Postpartum Cervical Repair in Mus musculus: Potential Role For Vascular Endothelial Growth Factor and Hypoxia Inducible Factor 1 Alpha in Cervical Wound Healing

Cervical remodeling (CR) is the active process where the birth canal prepares for parturition. CR is divided into four distinct yet overlapping phases, with the first three phases taking place during gestation and parturition, whereas the fourth and final phase, postpartum repair, ensures proper healing and recovery of the cervix back to a non-pregnant state. Postpartum repair is the least studied phase of CR, and to date, this is the only study of which we are aware that focuses exclusively on postpartum repair. Here, we examined the ultra-morphological changes taking place in the cervix during the first 48h postpartum, the expression profiles of four key proteins: vascular endothelial growth factor (VEGF), hypoxia inducible factor 1 alpha (HIF-1a), and two VEGF receptors (KDR and Flt-1), and using quantitative proteomics, we sought to determine the genome-wide protein expression patterns taking place in the cervix during the least studied phase of cervical remodeling. From these studies, we demonstrate 1) the cervix undergoes vast morphological changes during the first 48h postpartum, 2) HIF-1a, VEGF, and its receptors are readily expressed at both the gene and protein levels, and 3) quantitative proteomics revealed dynamic changes in several cytoskeletal elements as well as immune-related proteins.