Pregnant Uterine Arteries Research Articles

Ryanodine receptor subtypes regulate Ca2+ sparks/spontaneous transient outward currents and myogenic tone of uterine arteries in pregnancy.

Our recent study demonstrated that increased Ca2+ sparks and spontaneous transient outward currents (STOCs) played an important role in uterine vascular tone and haemodynamic adaptation to pregnancy. The present study examined the role of ryanodine receptor (RyR) subtypes in regulating Ca2+ sparks/STOCs and myogenic tone in uterine arterial adaptation to pregnancy. Uterine arteries isolated from non-pregnant and near-term pregnant sheep were used in the present study. Pregnancy increased the association of α and β1 subunits of large-conductance Ca2+-activated K+ (BKCa) channels and enhanced the co-localization of RyR1 and RyR2 with the β1 subunit in the uterine artery. In contrast, RyR3 was not co-localized with BKCa β1 subunit. Knockdown of RyR1 or RyR2 in uterine arteries of pregnant sheep downregulated the β1 but not α subunit of the BKCa channel and decreased the association of α and β1 subunits. Unlike RyR1 and RyR2, knockdown of RyR3 had no significant effect on either expression or association of BKCa subunits. In addition, knockdown of RyR1 or RyR2 significantly decreased Ca2+ spark frequency, suppressed STOCs frequency and amplitude, and increased pressure-dependent myogenic tone in uterine arteries of pregnant animals. RyR3 knockdown did not affect Ca2+ sparks/STOCs and myogenic tone in the uterine artery. Together, the present study demonstrates a novel mechanistic paradigm of RyR subtypes in the regulation of Ca2+ sparks/STOCs and uterine vascular tone, providing new insights into the mechanisms underlying uterine vascular adaptation to pregnancy.

Whole-Genome Uterine Artery Transcriptome Profiling and Alternative Splicing Analysis in Rat Pregnancy.

During pregnancy, the uterine artery (UA) undergoes extensive remodeling to permit a 20–40 fold increase in blood flow with associated changes in the expression of a multitude of genes. This study used next-gen RNA sequencing technology to identify pathways and genes potentially involved in arterial adaptations in pregnant rat UA (gestation day 20) compared with non-pregnant rat UA (diestrus). A total of 2245 genes were differentially expressed, with 1257 up-regulated and 970 down-regulated in pregnant UA. Gene clustering analysis revealed a unique cluster of suppressed genes implicated in calcium signaling pathway and vascular smooth muscle contraction in pregnant UA. Transcription factor binding site motif scanning identified C2H2 ZF, AP-2 and CxxC as likely factors functional on the promoters of down-regulated genes involved in calcium signaling and vascular smooth muscle contraction. In addition, 1686 genes exhibited alternative splicing that were mainly implicated in microtubule organization and smooth muscle contraction. Cross-comparison analysis identified novel genes that were both differentially expressed and alternatively spliced; these were involved in leukocyte and B cell biology and lipid metabolism. In conclusion, this first comprehensive study provides a valuable resource for understanding the molecular mechanism underlying gestational uterine arterial adaptations during pregnancy.

Doppler Sonography of Uterine Arteries in Pregnancy as a Marker of Preeclampsia

Doppler Sonography of Uterine Arteries in Pregnancy as a Marker of Preeclampsia

Pregnancy Enhances Calcium Spark Activity Independent of Altitude in Ovine Uterine Arterial Myocytes

During pregnancy, uterine artery blood flow increases in order to accommodate the growing fetus. However, the molecular mechanisms by which this change in uterine blood flow occurs remains to be elucidated. The BKCa channel, which is activated in response to ryanodine receptor (RyR) generated increases in intracellular Ca2+ known as Ca2+ sparks, helps regulate uterine artery blood flow. BKCa channel activation leads to vascular smooth muscle relaxation, thus decreasing uterine artery vascular tone and increasing uterine blood flow during pregnancy. Further to this, long term hypoxia due to high altitude exposure diminishes pregnancy – related increases in uterine blood flow. Based on these relationships we hypothesized that both pregnancy and membrane depolarization would increase Ca2+ spark activity, whereas ryanodine and long term hypoxia would inhibit Ca2+ spark activity. Uterine arteries were isolated from near‐term pregnant (n=6) and non‐pregnant sheep (n=6) in normoxia, as well as near‐term pregnant (n=6) and non‐pregnant sheep (n=6) exposed to hypoxic conditions at White Mountain (elevation 3,801 m) for 100 plus days. Isolated uterine arteries were subjected to three distinct ex vivo treatments: (1) control (saline), (2) 30mM potassium (30K), which causes membrane depolarization, and (3) 30K with ryanodine (10 μM), an RyR antagonist. Indeed, Ca2+ spark activity was increased in pregnant uterine arteries as compared to non‐pregnant uterine arteries, whereas hypoxia reduced spark frequency in all the aforementioned groups. Treatment with 30K increased Ca2+ spark activity in all groups. In comparison, 30K + ryanodine treatment decreased Ca2+ spark activity. Pregnancy increased the full width of sparks. However, pregnancy or hypoxia caused only minor changes in the amplitude and temporal aspects of sparks. These findings support the claim that membrane depolarization, due to 30K treatment, causes an increase in Ca2+ spark activity whereas ryanodine inhibits release of Ca2+ from the sarcoplasmic reticulum and thus decreases Ca2+ sparks. Taken together, these findings support the notion that the ryanodine receptors and BKCa channels work in conjunction with each other. This study provides further insight into the mechanisms that regulate uterine artery vascular tone and blood flow, and thus may prove useful in designing treatments for pregnancy complications that arise from increased uterine vascular tone, such as intrauterine growth restriction.Support or Funding InformationThis work is supported by The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development grant number HD083132, by the National Science Foundation under Grant No. MRI 0923559, and the Loma Linda University School of Medicine. VW was a Walter E Macpherson Medical Student Summer Research Fellow.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

307-POS

Objectives Gap junctions (GJ) are intercellular channels that contribute to the robust vasodilation found in pregnancy in several vascular beds. GJs allow for the coordination of endothelial cell responses by directing cell-cell communication via facilitated diffusion of signaling molecules (e.g. cAMP, cGMP). The phosphorylation of GJ protein Cx43 at serine (Ser) residues regulates both open (Ser365) and closed gating (Ser368), thus allowing the passage of signaling molecules between cells. Although the phosphorylation events of cAMP are well studied, little is known about cGMPs role on gap junction intracellular communication (GJIC) and function. Hypothesis: The inhibition of cAMP and cGMP-mediated pathways will modulate the phosphorylation and expression of Cx43 at their respective phosphorylation sites and thus increase or reduce GJIC in pregnant ovine uterine artery endothelial cells (P-UAECs) and human umbilical vein endothelial cells (HUVECs). Methods P-UAECs were pretreated with the respective cAMP and cGMP nucleotide cyclase inhibitors SQ22536 and ODQ (0.1–100 μ M) followed by treatment with 100 μ M of ATP or Forskolin, or 1 μ M–1 mM 8-Bromo-cAMP or 8-Bromo-cGMP and analyzed using ELISA, western analysis, or scrape-loading/dye transfer technique. Results ELISA revealed that the inhibitors SQ22536 and ODQ specifically and completely abrogated (P 0.01) cAMP and cGMP productions, respectively. Western analysis showed that SQ22536, decreased (P 0.05) the ATP, Forskolin, and cAMP-induced phosphorylation at Ser365 in P-UAECs and HUVECs, while GJIC function was reduced. ODQ decreased (P 0.05) ATP and cGMP-induced elevation at Ser365 in P-UAECs and HUVECs. In contrast, ODQ alone had no effect on GJIC. Conclusions cAMP via adenylyl clycase and cGMP via guanylyl cyclase differentially regulate Cx43 phosphorylation and expression, which is important in regulating GJIC. Although both cyclic nucleotides may serve as important regulation mechanisms in controlling vascular tone, cAMP may play the most important functional role in GJICs. These findings also suggest an expanded role of cGMP signaling on GJ function. Disclosures B. Ampey: None. I. Bird: None. R. Magness: None.

Gestational Hypoxia Increases Reactive Oxygen Species and Inhibits Steroid Hormone–Mediated Upregulation of Ca 2+ -Activated K + Channel Function in Uterine Arteries

Gestational hypoxia inhibits steroid hormone-induced upregulation of Ca(2+)-activated K(+) (KCa) channel activities in uterine arteries. We tested the hypothesis that increased reactive oxygen species play an important role in hypoxia-mediated inhibition of KCa channel activities. Uterine arteries were isolated from nonpregnant (nonpregnant uterine artery) and near-term (≈142-145 day) pregnant (pregnant uterine artery) sheep maintained at either sea level or high altitude (3820 m, Pao2: 60 mm Hg) for 110 days. In pregnant uterine arteries, hypoxia significantly decreased large conductance channel opener NS1619- and small conductance channel opener NS309-induced relaxations, which were partially restored by reactive oxygen species inhibitor N-acetylcysteine (NAC). NAC significantly increased large conductance KCa but not small conductance KCa current densities in uterine arterial smooth muscle cells in pregnant animals acclimatized to high altitude. The NAC-sensitive component of small conductance KCa-induced relaxations was diminished in endothelium-denuded arteries. In nonpregnant uterine arteries, NS1619- and NS309-induced relaxations were diminished compared with those in pregnant uterine arteries. Treatment of nonpregnant uterine arteries with 17β-estradiol and progesterone for 48 hours increased small conductance KCa type 3 protein abundance and NS1619- and NS309-induced relaxations, which were inhibited by hypoxia. This hypoxia-mediated inhibition was reversed by NAC. Consistently, steroid hormone treatment had no significant effects on large conductance KCa current density in nonpregnant uterine arteries of hypoxic animals in the absence of NAC but significantly increased it in the presence of NAC. These results suggest an important role of hypoxia-mediated reactive oxygen species in negatively regulating steroid hormone-mediated upregulation of KCa channel activity and adaptation of uterine vascular reactivity in pregnancy, which may contribute to the increased incidence of preeclampsia and fetal intrauterine growth restriction associated with gestational hypoxia.

DNA methylation contributes to chronic hypoxia‐induced downregulation of large‐conductance Ca2+‐activated K+ channels in uterine arteries in pregnancy (889.3)

Uterine blood flow increases dramatically during pregnancy in part due to an upregulation of the large‐conductance Ca2+‐activated K+ (BKCa) channel in the uterine artery. However, this hemodynamic change is complicated by chronic hypoxia. We hypothesized that DNA methylation may play a role in chronic hypoxia‐induced downregulation of BKCa channels. Uterine arteries were isolated from nonpregnant (NPUA) and near‐term (~140 days) pregnant (PUA) sheep and incubated under 21% or 10.5% O2 for 48 hours at 37°C. Exposure to chronic hypoxia significantly reduced the BKCa current density in PUA (p < 0.05), but not in NPUA. 5‐aza‐2'‐deoxycytidine (5‐aza), a DNA methylation inhibitor, blocked the hypoxia‐mediated effect in PUA. Accordingly, chronic hypoxia decreased a BKCa activator NS 1619‐induced relaxations of PUA, which was abrogated by 5‐aza. Treatment of NPUA ex vivo under 21% O2 with physiological concentrations of estrogen and progesterone (E2β/P4) resulted in increased BKCa current density; and chronic hypoxia suppressed this upregulation. However, 5‐aza reversed the impact of chronic hypoxia and restored the ability of E2β/P4 in upregulating the BKCa current density. Taken together, our findings suggest that an epigenetic modification of DNA methylation plays an important role in chronic hypoxia‐induced downregulation of BKCa channel function in uterine arteries in pregnancy.Grant Funding Source: HL089012, HL110125

Chronic hypoxia‐mediated oxidative stress downregulates the large‐conductance Ca2+‐activated K+ channel activity in uterine arteries in pregnancy (889.4)

Chronic hypoxia during pregnancy constitutes a major insult to maternal cardiovascular homeostasis, leading to complicated uteroplacental circulation. We recently demonstrated that long term high‐altitude hypoxia enhanced uterine arterial myogenic tone, which was mediated by the downregulation of the large‐conductance Ca2+‐activated K+ channel (BKCa) activity via enhanced oxidative stress. In the present study we tested the hypothesis that chronic hypoxia exposure directly increases generation of reactive oxygen species (ROS) in the uterine artery from pregnant sheep, which in turn suppresses BKCa channel activity in VSMCs of the vessel. Uterine arteries were isolated from near‐term (~140 days) pregnant sheep and incubated under 21% or 10.5% O2 for 48 hours at 37 °C. Exposure to chronic hypoxia significantly increased ROS levels and depressed the BKCa current density (p < 0.05). Neither ROS levels nor BKCa current density in tissues cultured in 21% O2 were altered by the antioxidant N‐acetylcysteine (NAC). However, the increased ROS level and depressed BKCa current density during exposure to chronic hypoxia were ablated by NAC. Our findings suggest a direct effect of chronic hypoxia in suppressing the function of BKCa channels in uterine arteries through increased generation of ROS, which may contribute to the increased myogenic tone of uterine arteries in response to chronic hypoxia during gestation.Grant Funding Source: HL089012, HL110125

Gestational hypoxia up-regulates protein kinase C and inhibits calcium-activated potassium channels in ovine uterine arteries.

Objective: The present study tested the hypothesis that gestational hypoxia up-regulates protein kinase C (PKC) and inhibits calcium-activated potassium channels (KCa)-mediated relaxations of uterine arteries in pregnancy. Study design: Uterine arteries were isolated from nonpregnant (NPUA) and pregnant (PUA) (~140 day gestation) sheep maintained at either sea level or high altitude (3,820 m for 110 days, PaO2: 60 mmHg). Contractions of uterine arteries were determined. Key findings: In normoxic PUA, selective inhibition of large-conductance KCa (BK) channels significantly enhanced PKC activator phorbol 12, 13-dibutyrate (PDBu)-induced contractions. This effect was abrogated by chronic hypoxia in gestation. Unlike BK channels, inhibition of small-conductance KCa (SK) channels had no significant effect on PDBu-mediated contractions. In normoxic PUA, activation of both BK with NS1619 or SK with NS309 produced concentration-dependent relaxations, which were not altered by the addition of PDBu. However, in uterine arteries treated with chronic hypoxia (10.5% O2 for 48 h), both NS1619- and NS309-induced relaxations were significantly attenuated by PDBu. In NPUAs, inhibition of BK channels significantly enhanced PDBu-induced contractions in both normoxic and hypoxic animals. Conclusion: The results suggest that in the normoxic condition BK inhibits PKC activity and uterine vascular contractility, which is selectively attenuated by chronic hypoxia during gestation. In addition, hypoxia induces PKC-mediated inhibition of BK and SK activities and relaxations of uterine arteries in pregnancy.

Pregnancy programming and preeclampsia: identifying a human endothelial model to study pregnancy-adapted endothelial function and endothelial adaptive failure in preeclamptic subjects.

We have previously reported that the increase in vasodilator production in an ovine model pregnancy is underpinned by an increase in connexin 43 (Cx43) gap junction function, so allowing more uterine artery endothelial cells to produce a more sustained Ca(2+) burst response to agonist stimulation. Since activation of endothelial nitric oxide synthase (eNOS) requires elevated [Ca(2+)]i, it follows that the direct result of enhanced bursting in turn is an increase in nitric oxide (NO) production per cell from more cells, and for a longer period of time. Preeclampsia (PE) is associated with endothelial vasodilatory dysfunction, and the endocrine profile of women with PE includes an increase in a number of factors found in wound sites. The common action of these growth factors and cytokines in wound sites is to mediate Cx43 dysfunction through kinase phosphorylation and closure. Translational studies are now needed to establish if inhibitory phosphorylation of Cx43 in human endothelium is the cause of endothelial dysfunction in PE subjects and if so, to identify the kinase pathways best targeted for therapy in PE subjects. Consistent with this we have already shown endothelial Ca(2+) and NO responses of human umbilical vein from normal subjects are similar to that of ovine pregnant uterine artery, and that those same responses in cords from PE subjects are blunted to levels more typical of nonpregnant uterine artery. In this review we summarize the further evidence that growth factors and cytokines may indeed mediate endothelial dysfunction in PE subjects through closure of Cx43 gap junctions. We also consider how we may clinically translate our studies to humans by using intact umbilical vein and isolated HUVEC in primary culture for an initial screen of drugs to prevent deleterious Cx43 phosphorylation, with the ultimate goal of reversing PE-related endothelial dysfunction.

Chronic Hypoxia Inhibits Pregnancy-Induced Upregulation of SK Ca Channel Expression and Function in Uterine Arteries

Small-conductance Ca(2+)-activated K(+) (SKCa) channels are crucial in regulating vascular tone and blood pressure. The present study tested the hypothesis that SKCa channels play an important role in uterine vascular adaptation in pregnancy, which is inhibited by chronic hypoxia during gestation. Uterine arteries were isolated from nonpregnant and near-term pregnant sheep maintained at sea level (≈300 m) or exposed to high-altitude (3801 m) hypoxia for 110 days. Immunohistochemistry revealed the presence of SKCa channels type 2 (SK2) and type 3 (SK3) in both smooth muscles and endothelium of uterine arteries. The expression of SK2 and SK3 channels was significantly increased during pregnancy, which was inhibited by chronic hypoxia. In normoxic animals, both SKCa channel opener NS309 and a large-conductance (BKCa) channel opener NS1619 relaxed norepinephrine-contracted uterine arteries in pregnant but not nonpregnant sheep. These relaxations were inhibited by selective SKCa and BKCa channel blockers, respectively. NS309-induced relaxation was largely endothelium-independent. In high-altitude hypoxic animals, neither NS1691 nor NS309 produced significant relaxation of uterine arteries in either nonpregnant or pregnant sheep. Similarly, the role of SKCa channels in regulating the myogenic reactivity of uterine arteries in pregnant animals was abrogated by chronic hypoxia. Accordingly, the enhanced SKCa channel activity in uterine arterial myocytes of pregnant animals was ablated by chronic hypoxia. The findings suggest a novel mechanism of SKCa channels in regulating myogenic adaptation of uterine arteries in pregnancy and in the maladaptation of uteroplacental circulation caused by chronic hypoxia during gestation.

Chronic Hypoxia Suppresses Pregnancy-Induced Upregulation of Large-Conductance Ca 2+ -Activated K + Channel Activity in Uterine Arteries

Our previous study demonstrated that increased Ca(2+)-activated K(+) (BK(Ca)) channel activity played a key role in the normal adaptation of reduced myogenic tone of uterine arteries in pregnancy. The present study tested the hypothesis that chronic hypoxia during gestation inhibits pregnancy-induced upregulation of BK(Ca) channel function in uterine arteries. Resistance-sized uterine arteries were isolated from nonpregnant and near-term pregnant sheep maintained at sea level (≈ 300 m) or exposed to high-altitude (3801 m) hypoxia for 110 days. Hypoxia during gestation significantly inhibited pregnancy-induced upregulation of BK(Ca) channel activity and suppressed BK(Ca) channel current density in pregnant uterine arteries. This was mediated by a selective downregulation of BK(Ca) channel β1 subunit in the uterine arteries. In accordance, hypoxia abrogated the role of the BK(Ca) channel in regulating pressure-induced myogenic tone of uterine arteries that was significantly elevated in pregnant animals acclimatized to chronic hypoxia. In addition, hypoxia abolished the steroid hormone-mediated increase in the β1 subunit and BK(Ca) channel current density observed in nonpregnant uterine arteries. Although the activation of protein kinase C inhibited BK(Ca) channel current density in pregnant uterine arteries of normoxic sheep, this effect was ablated in the hypoxic animals. The results demonstrate that selectively targeting BK(Ca) channel β1 subunit plays a critical role in the maladaption of uteroplacental circulation caused by chronic hypoxia, which contributes to the increased incidence of preeclampsia and fetal intrauterine growth restriction associated with gestational hypoxia.

Pregnancy reduces RhoA/Rho kinase and protein kinase C signaling pathways downstream of thromboxane receptor activation in the rat uterine artery

During pregnancy, reduced vascular responses to constrictors contribute to decreased uterine and total vascular resistance. Thromboxane A(2) (TxA(2)) is a potent vasoconstrictor that exerts its actions via diverse signaling pathways, and its biosynthesis increases in preeclampsia. In this study, we hypothesized that maternal vascular responses to TxA(2) will be attenuated via Rho kinase, PKC, p38 MAPK, and ERK1/2 signaling pathways. Isolated ring segments of uterine and small mesenteric arteries from late pregnant (19-21 days) and virgin rats were suspended in a myograph, and isometric force was measured. Pregnancy did not affect uterine and mesenteric artery responses to the TxA(2) analog U-46619 (10(-9)-10(-5) M), but transduction signals associated with these contractions were different between pregnant and nonpregnant rats. Inhibition of Rho kinase (10(-6) M Y-27632) reduced sensitivity to U-46619 in virgin uterine vessels but did not inhibit these contractions in pregnant uterine arteries and had no effect on mesenteric vessels. Treatment of arterial segments with a PKC inhibitor (10(-6) M bisindolylmaleimide I) reduced U-46619-induced contractions in virgin uterine and mesenteric arteries and in pregnant mesenteric arteries. Pregnant uterine arteries, however, were unresponsive to PKC inhibition. Inhibition of ERK1/2 (10(-5) M PD-98059) and p38 MAPK (10(-5) M SB-203580) reduced U46619-induced contractions in nonpregnant vessels and in pregnant uterine and mesenteric vessels. These data suggest that normal pregnancy does not affect uterine and mesenteric contractile responses to TxA(2) but reduces the contribution of Rho kinase and PKC signaling pathways to these contractions in the uterine vasculature. In contrast, the role of ERK1/2 and p38 MAPK in U-46619-induced uterine contractions remains unchanged with pregnancy. TxA(2)-associated transduction signals and its regulators might present potential targets for the development of new treatments for preeclampsia and other pregnancy-associated vascular diseases.

Hypoxia modulates pregnancy‐mediated transcriptional regulation of BKca β1 subunit expression in ovine uterine arteries

BKca channels play a key role in the increased uterine artery blood flow in pregnancy, which is attenuated by chronic hypoxia during gestation. We examined transcriptional mechanisms of BKca β1 subunit promoter in ovine uterine arteries. We cloned a 2‐kb promoter of β1 gene in sheep, which contains several transcription factor binding sites with CpG dinucleotides in their core binding sequences, including ERα/SP1, SP1, and AP1. ERα/SP1, but not SP1 or AP1, sites were hypomethylated in uterine arteries of pregnant as compared with nonpregnant animals, which was reversed by chronic hypoxia. The binding of ERα and SP1 to the site was confirmed by EMSA with super shift and ERα and SP1 bind simultaneously to the site. CpG methylation inhibited the binding. Deletion of the ERα/SP1 binding site significantly attenuated reporter gene activity of β1 promoter. ChIP assay showed an increase in ERα and SP1 binding to β1 promoter in pregnant uterine arteries, which was abrogated by chronic hypoxia. In accordance, β1 protein expression was increased in pregnant uterine arteries, which was blocked by hypoxia. The results demonstrate a novel mechanism of promoter methylation in transcriptional regulation of BKca β1 subunit gene expression patterns in uterine arteries in response to pregnancy and hypoxia. (Supported in part by NIH grants HL89012 and HL110125).

Pregnancy Upregulates Large-Conductance Ca 2+ -Activated K + Channel Activity and Attenuates Myogenic Tone in Uterine Arteries

Uterine vascular tone significantly decreases whereas uterine blood flow dramatically increases during pregnancy. However, the complete molecular mechanisms remain elusive. We hypothesized that increased Ca(2+)-activated K(+) (BK(Ca)) channel activity contributes to the decreased myogenic tone of uterine arteries in pregnancy. Resistance-sized uterine arteries were isolated from nonpregnant and near-term pregnant sheep. Electrophysiological studies revealed a greater whole-cell K(+) current density in pregnant compared with nonpregnant uterine arteries. Tetraethylammonium and iberiotoxin inhibited K(+) currents to the same extent in uterine arterial myocytes. The BK(Ca) channel current density was significantly increased in pregnant uterine arteries. In accordance, tetraethylammonium significantly increased pressure-induced myogenic tone in pregnant uterine arteries and abolished the difference in myogenic responses between pregnant and nonpregnant uterine arteries. Activation of protein kinase C produced a similar effect to tetraethylammonium by inhibiting BK(Ca) channel activity and increasing myogenic tone in pregnant uterine arteries. Chronic treatment of nonpregnant uterine arteries with physiologically relevant concentrations of 17β-estradiol and progesterone caused a significant increase in the BK(Ca) channel current density. Western blot analyses demonstrated a significant increase of the β1, but not α, subunit of BK(Ca) channels in pregnant uterine arteries. In accordance, steroid treatment of nonpregnant uterine arteries resulted in an upregulation of the β1, but not α, subunit expression. The results indicate that the steroid hormone-mediated upregulation of the β1 subunit and BK(Ca) channel activity may play a key role in attenuating myogenic tone of the uterine artery in pregnancy.

Pregnancy Downregulates Actin Polymerization and Pressure-Dependent Myogenic Tone in Ovine Uterine Arteries

Pregnancy is associated with significantly decreased uterine vascular tone and increased uterine blood flow. The present study tested the hypothesis that the downregulation of actin polymerization plays a key role in reduced vascular tone of uterine arteries in the pregnant state. Uterine arteries were isolated from nonpregnant and near-term pregnant sheep. Activation of protein kinase C significantly increased the filamentous:globular actin ratio and contractions in the uterine arteries, which were inhibited by an actin polymerization inhibitor cytochalasin B. The basal levels of filamentous:globular actin were significantly higher in nonpregnant uterine arteries than those in near-term pregnant sheep. Prolonged treatment (48 hours) of nonpregnant sheep with 17β-estradiol (0.3 nmol/L) and progesterone (100.0 nmol/L) caused a significant decrease in the filamentous:globular actin. In accordance, the treatment of near-term pregnant sheep for 48 hours with an estrogen antagonist ICI 182 780 (10.0 μmol/L) and progesterone antagonist RU 486 (1.0 μmol/L) significantly increased the levels of filamentous:globular actin. Increased intraluminal pressure from 20 to 100 mm Hg resulted in an initial increase in uterine arterial diameter and vascular wall Ca(2+) concentrations, followed by a decrease in the diameter at a constant steady-state level of Ca(2+). Cytochalasin B blocked pressure-induced myogenic constrictions without effect on vascular wall Ca(2+) levels and eliminated the differences in pressure-dependent myogenic tone between nonpregnant sheep and near-term pregnant sheep. The results indicate a key role of actin polymerization in protein kinase C-induced myogenic contractions and suggest a novel mechanism of sex steroid hormone-mediated downregulation of actin polymerization underlying the decreased myogenic tone of uterine arteries in pregnancy.

Role of K ATP and L-type Ca 2+ channel activities in regulation of ovine uterine vascular contractility: effect of pregnancy and chronic hypoxia

Our objective was to determine whether the pregnancy and high altitude long-term hypoxia-mediated changes in uterine artery contractility were regulated by K(ATP) and L-type Ca(2+) channel activities. Uterine arteries were isolated from nonpregnant and near-term pregnant ewes that had been maintained at sea level (∼300 m) or exposed to high altitude (3801 m) for 110 days. Isometric tension was measured in a tissue bath. Pregnancy increased diazoxide, but not verapamil-induced relaxations. Long-term hypoxia attenuated diazoxide-induced relaxations in near-term pregnant uterine arteries, but enhanced verapamil-induced relaxations in nonpregnant uterine arteries. Diazoxide decreased the maximal response (E(max)) of phenylephrine-induced contractions in near-term pregnant uterin arteries but not nonpregnant uterine arteries in normoxic sheep. In contrast, diazoxide had no effect on phenylephrine-induced E(max) in near-term pregnant uterine arteries but decreased it in nonpregnant uterine arteries in long-term hypoxia animals. Verapamil decreased the E(max) and pD(2) (-logEC(50)) of phenylephrine-induced contractions in both nonpregnant uterine arteries and near-term pregnant uterine arteries in normoxic and long-term hypoxia animals, except nonpregnant uterine arteries of normoxic animals in which verapamil showed no effect on the pD(2). The results suggest that pregnancy selectively increases K(ATP), but not L-type Ca(2+) channel activity. Long-term hypoxia decreases the K(ATP) channel activity, which may contribute to the enhanced uterine vascular myogenic tone observed in pregnant sheep at high altitude hypoxia.

Direct Chronic Effect of Steroid Hormones in Attenuating Uterine Arterial Myogenic Tone

Pregnancy is associated with a significant decrease in uterine vascular tone and an increase in uterine blood flow. The present study tested the hypothesis that estrogen and progesterone differentially regulate the extracellular signal–regulated kinase (ERK)1/2 and protein kinase C (PKC) signaling pathways in vascular smooth muscle, resulting in a decrease in uterine vascular myogenic tone in pregnancy. Uterine arteries were isolated from nonpregnant and near-term pregnant sheep. Chronic treatment (48 hours) of nonpregnant uterine arteries with 17β-estradiol and progesterone caused a significant decrease in PKC-mediated contractions and pressure-induced myogenic tone. In accordance, treatment of near-term pregnant uterine arteries for 48 hours with ICI 182780 and RU 486 significantly increased PKC-induced contractions and myogenic tone. In contrast, acute treatment for 30 minutes had no effect on uterine artery contractility. An ERK1/2 inhibitor, PD098059, restored the chronic effect of steroids on PKC-mediated contractions in nonpregnant sheep. ERK1/2 protein and mRNA levels were greater in near-term pregnant as compared with nonpregnant uterine arteries. 17β-Estradiol and progesterone increased ERK1/2 protein in nonpregnant sheep. In agreement, ICI 182780 and RU 486 caused significant decreases in ERK1/2 protein in near-term pregnant sheep. Western blot showed 6 PKC isozymes, α, β I , β II , δ, ε, and ζ, in the uterine arteries. 17β-Estradiol and progesterone decreased the particulate:cytosolic ratios of PKCα, ε, and ζ, respectively, in nonpregnant sheep. ICI 182780 and RU 486 increased the ratios in near-term pregnant sheep. The results indicate a direct chronic effect of the steroid hormones in the upregulation of ERK1/2 expression and downregulation of the PKC signaling pathway, resulting in attenuated myogenic tone of the uterine artery in pregnancy.

Low-dose versus a Higher-dose Bupivacaine Spinal Anesthesia for Cesarean Delivery

Low-dose <i>versus</i> a Higher-dose Bupivacaine Spinal Anesthesia for Cesarean Delivery

Evaluation of metalloproteinases 2 and 9 and their inhibitors in physiologic and pre‐eclamptic pregnancy

Matrix metalloproteinases (MMPs) are a family of zinc and calcium-dependent endopeptidases involved in remodeling and physiological homeostasis of extracellular matrix (ECM). The metalloproteinases activity is predominantly modulated by specific tissue inhibitors of matrix metalloproteinases (TIMPs). The balance between MMPs and TIMPs is likely to play an important role in remodeling uterine arteries in pregnancy, and it may represent means by which vasodilatation is maintained in later pregnancy. Moreover, increased levels of MMPs and in particular MMP-2 play a role in the vascular alterations induced by hypertension. The aim of this study was the evaluation of MMP-2 and -9, along with their inhibitors TIMP-1 and -2, in pre-eclamptic women compared with normotensive pregnancy and non-pregnant women. Fourteen pre-eclamptic women were compared with 37 normotensive women in different gestational age and 21 non-pregnant women. Multiplexed sandwich enzyme-linked immunosorbent assay was used to measure MMPs and TIMPs simultaneously. MMP-2 levels were significantly higher in pre-eclamptic women vs. both non-pregnant and physiologic pregnant women. MMP-9 concentrations were significantly higher in physiologic pregnant vs. non-pregnant women. The serum levels of TIMP-1 were significantly higher in pre-eclamptic vs. both non-pregnant and physiologic pregnant women. TIMP-2 values were higher in physiologic pregnant women and pre-eclamptic women vs. non-pregnant women. A positive correlation between MMP-9 values and gestational age was observed in normal pregnant women. Results of the present investigation confirm that MMP-2 and TIMP-1 values are significantly higher in preeclampsia. We confirm that the modification of the fine balance between MMPs and their inhibitors plays a greater role in the structural and functional vascular changes of women with complicated pregnancies.