of the prolactin receptor S1 and S2 isoforms than in the other isoforms. However, the combined estrogen plus progesterone treatment led to an increase in the S3 and L forms of the receptor, while progesterone alone resulted solely in a higher expression of the L form of the prolactin receptor in the endometrium of the castrated mice. CONCLUSION: Our data suggest that metoclopramide treatment induces different changes in the expression of prolactin and its receptors according to whether the effect occurs in the pituitary or the uterus of castrated female mice treated with sex steroids

L’accouchement prématuré est un problème de santé publique dans le monde et notamment dans les pays économiquement développés avec un taux variant entre 7 et 12 % des naissances. Le diagnostic du risque d’accouchement prématuré est difficile à faire et les outils à notre disposition ont peu évolué ces dernières années. La contraction utérine est la conséquence directe de l’activité électrique au niveau du myomètre. Le type de contraction est lié à l’importance de l’excitabilité cellulaire et de sa diffusion à l’ensemble du myomètre. Le recueil et l’analyse de cette activité électrique par des électrodes de surface est aujourd’hui le seul moyen non invasif d’étudier, pendant la grossesse, les mécanismes qui sont à l’origine de la contraction. L’enregistrement de l’électromyogramme utérin ou électrohystérogramme (EHG) est donc prometteur pour réaliser un diagnostic et une surveillance des femmes à risque d’accouchement prématuré. Dans ce travail de thèse 3 études cliniques ont été réalisées. Dans la première, j’ai étudié différentes électrodes de surface permettant d’enregistrer les signaux électriques. Je propose à la fin de cette première partie un système d’électrodes pour permettre à la fois un enregistrement de qualité et une pose aisée compatible avec une application clinique. Dans la deuxième étude j’ai étudié la détection automatique des contractions par l’EHG avec des résultats encourageants pour l’application clinique et notamment en ambulatoire. Enfin dans la troisième étude j’ai étudié la prédiction du risque d’accouchement prématuré par l’analyse de paramètres électriques issus de l’EHG. Les résultats obtenus permettent d’améliorer la prédiction du risque d’accouchement prématuré par rapport aux outils utilisés en routine. / Premature birth is a public health problem in the world, particularly in economically developed countries with a rate varying between 7% and 12% of births. The diagnosis of the risk of premature labor is difficult to make and the tools at our disposal have changed little in recent years. Uterine contraction is a direct consequence of electrical activity at the level of the myometrium. The type of contraction is related to the importance of cell excitability and its diffusion to the entire myometrium. The analysis of this electrical activity by surface electrodes is currently the only non-invasive way to study the mechanisms that are at the origin of the contraction. The recording of the uterine electromyogram or electrohysterogram (EHG) is therefore promising for the diagnosis and surveillance of women at risk of preterm birth. In this thesis work 3 clinical studies have been carried out. In the first clinical study, different surface electrodes to record electrical signals were tested. I propose at the end of this first part a system of electrodes to allow at the same time a recording of quality and an easy pose compatible with a clinical application. In the second study , the automatic detection of contractions by the El-IG was studied with encouraging results for the clinical application and especially in ambulatory. Finally, in the third clinical experiment, I studied the prediction of the risk of premature delivery by the analysis of electrical parameters extracted from the EHG. The results obtained make it possible to improve the prediction of the risk of premature delivery compared to the tools used routinely.