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Multiparity and Aging Impact Chondrogenic and Osteogenic Potential at Symphyseal Enthesis: New Insights into
Lizandra Maia de Sousa1, Bianca Gazieri Castelucci2, Paula Andrea Saenz Suarez1
1Laboratory of Cytochemistry and Immunocytochemistry, Department of Biochemistry and Tissue Biology, Institute of Biology (IB), State University of Campinas (Unicamp), Campinas 13083-970, Brazil.
Insights
Repeated pregnancies in older female mice impair pubic symphysis recovery by altering cartilage repair mechanisms at the joint enthesis. This impacts pelvic floor health and recovery after childbirth.
Area of Science:
- Reproductive Biology
- Skeletal Biology
- Connective Tissue Research
Background:
- Childbirth necessitates significant adaptations in the maternal birth canal, including changes to the pubic symphysis, to facilitate delivery and enable rapid recovery.
- The pubic symphysis forms an interpubic ligament (IpL) and enthesis in first-time mothers (primiparous), but subsequent deliveries can affect joint healing.
- Understanding these postpartum recovery dynamics is crucial for addressing pelvic floor disorders.
Purpose of the Study:
- To investigate the tissue morphology and the chondrogenic and osteogenic potential at the symphyseal enthesis during pregnancy and postpartum periods.
- To compare these processes in both primiparous and multiparous senescent female mice.
Main Methods:
- Comparative analysis of tissue morphology at the symphyseal enthesis.
- Assessment of chondrogenic and osteogenic marker expression.
- Evaluation of cellular activity and extracellular matrix composition in different reproductive states and ages.
Main Results:
- Significant morphological and molecular differences were observed at the symphyseal enthesis across the studied groups.
- Multiparous senescent mice showed an apparent inability to restore cartilage, despite active symphyseal enthesis cells.
- These cells exhibited reduced chondrogenic and osteogenic marker expression and were embedded in dense collagen fibers near a persistent IpL.
Conclusions:
- Findings suggest alterations in progenitor cell populations and lineage maintenance at the symphyseal enthesis in multiparous senescent mice, potentially hindering joint recovery.
- These cellular changes may compromise the structural integrity of the pubic symphysis, impacting pelvic floor biomechanics.
- This research offers insights into the mechanisms underlying birth canal distention and its potential contribution to pubic symphysis diastasis (PSD) and pelvic organ prolapse (POP) in women.
Abstract:
Pregnancy and childbirth cause adaptations to the birth canal to allow for delivery and fast recovery. To accommodate delivery through the birth canal, the pubic symphysis undergoes changes that lead to the interpubic ligament (IpL) and enthesis formation in primiparous mice. However, successive deliveries influence joint recovery. We aimed to understand tissue morphology and chondrogenic and osteogenic potential at symphyseal enthesis during pregnancy and postpartum in primiparous and multiparous senescent female mice. Morphological and molecular differences were found at the symphyseal enthesis among the study groups. Despite the apparent incapacity to restore cartilage in multiparous senescent animals, the symphyseal enthesis cells are active. However, these cells have reduced expression of chondrogenic and osteogenic markers and are immersed in densely packed collagen fibers contiguous to the persistent IpL. These findings may indicate alterations of key molecules in the progenitor cell population maintenance of the chondrocytic and osteogenic lineages at the symphyseal enthesis in multiparous senescent animals, possibly compromising the mouse joint histoarchitecture recovery. This sheds light on the distention of the birth canal and the pelvic floor that may play a role in pubic symphysis diastasis (PSD) and pelvic organ prolapse (POP), both in orthopedic and urogynecological practice in women.
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