Regulation Of Uterine Contractility Research Articles

Identification of FDA approved drugs and their synergistic combinations as potent and selective regulators of uterine contractility for therapeutic control of preterm labor

IntroductionCurrently, there are no FDA‐approved tocolytics for the management of preterm labor (PTL) due to adverse effects and lack of efficacy. Repurposing FDA‐approved drugs offers a better risk‐vs‐benefit compared to traditional drug development. Drug combinations targeting different molecular signaling pathways involved in uterine contractility may provide a synergistic effect, permitting lower doses that reduce off‐target effects or increase therapeutic efficacy. The study objective was to: 1) screen FDA‐approved drugs for their ability to inhibit Ca2+‐mobilization in uterine myometrial (UT‐myo) cells, 2) omit hit‐drugs that display cytotoxicity and lack uterine‐selectivity, 3) identify synergistic combinations of hit‐drugs and 4) evaluate ex vivo tocolytic efficacy and potency of single and combination drugs.MethodsA phenotypic high‐throughput Ca2+‐mobilization assay using primary term‐pregnant human myometrial cells was performed to screen the SelleckChem FDA library of 1,180 drugs at 10μM to identify antagonists of oxytocin (OT)‐induced Ca2+‐mobilization. Uterine‐selectivity was determined by comparing the concentration‐response (Emax and IC50) of hit‐antagonists between UT‐myo and vascular smooth muscle cells (VSMCs) – the main off‐target limiting the use of current tocolytics. The high‐throughput assay was adapted for combination screening in 8×8 dose matrices to determine synergy using Combenefit. A WST‐1 assay with myometrial, hepatic and renal cells was used to determine cytotoxicity and safety index (SI, ratio of IC50 values from cell viability and Ca2+ assays). The tocolytic efficacy and potency were examined using human myometrial tissue in an ex vivo isometric contractility assay.ResultsWe identified 27 hit‐antagonists of Ca2+‐mobilization from the screen of 1,180 FDA‐approved drugs. Twelve drugs were identified as uterine selective (≥ 5‐fold potency towards myometrial cells), of which 9 were potent with an IC50 ≤10μM without reported reproductive toxicity. Combining these drugs that target different molecular signaling pathways, with one another and 3 currently utilized tocolytics (atosiban, indomethacin and nifedipine), yielded 66 non‐redundant combinations. We found 25 combinations that synergistically resulted in increased efficacy and 39 combinations displayed increased potency for at least one drug. At present, at least 12 combinations have a favorable SI. Fosaprepitant dimeglumine demonstrated the greatest ex vivo tocolytic efficacy and potency, and to date, we have tested and confirmed tocolytic potency and efficacy of two drug combinations (atosiban and indomethacin; fosaprepitant dimeglumine and atosiban).ConclusionPhenotypic high‐throughput screening of FDA‐approved drugs against UT‐myo and VSMCs identified potent and uterine‐selective modulators of myometrial contractions with potential to be repurposed for the treatment of PTL. Furthermore, the HTS combination screen was an important tool to rapidly and reliably identify synergistic drug combinations with improved potency and efficacy.Support or Funding InformationNICHD grants HD098213 and HD088830.

The effects of extended nitric oxide release on responses of the human non-pregnant myometrium to endothelin-1 or vasopressin.

Uterotonic mediators: endothelin-1 (ET-1), arginine vasopressin (AVP), and nitric oxide (NO) play important roles in the regulation of uterine contractility. We hypothesize that NO affects both ET-1 or AVP. Therefore, this study investigated the involvement of extended exogenous NO release in the regulation of responses of the human non-pregnant myometrium to ET-1 and AVP. Specimens were obtained from 10 premenopausal women, undergoing hysterectomy for benign gynecological disorders. Responses of the myometrial strips to ET-1 or AVP in the absence and presence of an exogenous NO donor (diethylenetriamine; DETA/NO; 10-4 mol/L) were recorded under isometric conditions. To inhibit endogenous NO, a competitive inhibitor of NO synthase, L-NG-nitroarginine (L-NNA) was added to the organ bath. ET-1 enhanced the spontaneous contractile activity of the myometrium more powerfully (p < 0.01) than AVP. Preincubation with exogenous NO weakened ET-1- or AVP-induced increases in this contractile activity (p < 0.05). However, unexpected results were obtained after preincubation with L-NNA and with DETA/NO then added. Both ET-1 and AVP induced augmented contractile effects in almost all concentrations compared with the responses to these peptides alone or after NOS synthase inhibition (both p < 0.01). This study demonstrated for the first time that extended incubation with a NO donor influences the uterine muscle response evoked by ET-1 and AVP. Both endogenous and exogenous NO is involved in the control of the uterine responses to ET-1 or AVP of non-pregnant myometrium. Furthermore, both peptides stimulate increased uterine contractility when the local imbalance between the constrictive and relaxing mediators takes place.

Phenylephrine, a common cold remedy active ingredient, suppresses uterine contractions through cAMP signalling

Regulation of uterine contractility is an important aspect of women’s health. Phenylephrine, a selective agonist of the α1-adrenoceptor and a potent smooth muscle constrictor, is widely used in women even during pregnancy to relieve cold-related symptoms, to treat postpartum haemorrhoid, and during routine eye exams. We performed isometric tension recordings to investigate the effect of phenylephrine on mouse uterine contractility. Phenylephrine decreased spontaneous and oxytocin-induced contractions in non-pregnant mouse uterine rings and strips with an IC50 of ~1 μM. Prazosin, an inhibitor of α1-adrenoceptor, did not prevent phenylephrine-mediated relaxations. Conversely, ICI118551, an antagonist of β2-adrenoceptors, inhibited phenylephrine relaxation. In the presence of ICI118551, high concentrations (>30 μM) of phenylephrine caused mouse uterine contractions, suggesting that β-adrenoceptor-mediated inhibition interferes with the phenylephrine contractile potential. Phenylephrine-dependent relaxation was reduced in the uterus of pregnant mice. We used primary mouse and human uterine smooth muscle cells (M/HUSMC) to establish the underlying mechanisms. Phenylephrine stimulated large increases in intracellular cAMP in M/HUSMCs. These cAMP transients were decreased when HUSMCs were cultured in the presence of oestrogen and progesterone to mimic the pregnancy milieu. Thus, phenylephrine is a strong relaxant in the non-pregnant mouse uterus, but exhibits diminished effect in the pregnant uterus.

Immunohistochemical and functional studies on calcium‐sensing receptors in rat uterine smooth muscle

1. Activation of calcium-sensing receptors (CaS) leads to relaxation of vascular smooth muscle. However, the role of CaS in uterine smooth muscle is unknown. Therefore the aim of the present study was to investigate the expression and function of CaS in the uterus. 2. The expression of CaS in the oestrogen-dominated rat uterus was investigated using immunohistochemistry. The effects of putative CaS ligands on oxytocin-induced contractions of longitudinally orientated uterine strips from oestrogen-dominated rats were determined at reduced extracellular Ca²⁺ concentrations using conventional organ bath techniques. 3. Immunohistochemical evidence showed the presence of CaS in the endometrium and smooth muscle layers of the rat uterus. Oxytocin-induced contractions were inhibited by cations (Gd³⁺ > Ca²⁺ = Mg²⁺), polyamines (spermine > spermidine) and the positive allosteric modulators cinacalcet and calindol. However (R)- and (S)-cinacalcet were equipotent, indicating a lack of stereoselectivity, and the negative allosteric modulator calhex-231 also caused dose-dependent relaxation. In addition, although intermediate-conductance calcium-activated potassium channels and cytochrome P450-dependent signal transduction have been implicated in CaS-induced relaxation of vascular smooth muscle, neither Tram-34 nor miconazole (1 μmol/L), which block these pathways, respectively, had any effect on the ability of cinacalcet to inhibit oxytocin-induced contractions. 4. Calcium-sensing receptors are expressed in smooth muscle layers of the rat uterus and their ligands produce potent relaxation of longitudinally orientated uterine strips. However, the pharmacological profile of inhibition of contractility by CaS ligands is not consistent with a role for CaS in the regulation of uterine contractility in the rat.

Stretch Activates Human Myometrium via ERK, Caldesmon and Focal Adhesion Signaling

An incomplete understanding of the molecular mechanisms responsible for myometrial activation from the quiescent pregnant state to the active contractile state during labor has hindered the development of effective therapies for preterm labor. Myometrial stretch has been implicated clinically in the initiation of labor and the etiology of preterm labor, but the molecular mechanisms involved in the human have not been determined. We investigated the mechanisms by which gestation-dependent stretch contributes to myometrial activation, by using human uterine samples from gynecologic hysterectomies and Cesarean sections. Here we demonstrate that the Ca requirement for activation of the contractile filaments in human myometrium increases with caldesmon protein content during gestation and that an increase in caldesmon phosphorylation can reverse this inhibitory effect during labor. By using phosphotyrosine screening and mass spectrometry of stretched human myometrial samples, we identify 3 stretch-activated focal adhesion proteins, FAK, p130Cas, and alpha actinin. FAK-Y397, which signals integrin engagement, is constitutively phosphorylated in term human myometrium whereas FAK-Y925, which signals downstream ERK activation, is phosphorylated during stretch. We have recently identified smooth muscle Archvillin (SmAV) as an ERK regulator. A newly produced SmAV-specific antibody demonstrates gestation-specific increases in SmAV protein levels and stretch-specific increases in SmAV association with focal adhesion proteins. Thus, whereas increases in caldesmon levels suppress human myometrium contractility during pregnancy, stretch-dependent focal adhesion signaling, facilitated by the ERK activator SmAV, can contribute to myometrial activation. These results suggest that focal adhesion proteins may present new targets for drug discovery programs aimed at regulation of uterine contractility.

RHO protein regulation of contraction in the human uterus

The state of contraction in smooth muscle cells of the human uterus is dependent on the interaction of activated forms of actin and myosin. Ras homology (RHO) proteins are small monomeric GTP-binding proteins that regulate actin polymerisation and myosin phosphorylation in smooth muscle cells. Their action is determined by their level of expression, GTP-bound state, intracellular localisation and phosphorylated status. Agonist activated RHO proteins bind to effector kinases such as RHO kinase (ROCK) and diaphanous proteins (DIAPH) to regulate smooth muscle contraction by two mechanisms: ROCK activates smooth muscle myosin either by direct phosphorylation at Ser19/Thr18 or through inhibition of myosin phosphatase which is a trimeric protein regulated by ROCK and by other protein kinases. Actin-polymerising proteins such as DIAPH homolog 1 increase filamentous actin assembly to enhance acto-myosin cross bridge formation and contraction. This review explores recent advances in RHO protein signalling in human myometrium and proposes areas of further research to investigate the involvement of these proteins in the regulation of uterine contractility in pregnancy and labour.

Progesterone decreases the relaxing effect of the β3-adrenergic receptor agonist BRL 37344 in the pregnant rat myometrium

Although the published results regarding the function of the beta(3)-adrenergic receptors (beta(3)-ARs) in the regulation of smooth muscle activity are very promising, the question of the mechanism of beta(3)-ARs' action in the pregnant myometrium cannot be fully answered by human investigations. To assess whether it possesses an essential role in the regulation of uterine contractility in pregnant rats, as in humans, we performed functional, western blotting and molecular biology experiments on the late-pregnant rat myometrium. The influence of progesterone on the function of the beta(3)-ARs was also investigated. We demonstrated the presence and the functional activity of the beta(3)-ARs in the late-pregnant rat myometrium. The maximum dose-dependent uterus-relaxing effect of the selective beta(3)-agonist BRL 37344 was recorded at the end of pregnancy in rats, similarly as in humans. The extent of its relaxing action was regarded as moderate. The expression of beta(3)-AR protein and mRNA remained unchanged during the investigated period. The administration of progesterone had no effect on the beta(3)-AR mRNA and protein expression or the maximum relaxation effect of BRL 37344, but shifted the dose-response curve to the right and decreased the synthesis of the second messenger, cAMP. It can be concluded that the beta(3)-ARs play an additional role in the regulation of the contractile activity of the pregnant rat uterus. The inhibitory effect of progesterone on the functional activity of the beta(3)-ARs may have important consequences in the case of human application if this effect is also demonstrated in pregnant human myometrial tissue.

Cloning and Characterization of a Calcium-Activated Chloride Channel in Rat Uterus1

In a search for genes involved in regulation of uterine contractility, we cloned a novel calcium-activated chloride channel gene, named rat Clca4, from pregnant rat uterus. The gene shares approximately 83% and 70% nucleotide homology with mouse Clca6 and human CLCA4, respectively, and was expressed primarily in rat uterus. The transcripts were upregulated at Gestational Day 22 (prior to parturition), implying a functional involvement in parturition. Western blot analysis showed that rat CLCA4 protein was present in uterus, lung, and heart, but not in any other tissues examined. Confocal microscopy revealed that rat CLCA4 is localized in cell membrane and could not be removed by alkaline or PBS washing. Transient transfection of rat CLCA4-enhanced green fluorescent protein in Chinese hamster ovary cells resulted in production of characteristic Cl(-) currents that could be activated by Ca(2+) and ionomycin but inhibited by niflumic acid, a CLCA-channel blocker. The identification and characterization of rat Clca4 help decipher the contribution of Ca(2+)-activated Cl(-) conductance in myometrial contractility.

The role of voltage-gated potassium channels in the regulation of mouse uterine contractility

BackgroundUterine smooth muscle cells exhibit ionic currents that appear to be important in the control of uterine contractility, but how these currents might produce the changes in contractile activity seen in pregnant myometrium has not been established. There are conflicting reports concerning the role of voltage-gated potassium (Kv) channels and large-conductance, calcium-activated potassium (BK) channels in the regulation of uterine contractility. In this study we provide molecular and functional evidence for a role for Kv channels in the regulation of spontaneous contractile activity in mouse myometrium, and also demonstrate a change in Kv channel regulation of contractility in pregnant mouse myometrium.MethodsFunctional assays which evaluated the effects of channel blockers and various contractile agonists were accomplished by quantifying contractility of isolated uterine smooth muscle obtained from nonpregnant mice as well as mice at various stages of pregnancy. Expression of Kv channel proteins in isolated uterine smooth muscle was evaluated by Western blots.ResultsThe Kv channel blocker 4-aminopyridine (4-AP) caused contractions in nonpregnant mouse myometrium (EC50 = 54 micromolar, maximal effect at 300 micromolar) but this effect disappeared in pregnant mice; similarly, the Kv4.2/Kv4.3 blocker phrixotoxin-2 caused contractions in nonpregnant, but not pregnant, myometrium. Contractile responses to 4-AP were not dependent upon nerves, as neither tetrodotoxin nor storage of tissues at room temperature significantly altered these responses, nor were responses dependent upon the presence of the endometrium. Spontaneous contractions and contractions in response to 4-AP did not appear to be mediated by BK, as the BK channel-selective blockers iberiotoxin, verruculogen, or tetraethylammonium failed to affect either spontaneous contractions or 4-AP-elicited responses. A number of different Kv channel alpha subunit proteins were found in isolated myometrium from both nonpregnant and term-pregnant mice, and one of these proteins – Kv4.3 – was found to disappear in term-pregnant tissues.ConclusionThese findings suggest a role for Kv channels in the regulation of uterine contractility, and that changes in the expression and/or function of specific Kv channels may account for the functional changes seen in pregnant myometrium.

Expression and interaction of proteinase-activated receptor-2 on rat myometrium

Objective: Regulation of uterine contractility at all stages in gestation is extremely important. The function of uterine activity depends on spontaneous contractions of the myometrial smooth muscle cells, triggered by incoming action potentials. Stimulation of proteinase-activated receptor-2 (PAR-2) has been shown to induce myometrial activity. This study wanted to 1) determine the expression of PAR-2 on rat myometrium at different times of the gestational cycle and 2) investigate how PAR-2 gestation-dependently interacts with a variety of uterine receptors known to modulate myometrial activity.

Prostaglandin E and F Receptor Expression and Myometrial Sensitivity at Labor Onset in the Sheep1

Prostaglandins (PGs) play a pivotal role in the initiation and progression of term and preterm labor. Uterine activity is stimulated primarily by PGE(2) and PGF(2alpha) acting on prostaglandin E (EP) and prostaglandin F (FP) receptors, respectively. Activation of FP receptors strongly stimulates the myometrium, whereas stimulation of EP receptors may lead to contraction or relaxation, depending on the EP subtype (EP1-4) expression. Thus, the relative expression of FP and EP1-4 may determine the responsiveness to PGE(2) and PGF(2alpha). The aims of this study were to characterize the expression of EP1-4 and FP in intrauterine tissues and placentome, together with myometrial responsiveness to PG, following the onset of dexamethasone-induced preterm and spontaneous term labor. Receptor mRNA expression was measured using quantitative real-time polymerase chain reaction using species-specific primers. There was no increase in myometrial contractile receptor expression at labor onset, nor was there a change in sensitivity to PGE(2) and PGF(2alpha). This suggests expression of these receptors reaches maximal levels by late gestation in sheep. Placental tissue showed a marked increase in EP2 and EP3 receptor expression, the functions of which are unknown at this time. Consistent with previous reports, these results suggest that PG synthesis is the main factor in the regulation of uterine contractility at labor. This is the first study to simultaneously report PG E and F receptor expression in the key gestational tissues of the sheep using species-specific primers at induced-preterm and spontaneous labor onset.

Expression of Messenger RNA Coding for 5‐HT Receptor, Alpha and Beta Adrenoreceptor (Subtypes) during Oestrus and Dioestrus in the Bovine Uterus

Serotoninergic and adrenergic receptors (5-HTR and AR) are involved in the regulation of uterine contractility. The objective of this study was to compare mRNA levels of 5-HTR(1A), 5-HTR(1B), 5-HTR(1D), 5-HTR(1F), 5-HTR(2A), 5-HTR(2B), 5-HTR(2C), 5-HTR(4) and alpha(1A), alpha(1B), alpha(1D), alpha(2AD), alpha(2B), alpha(2C), and beta(1), beta(2), beta(3)-AR in oestrus and dioestrus, and at three uterine locations (tip, middle and base) using quantitative real-time polymerase chain reaction. Uterine specimens consisting of endometrium and myometrium including vessels and serosa were collected from cows in oestrus (n = 10) and dioestrus (n = 15) respectively. Levels of 5-HTR and AR mRNA were expressed relative to the geometric mean of ribosomal RNA (18S), ubiquitin and glyceraldehyde phosphate dehydrogenase by the mean values of geNorm algorithm. 5-HTR(1A), 5-HTR(2C) and beta(3)-AR mRNA could not be detected in uterine tissues. The mRNA levels of 5-HTR(1F) and 5-HTR(2B) were lower (P < 0.05), but of 5-HTR(4) were higher (P < 0.05) in oestrus than in dioestrus. The mRNA levels of alpha(1A)-AR, alpha(2AD)-AR, alpha(2B)-AR were lower (P < 0.05), but of alpha(2C)-AR and beta(2)-AR were higher (P < 0.05) in oestrus than dioestrus. The mRNA levels of 5-HTR(1B) and 5-HTR(1D) (oestrus) and of alpha(2AD)-AR (dioestrus) differed among uterine locations (base > middle > tip; P < 0.05). The mRNA expression of 5-HTR and AR (subtypes) in bovine uterus was associated with cycle activity and varied according to uterine location. Additional studies on protein level will be carried out in order to elucidate the role of these receptor families on uterine contractility, which may then help to clarify clinical relevance.

The history of tocolysis

In 1950, the World Health Organisation (WHO) defined prematurity as a birthweight of 2500 g or less and in 1961 as a gestational age of less than 37 weeks. The time in between marks an era in which there was growing recognition of the importance of gestational age at birth and how to influence it. The latter was facilitated too by the development of tocography, which permitted some semi-objective measurement of uterine contractility. Along with it, came a growing interest in agents that could control uterine contractility beyond the earlier classical approaches of hormones and gastrointestinal spasmolytics. Hence, the early 1960s saw much research interest in agents, such as nylidrine, isoxsuprine, and orciprenaline that could suppress uterine contractility as one of their many beta-agonist properties. Subsequently, two approaches would be used to shift the balance towards uterine function over and above the influence on other bodily functions. One consisted of supplementing these drugs with agents, such as calcium antagonists and beta-receptor blockers that were hoped to suppress non-uterine actions. The other was a search for drugs in the same class with greater uterospecificity and more selective binding to uterine as opposed to other receptors. Neither of these approaches has ever fully fulfilled the hopes that were pinned on them, but they resulted in the availability of a large number of agents to suppress uterine contractility. The advent of prostaglandins as regulators of uterine contractility and the ability to suppress their biosynthesis saw another range of attempts to suppress uterine activity. They included aspirin, sodium salicylate, flufenamic acid, sulindac and indomethacin, but some were clearly based on a defective understanding of how uterine prostaglandin synthesis can be influenced. In the meantime, a flurry of other agents came and went, often more than once, testifying to the ingenuity of clinicians in trying to solve a problem that is poorly understood. Some, such as relaxin and ethanol, came and disappeared. Others, such as calcium antagonists, entered the scene as protectors against the non-uterine effects of other agents, went, and re-entered the scene in their own right. Still others, such as magnesium sulphate, came, lingered around, and became credited with effects in preterm labour that do not depend on affecting uterine contractility. Amidst this all arose the term tocolysis, coined in 1964 by Mosler from the Greek stems 'tauomicronkappaomicronzeta' and 'lambdaupsilonepsiloniotanu', to epitomise all of this ingenuity.

The history of tocolysis

In 1950, the World Health Organisation (WHO) defined prematurity as a birthweight of 2500 g or less and in 1961 as a gestational age of less than 37 weeks. The time in between marks an era in which there was growing recognition of the importance of gestational age at birth and how to influence it. The latter was facilitated too by the development of tocography, which permitted some semi-objective measurement of uterine contractility. Along with it, came a growing interest in agents that could control uterine contractility beyond the earlier classical approaches of hormones and gastrointestinal spasmolytics. Hence, the early 1960s saw much research interest in agents, such as nylidrine, isoxsuprine, and orciprenaline that could suppress uterine contractility as one of their many beta-agonist properties. Subsequently, two approaches would be used to shift the balance towards uterine function over and above the influence on other bodily functions. One consisted of supplementing these drugs with agents, such as calcium antagonists and beta-receptor blockers that were hoped to suppress non-uterine actions. The other was a search for drugs in the same class with greater uterospecificity and more selective binding to uterine as opposed to other receptors. Neither of these approaches has ever fully fulfilled the hopes that were pinned on them, but they resulted in the availability of a large number of agents to suppress uterine contractility. The advent of prostaglandins as regulators of uterine contractility and the ability to suppress their biosynthesis saw another range of attempts to suppress uterine activity. They included aspirin, sodium salicylate, flufenamic acid, sulindac and indomethacin, but some were clearly based on a defective understanding of how uterine prostaglandin synthesis can be influenced. In the meantime, a flurry of other agents came and went, often more than once, testifying to the ingenuity of clinicians in trying to solve a problem that is poorly understood. Some, such as relaxin and ethanol, came and disappeared. Others, such as calcium antagonists, entered the scene as protectors against the non-uterine effects of other agents, went, and re-entered the scene in their own right. Still others, such as magnesium sulphate, came, lingered around, and became credited with effects in preterm labour that do not depend on affecting uterine contractility. Amidst this all arose the term tocolysis, coined in 1964 by Mosler from the Greek stems ‘τοκοζ’ and ‘λυειν’, to epitomise all of this ingenuity.

Calcium ion channels in myometrium: molecular basis for forceful contractility

The entry of calcium ion (Ca2+) through voltage-dependent Ca2+ channels (VDCCs) is responsible for the excitation-contraction coupling in uterine smooth muscle. VDCCs are opened in response to depolarization of the plasma membrane as action potentials propagated over the surface of muscle cells. This leads to a rapid influx of Ca2+, activation of myosin light-chain kinase, and initiation of muscle contraction. Since the contraction of myometrium is dependent upon action potentials, VDCCs play a critical role in the regulation of uterine contractility. On the basis of electrophysiological and pharmacological properties of Ca2+ channels, six major types of VDCCs have been described. Most knowledge on the structure of VDCCs, especially the L-type VDCC, comes from research on skeletal muscle. It is now accepted that the VDCC protein is constituted of five subunits (α1, α2/δ, β, γ), and that the α1-subunit is the main, pore-forming, and minimum component of the L-type VDCC. There are some electrophysiological studies with respect to measuring the Ca2+ current of the myometrial cells. In the rat myometrium, it has been proposed that Ca2+ current density of VDCC may increase during gestation, or may be almost unchanged during pregnancy. We investigated the levels of L-type VDCC subunit mRNA in myometrium to determine whether alterations are associated with term or preterm labor. The observed changes indicate that the mRNA levels increase gradually in the late pregnancy to reach peaks prior to term labor, then decrease sharply during labor and post partum. In addition, antiprogesterone and progesterone treatments, which either stimulate preterm labor or inhibit term labor, respectively increased or decreased the subunit mRNA of VDCCs. These results show that alterations of the VDCC subunit gene transcripts are associated with either the term or preterm labor. The increase in the expression of VDCCs during periods of term and preterm labor may facilitate uterine contractility. However, the development of VDCC mRNA transcript may be only one of many changes that occur in the muscle cells in preparation for forceful contractility to facilitate parturition.

Phospholipase-Mediated Inhibition of Spontaneous Oscillatory Uterine Contractions by Lindane in Vitro

Although regulation of uterine contractility is fundamental for parturition, mechanisms by which toxicants modify uterine muscle contractions remain poorly understood. In a previous cumulative concentration-response study, 10 μM lindane (γ-hexachlorocyclohexane) reduced contraction force and 30 μM lindane abolished contractions in Gestation Day 10 rat uterine strips when lindane was added to muscle baths at 10-min intervals. Other studies showed that brief (<10 min) exposures to 10–100 μM lindane inhibit gap junctions and activate phospholipase pathways in rat myometrial cells in culture. Consequently, lindane was used as a prototype toxicant with known uterine activity to investigate the hypothesis that activation of a specific phospholipase pathway provides a mechanistic link between inhibition of uterine contraction and inhibition of myometrial gap junctions. Uterine tissue and cells were pretreated with phospholipase pathway inhibitors to evaluate the role of phospholipase pathways in lindane's actions in the uterus. Concentrations of inhibitors were selected based on previous reports of effective concentrations for the enzyme activity and on pilot toxicity studies of the inhibitors on uterine contraction and gap junction communication. To monitor uterine contractions, longitudinal uterine strips were excised from Gestation Day 10 rats and suspended in isometric muscle baths, consistent with previous experiments. Exposure in vitro for 60 min to 10–50 μM lindane, an effective concentration range for the uterine responses of interest, revealed that 30 μM lindane rapidly abolished contractions. Subsequently, uterine strips were pretreated with phospholipase pathway inhibitors and then challenged with 30 μM lindane, the lindane concentration that elicited maximal inhibition of uterine contraction. Pretreatment with 20–50 μM of the phosphatidylinositol-specific phospholipase C inhibitor 1- O-octadecyl-2- O-methyl- sn-glycerol-3-phosphorylcholine (ET-18-OCH 3) reversed lindane-induced inhibition of spontaneous uterine contractions. Gap junction intercellular communication was monitored by injecting the fluorescent dye Lucifer yellow into rat myometrial cells grown in culture and assessing dye transfer to adjacent cells using epifluorescence microscopy. Similar to uterine contraction, pretreatment of cell cultures with phospholipase C inhibitors (30 μM ET-18-OCH 3, 50 μM tricyclodecan- p-yl-xanthogenate · K [D609] or 50 μM tricyclodecan- p-yl-xanthogenate · K or 2-nitro-4-carboxyphenyl- N,N-dophenylcarbamate [NCDC]) partially reversed inhibition of dye transfer by 100 μM lindane, a lindane concentration previously shown to abolish myometrial Lucifer yellow dye transfer under similar culture conditions. In contrast, pretreatment with 20 μM of bromoenol lactone (BEL) to inhibit the calcium-independent phospholipase A 2 or 100 mM ethanol to interrupt the phospholipase D pathway failed to prevent inhibition of spontaneous uterine contractions and inhibition of Lucifer yellow dye transfer by lindane (100 μM). These data suggest that lindane inhibits myometrial gap junctions and spontaneous oscillatory contractions by a phospholipase C-mediated pathway.

Altered levels of mRNA expression and pharmacological reactivity of α1‐adrenergic receptor subtypes in the late‐pregnant rat myometrium

The adrenergic system plays a major role in the regulation of the uterine contractility during pregnancy. Our previous studies have shown the significance of the alpha1-adrenergic receptors (ARs) in the control of pregnant uterine contractility both in vitro and in vivo. Our present aim was to determine the changes in mRNA expression and pharmacological reactivity of the alpha1-ARs on days 18, 20, and 22 of pregnancy. To demonstrate the expressions of alpha1-AR subtype mRNA, we used a reverse transcription-polymerase chain reaction (RT-PCR); the pharmacological reactivity was tested by electric field stimulation (EFS). The expression of alpha1A-AR mRNA increased from day 18 to 22, while no alpha1B-AR mRNA was detectable. We found a small increase in the expression of alpha1D-AR mRNA on day 20, which was not followed by a significant change in pharmacological reactivity. The alpha1D-receptor expression and pharmacological reactivity decreased significantly up to day 22. EFS studies revealed that the alpha1A-AR antagonist 5-methylurapidil had EC50 values (1.9 x 10(-6)-6.3 x 10(-6) M) about one order of magnitude lower than those of the alpha1D-AR antagonist BMY 7378 (4 x 10(-6)-3.6 x 10(-5) M). However, the alpha1B-AR antagonist cyclazosine exerted only a slight effect on the stimulated contractions. Strong correlations were found between the alpha1A-mRNA expression and the EC50 of 5-methylurapidil (r(2) =0.9712), and between the alpha1D-AR mRNA expression and the EC50 of BMY 7378 (r(2) = 0.9937). Our findings suggest that both alpha1A- and alpha1D-ARs are involved in the regulation of the pregnant uterine contractility. The density and pharmacological reactivity indicate that the alpha(1A)-AR seems to play the major role in late-pregnant myometrial contraction.

Modulation of rat uterine contractility by mast cells and their mediators

Objective: This study was designed to test the possibility that mast cells play a role in the regulation of uterine contractility. Study Design: Histamine and rat mast cell protease II levels were determined by radioenzymatic assay and standard radial immunodiffusion techniques, respectively, in uterine tissues from Wistar rats with timed pregnancies. Isolated uterine strips from nonsensitized and ovalbumin-sensitized nonpregnant and pregnant Wistar rats were used for isometric tension recording. Contractile responses to compound 48/80, carbachol, ovalbumin, normal rabbit serum, antirat immunoglobulin E, and 5-hydroxytryptamine were obtained. Antagonists methysergide, ketanserin, 5,8,11,14-eicosatetraynoic acid, diphenhydramine, and sodium meclofenamate were also used. Results: Tissue levels of rat mast cell protease II and histamine were decreased during delivery compared with prepartum and postpartum levels. Carbachol and compound 48/80 stimulated uterine contractility, and responses were highest during late gestation (day 16 to term). Responses to ovalbumin of uterine tissues in rats sensitized to the antigen were highest at midpregnancy and decreased during the last 10 days of gestation. Ovalbumin challenge in vitro increased the frequency and magnitude of contractions in tissues from ovalbumin-sensitized rats. Compound 48/80 and antirat immunoglobulin E stimulated contractility in both control and sensitized rats. None of the antagonists prevented the contractile responses. Conclusions: Activation of mast cells is an effective mechanism for stimulation of uterine contractility and may play an important role in the control of term and preterm parturition. (Am J Obstet Gynecol 2000; 183:118-25.)

Modulation of rat uterine contractility by mast cells and their mediators

Objective: This study was designed to test the possibility that mast cells play a role in the regulation of uterine contractility. Study Design: Histamine and rat mast cell protease II levels were determined by radioenzymatic assay and standard radial immunodiffusion techniques, respectively, in uterine tissues from Wistar rats with timed pregnancies. Isolated uterine strips from nonsensitized and ovalbumin-sensitized nonpregnant and pregnant Wistar rats were used for isometric tension recording. Contractile responses to compound 48/80, carbachol, ovalbumin, normal rabbit serum, antirat immunoglobulin E, and 5-hydroxytryptamine were obtained. Antagonists methysergide, ketanserin, 5,8,11,14-eicosatetraynoic acid, diphenhydramine, and sodium meclofenamate were also used. Results: Tissue levels of rat mast cell protease II and histamine were decreased during delivery compared with prepartum and postpartum levels. Carbachol and compound 48/80 stimulated uterine contractility, and responses were highest during late gestation (day 16 to term). Responses to ovalbumin of uterine tissues in rats sensitized to the antigen were highest at midpregnancy and decreased during the last 10 days of gestation. Ovalbumin challenge in vitro increased the frequency and magnitude of contractions in tissues from ovalbumin-sensitized rats. Compound 48/80 and antirat immunoglobulin E stimulated contractility in both control and sensitized rats. None of the antagonists prevented the contractile responses. Conclusions: Activation of mast cells is an effective mechanism for stimulation of uterine contractility and may play an important role in the control of term and preterm parturition. (Am J Obstet Gynecol 2000; 183:118-25.)

Physiologic role of nitric oxide in the maintenance of uterine quiescence in nonpregnant and pregnant sheep

Objective: This study evaluated the role of nitric oxide in the maintenance of uterine quiescence in nonpregnant and pregnant ewes. Study Design: Sixteen ovariectomized nonpregnant and 10 pregnant (115 days’ gestation) chronically instrumented ewes were studied. Uterine contractility was assessed by electromyography and intrauterine pressure recordings. Nitric oxyde synthase inhibition was induced with nitro-L -arginine methyl ester or aminoguanidine (4.5 mg/kg per hour) given during estrogen replacement with 17β-estradiol (100 μg/d) or in late gestation. In the pregnant group we evaluated the ability of nitric oxide synthase inhibition to alter the responsiveness to oxytocin-induced uterine contractility. Blood pressure and common internal iliac artery blood flow were assessed to confirm nitric oxide synthase inhibition. In addition, the effects of the nitric oxide donor nitroglycerin and the cyclooxygenase inhibitor indomethacin were studied in nonpregnant sheep. The effect of nitric oxide in vitro on myometrial spontaneous and induced contractions was also studied. Results: In nonpregnant estrogen-replaced sheep, nitric oxide synthase inhibition and nitroglycerin administration did not alter uterine contractility, despite significant changes in blood pressure. In contrast, indomethacin decreased electromyographic results to 70% of baseline after 1 hour and 47% after 2 hours. In pregnant ewes nitric oxide synthase inhibition failed to alter uterine contractility in response to oxytocin. These findings are in contrast to results of the in vitro study in which nitric oxide was shown to relax sheep myometrium. Conclusion: The absence of significant effects of nitric oxide synthase inhibition and nitric oxide donors on uterine contractility in vivo suggests that nitric oxide does not play a physiologic role in the regulation of uterine contractility in nonpregnant or pregnant ewes. (Am J Obstet Gynecol 2000;183:191-8.)