395 Dual effect of nifedipine on term pregnant human myometrium contractility

Abstract

Nifedipine, L-type voltage-gated Ca2+ channels (L-VGCC) blocker, is one of the most used tocolytics to treat preterm labor. In clinical practice, nifedipine efficiently decreases uterine contractions but its efficacy is limited overtime (48h). The aim of this study was to understand why nifedipine has short-lasting efficiency for inhibition of uterine contractions. Term pregnant human myometrial strips with different ex vivo contractile capacities [either regular (n=6) or irregular (n=5) spontaneous contractions] were mounted in an organ bath, and treated with cumulative doses of nifedipine. Tissue contractility in response to nifedipine was analyzed. Then, to investigate the molecular mechanisms activated by nifedipine in myometrial cells with irregular contractile capacity, we used the pregnant human myometrial cell line PHM1-41 that does express L-VGCC. Cells were transfected with siRNA for ORAI1, a non-voltage gated Ca2+ channel, and STIM1, the ORAI1 regulator. Both transfected and non-transfected cells were treated with different doses of nifedipine. Evolution of intracellular Ca2+ level was monitored with a Ca2+ indicator dye. Treatment of myometrial strips with cumulative doses of nifedipine inhibited spontaneous myometrial contraction in tissues with high contractility, even at low doses. On the contrary, nifedipine treatment appeared to increase contractions in tissues with low contractility (Fig1). In vitro, high doses of nifedipine (>10-6M) induced an important intracellular Ca2+ entry in myometrial cells (Fig2). Nifedipine-induced Ca2+ influx was not affected by knock-down of ORAI1 and STIM1 neither individually, nor together This study highlighted existence of a dual action of nifedipine. In addition to inhibit contraction in contracting myometrial tissue, we showed that nifedipine had an opposite pro-contractile effect in weak-contracting muscle. This effect could involve an activation of Ca2+ entry into myometrial cells, but this process does not seem to involve neither STIM1 nor ORAI1 Ca2+ channel.View Large Image Figure ViewerDownload Hi-res image Download (PPT)