Cervical expression of elafin and secretory leukocyte peptidase inhibitor does not predict preterm delivery in twin pregnancy – results from a pilot study





twin pregnancy, elafin, secretory leukocyte peptidase inhibitor, preterm delivery


Background. Elafin and secretory leukocyte peptidase inhibitor may serve as the predictors of cervical shortening and preterm delivery in twin gestation.

Material and Methods. A prospective observational study was conducted between September 2016 and March 2017. Cervicovaginal swabs collected from 40 women with twin gestation were analysed and the mRNA expression of elafin and secretory leukocyte peptidase inhibitor (SLPI) correlated with preterm delivery.

Results. The mean gestational age at delivery was 35.6 ± 5.8 weeks, with 23 women delivering before 37 weeks (57.5%), 7 before 34 weeks (17.5%) and 3 before 32 weeks of gestation (7.5%). The mRNA expression of elafin and SLPI was not dependent on chorionicity and did not correlate with gestational age at delivery.

Conclusions. Elafin and SLPI are not appropriate predictors of preterm delivery in twins.


Download data is not yet available.

Author Biography

Katarzyna Kosińska-Kaczyńska, Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education

Assoc. Prof. Katarzyna Kosinska-Kaczynska, MD, PhD, Second Department of Obstetrics and Gynecology, Canter of Postgraduate Medical Education, Marymoncka St. 99/103, 01-813 Warsaw, Poland; phone: +48225690274; e-mail: katarzyna.kosinska-kaczynska@cmkp.edu.pl


Sallenave J. Secretory Leukocyte Protease Inhibitor and Elafin/Trappin-2. American Journal of Respiratory Cell and Molecular Biology. 2010 Jun;42(6):635-643. https://doi.org/10.1165/rcmb.2010-0095rt

Tromp G, Kuivaniemi H, Romero R, Chaiworapongsa T, Kim YM, Kim MR, Maymon E, Edwin S. Genome-wide expression profiling of fetal membranes reveals a deficient expression of proteinase inhibitor 3 in premature rupture of membranes. American Journal of Obstetrics and Gynecology. 2004 Oct;191(4):1331-1338. https://doi.org/10.1016/j.ajog.2004.07.010

Abbott DS, Chin-Smith EC, Seed PT, Chandiramani M, Shennan AH, Tribe RM. Raised Trappin2/elafin Protein in Cervico-Vaginal Fluid Is a Potential Predictor of Cervical Shortening and Spontaneous Preterm Birth. Landay A. PLoS ONE. 2014 Jul 30;9(7):e100771. https://doi.org/10.1371/journal.pone.0100771

Samejima T, Nagamatsu T, Akiba N, Fujii T, Sayama S, Kawana K, Taguchi A, Kumasawa K, Iriyama T, Osuga Y, Fujii T. Secretory leukocyte protease inhibitor and progranulin as possible regulators of cervical remodeling in pregnancy. Journal of Reproductive Immunology. 2021 Feb;143:103241. https://doi.org/10.1016/j.jri.2020.103241

Romero R, Espinoza J, Gonçalves L, Kusanovic J, Friel L, Hassan S. The Role of Inflammation and Infection in Preterm Birth. Seminars in Reproductive Medicine. 2007 Jan;25(1):21-39. https://doi.org/10.1055/s-2006-956773

Tarter JG, Khoury A, Barton JR, Jacques DL, Sibai BM. Demographic and obstetric factors influencing pregnancy outcome in twin gestations. American Journal of Obstetrics and Gynecology. 2002 May;186(5):910-912. https://doi.org/10.1067/mob.2002.123989

Goldenberg RL, Iams JD, Miodovnik M, Van Dorsten J, Thurnau G, Bottoms S, Mercer BM, Meis PJ, Moawad AH, Das A, Caritis SN, McNellis D. The preterm prediction study: Risk factors in twin gestations. American Journal of Obstetrics and Gynecology. 1996 Oct;175(4):1047-1053. https://doi.org/10.1016/s0002-9378(96)80051-2

ACOG. Obstetrics & Gynecology. 2019 Jan;133(1):1-1. https://doi.org/10.1097/aog.0000000000003018

Wender-Ożegowska E, Bomba-Opoń D, Brązert J, Celewicz Z, Czajkowski K, Gutaj P, Malinowska-Polubiec A, Zawiejska A, Wielgoś M. Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes. Ginekol Pol. 2018;89(6):341-50. https://doi.org/10.5603/GP.a2018.0059 PMID 30010185

Manning R, James CP, Smith MC, Innes BA, Stamp E, Peebles D, Bajaj-Elliott M, Klein N, Bulmer JN, Robson SC, Lash GE. Predictive value of cervical cytokine, antimicrobial and microflora levels for pre-term birth in high-risk women. Scientific Reports. 2019 Aug 2;9(1). https://doi.org/10.1038/s41598-019-47756-7

Hezelgrave NL, Seed PT, Chin-Smith EC, Ridout AE, Shennan AH, Tribe RM. Cervicovaginal natural antimicrobial expression in pregnancy and association with spontaneous preterm birth. Scientific Reports. 2020 Jul 21;10(1). https://doi.org/10.1038/s41598-020-68329-z

Bastek JA, Hirshberg A, Chandrasekaran S, Owen CM, Heiser LM, Araujo BA, McShea MA, Ryan ME, Elovitz MA. Biomarkers and Cervical Length to Predict Spontaneous Preterm Birth in Asymptomatic High-Risk Women. Obstetrics & Gynecology. 2013 Aug;122(2):283-289. https://doi.org/10.1097/aog.0b013e31829ab714

Itaoka N, Nagamatsu T, Schust DJ, Ichikawa M, Sayama S, Iwasawa-Kawai Y, Kawana K, Yamashita T, Osuga Y, Fujii T. Cervical Expression of Elafin and SLPI in Pregnancy and Their Association With Preterm Labor. American Journal of Reproductive Immunology. 2015 Jan 5;73(6):536-544. https://doi.org/10.1111/aji.12354

Stock SJ, Duthie L, Tremaine T, Calder AA, Kelly RW, Riley SC. Elafin (SKALP/Trappin-2/proteinase inhibitor-3) Is Produced by the Cervix in Pregnancy and Cervicovaginal Levels Are Diminished in Bacterial Vaginosis. Reproductive Sciences. 2009 Sep;16(12):1125-1134. https://doi.org/10.1177/1933719109341998

Helmig R, Uldbjerg N, Ohlsson K. Secretory leukocyte protease inhibitor in the cervical mucus and in the fetal membranes. European Journal of Obstetrics & Gynecology and Reproductive Biology. 1995 Mar;59(1):95-101. https://doi.org/10.1016/0028-2243(94)02023-8

King AE, Morgan K, Sallenave J, Kelly RW. Differential regulation of secretory leukocyte protease inhibitor and elafin by progesterone. Biochemical and Biophysical Research Communications. 2003 Oct;310(2):594-599. https://doi.org/10.1016/j.bbrc.2003.08.151

Stock S, Norman J. Preterm and term labour in multiple pregnancies. Seminars in Fetal and Neonatal Medicine. 2010 Dec;15(6):336-341. https://doi.org/10.1016/j.siny.2010.06.006

How to Cite

Saletra-Bielińska A, Kosińska-Kaczyńska K, Szymusik I, Niderla-Bielińska J, Malejczyk J, Wielgoś M. Cervical expression of elafin and secretory leukocyte peptidase inhibitor does not predict preterm delivery in twin pregnancy – results from a pilot study. JMS [Internet]. 2021 Feb. 24 [cited 2023 Jun. 1];90(1):e490. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/490



Original Papers
Received 2020-12-07
Accepted 2021-01-29
Published 2021-02-24