Cervical Glycosaminoglycans and Extracellular Matrix Remodeling: New Insights and the Therapeutic Promise of Tafoxiparin

Highlights What are the main findings? Heparan sulfate and hyaluronan dynamically remodel the cervical extracellular matrix and integrate inflammatory and endocrine signals during cervical ripening. Cervical glycosaminoglycans emerge as key regulators of collagen disorganization, tissue hydration, and biomechanical softening of the cervix. What are the implications of the main findings? Targeting glycosaminoglycan biology offers a novel, mechanism-based strategy for cervical ripening and labour induction. Heparan-sulfate-based analogues such as tafoxiparin may provide effective cervical ripening with minimal anticoagulant activity and a favourable safety profile. Abstract Cervical ripening is a multifaceted process involving endocrine, inflammatory, and biomechanical signals that act on the cervical extracellular matrix. While previous reviews have focused on hormonal and immune mechanisms, the specific role of cervical glycosaminoglycans (GAGs)—particularly hyaluronan and heparan sulfate—has received limited dedicated attention. This review addresses that gap by exploring how these GAGs function as integrators of hormonal cues, immune activation, and extracellular matrix remodeling during pregnancy and labour. We conducted a narrative synthesis of experimental, translational, and clinical studies on GAG composition, metabolism, and signaling, with particular attention to tafoxiparin, a heparan-sulfate-based compound with minimal anticoagulant activity. Available evidence suggests that alterations in hyaluronan and heparan sulfate content influence collagen disorganization, tissue hydration, immune cell infiltration, and prostaglandin production—collectively contributing to cervical softening and dilatation. Although tafoxiparin may replicate some actions of endogenous GAGs, current clinical data remain sparse and inconclusive. Thus, targeting cervical GAG biology represents a mechanistic yet still investigational strategy, requiring further studies to determine its therapeutic value.

• Publication year

  2025

• Venue

  Cells

• Publication date

  2025-12-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.3390/cells14241934PMID 41439951PMCID 12731191
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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