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Carvajal JA, Oporto JI. The Myometrium in Pregnant Women with Obesity. Curr Vasc Pharmacol 2021; 19:193-200. [PMID: 32484103 DOI: 10.2174/1570161118666200525133530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022]
Abstract
Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the resulting high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women, compared with that in nonobese women, is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, the disruptions of myometrial myocytes were reviewed in obese women during pregnancy that may explain the dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, a lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function, and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, at least partially explaining the higher rate of cesarean of sections in obese women.
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Affiliation(s)
- Jorge A Carvajal
- Departamento de Obstetricia, Unidad de Medicina Materno Fetal, Mexico City, Mexico
| | - Joaquín I Oporto
- Estudiante de Medicina, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Prendergast C. Maternal phenotype: how do age, obesity and diabetes affect myometrial function? CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Parkington HC, Siriwardhana ER, Coleman HA. Intracellular organelles; key regulators of myometrial activity. CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Larsen LH, Sandø-Pedersen S, Ørstrup LKH, Grunnet N, Quistorff B, Mortensen OH. Gestational Protein Restriction in Wistar Rats; Effect of Taurine Supplementation on Properties of Newborn Skeletal Muscle. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 975 Pt 1:413-433. [PMID: 28849472 DOI: 10.1007/978-94-024-1079-2_34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Taurine ameliorates changes occurring in newborn skeletal muscle as a result of gestational protein restriction in C57BL/6 mice, but taurine supplementation effects may be exaggerated in C57BL/6 mice due to their inherent excessive taurinuria.We examined if maternal taurine supplementation could ameliorate changes in gene expression levels, properties of mitochondria, myogenesis, and nutrient transport and sensing, in male newborn skeletal muscle caused by a maternal low protein (LP) diet in Wistar rats.LP diet resulted in an 11% non-significant decrease in birth weight, which was not rescued by taurine supplementation (LP-Tau). LP-Tau offspring had significantly lower birth weight compared to controls. Gene expression profiling revealed 895 significantly changed genes, mainly an LP-induced down-regulation of genes involved in protein translation. Taurine fully or partially rescued 32% of these changes, but with no distinct pattern as to which genes were rescued.Skeletal muscle taurine content in LP-Tau offspring was increased, but no changes in mRNA levels of the taurine synthesis pathway were observed. Taurine transporter mRNA levels, but not protein levels, were increased by LP diet.Nutrient sensing signaling pathways were largely unaffected in LP or LP-Tau groups, although taurine supplementation caused a decrease in total Akt and AMPK protein levels. PAT4 amino acid transporter mRNA was increased by LP, and normalized by taurine supplementation.In conclusion, gestational protein restriction in rats decreased genes involved in protein translation in newborn skeletal muscle and led to changes in nutrient transporters. Taurine partly rescued these changes, hence underscoring the importance of taurine in development.
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Affiliation(s)
- Lea Hüche Larsen
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark
| | - Sofie Sandø-Pedersen
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark
| | - Laura Kofoed Hvidsten Ørstrup
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark
| | - Niels Grunnet
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark
| | - Bjørn Quistorff
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark
| | - Ole Hartvig Mortensen
- Department of Biomedical Sciences, Cellular and Metabolic Research Section, University of Copenhagen, København, Denmark.
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Gam CMBF, Mortensen OH, Larsen LH, Poulsen SS, Qvortrup K, Mathiesen ER, Damm P, Quistorff B. Diabetes, myometrium, and mitochondria in pregnant women at term. Acta Diabetol 2018; 55:999-1010. [PMID: 29931421 DOI: 10.1007/s00592-018-1171-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/28/2018] [Indexed: 12/25/2022]
Abstract
AIMS Poor myometrial contractility has been demonstrated in women at term with diabetes and decreased muscular mitochondrial content and/or function has been extensively implicated in the progression of type 2 diabetes. Alterations of the uterine mitochondrial phenotype in pregnant women with diabetes have yet to be investigated as a causal link to decreased myometrial contractility. METHODS Observational study of 18 women with diabetes (type 2 and gestational) scheduled for an elective Caesarean section at term with matching controls. A uterine biopsy and fasting blood samples were taken on the day of delivery. RESULTS Respiration rates in isolated mitochondria and myometrial mRNA levels of genes related to mitochondrial biogenesis were unaffected by diabetes. Mitochondrial quantity examined by quantification of the complexes of the respiratory chain and histology did not indicate alterations in mitochondrial quantity. Citrate syntase activity was higher (0.31 ± 0.02 vs. 0.24 ± 0.02 U/mg protein, P = 0.008), whereas protein content was lower in women with diabetes compared with the control group (94.6 ± 6.9 vs. 118.6 ± 7.4 mg/g wet wt, P = 0.027). Histological examinations did not support any structural alterations in the myometrium or its mitochondria. CONCLUSION No indication of decreased mitochondrial function, content, morphology, or localization in the myometrium at term in women with diabetes compared with controls was observed. The increase in citrate syntase activity in the myometrium could be explained by the lower protein content in the myometrium, which we suggest is due to alterations in tissue or cellular composition.
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Affiliation(s)
- Christiane Marie Bourgin Folke Gam
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Blegdamsvej 3, Bygning 6.5, 2200, Copenhagen N, Denmark.
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen N, Denmark.
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
| | - Ole Hartvig Mortensen
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Blegdamsvej 3, Bygning 6.5, 2200, Copenhagen N, Denmark
| | - Lea Hüche Larsen
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Blegdamsvej 3, Bygning 6.5, 2200, Copenhagen N, Denmark
| | - Steen Seier Poulsen
- Endocrinology Research Section, University of Copenhagen, Copenhagen N, Denmark
| | - Klaus Qvortrup
- Core Facility for Integrated Microscopy, Department of Biomedical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Elisabeth Reinhart Mathiesen
- Departement of Endocrinology, Rigshospitalet, Copenhagen N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen N, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen N, Denmark
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen N, Denmark
| | - Bjørn Quistorff
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Blegdamsvej 3, Bygning 6.5, 2200, Copenhagen N, Denmark
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Gam CMBF, Larsen LH, Mortensen OH, Engelbrechtsen L, Poulsen SS, Qvortrup K, Mathiesen ER, Damm P, Quistorff B. Unchanged mitochondrial phenotype, but accumulation of lipids in the myometrium in obese pregnant women. J Physiol 2017; 595:7109-7122. [PMID: 29119568 DOI: 10.1113/jp274838] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/13/2017] [Indexed: 12/17/2022] Open
Abstract
KEY POINTS Obesity during pregnancy and childbirth is associated with labour dystocia leading to instrumental or operative delivery, but the underlying pathophysiological mechanisms remain unclear and insufficient uterine contractility has been suggested. This study examined whether reduced myometrial mitochondrial capacity or quantity could contribute as a pathophysiological mechanism to labour dystocia. Data did not support reduced myometrial mitochondrial capacity or quantity in the myometrium at term in obese women, but a reduced myocyte density with increased triglyceride content was demonstrated, which could lead to poorer uterine contractility. These results add to the understanding of systemic effects of obesity, placing also the myometrium at term as an affected non-adipose tissue. ABSTRACT Obesity is known to increase the risk of labour dystocia and insufficient energy supply, due to reduced mitochondrial capacity or quantity, could be a possible mechanism leading to reduced efficiency of uterine contractility during labour. In the present study of 36 women having an elective Caesarean section at term, obesity did not change mitochondrial phenotype in the myometrial myocyte obtained from uterine biopsies taken at delivery. Respiration rates in isolated mitochondria were unaffected by obesity. No indication of reduced content, investigated by quantification of the complexes of the respiratory chain, or altered regulation, examined by myometrial mRNA levels of genes related to mitochondrial biogenesis and inflammation, was detected. Yet we found increased myometrial triglyceride content in the obese group (2.39 ± 0.26 vs. 1.56 ± 0.20 mm, P = 0.024), while protein content and citrate synthase activity per gram wet weight myometrium were significantly lower in the obese (109.2 ± 7.2 vs. 139.4 ± 5.6 mg g-1 , P = 0.002, and 24.8 ± 1.0 vs. 29.6 ± 1.4 U g-1 wet wt, P = 0.008, respectively). These differences were substantiated by our histological findings where staining for nuclei, cytoplasm, glycogen and collagen supported the idea of a smaller muscle content in the myometrium in obese women. In conclusion no indication of myometrial mitochondrial dysfunction in the isolated state was found, but the observed increase of lipid content might play a role in the pathophysiological mechanisms behind labour dystocia in obese women.
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Affiliation(s)
- Christiane Marie Bourgin Folke Gam
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200.,Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100.,Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100
| | - Lea Hüche Larsen
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Ole Hartvig Mortensen
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Line Engelbrechtsen
- Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100
| | - Steen Seier Poulsen
- Endocrinology Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Klaus Qvortrup
- Core Facility for Integrated Microscopy, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Elisabeth Reinhart Mathiesen
- Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100.,Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100.,Institute of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100.,Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, 2100.,Institute of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
| | - Bjørn Quistorff
- Cellular and Metabolic Research Section, Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark, 2200
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Carlson NS, Hernandez TL, Hurt KJ. Parturition dysfunction in obesity: time to target the pathobiology. Reprod Biol Endocrinol 2015; 13:135. [PMID: 26684329 PMCID: PMC4683915 DOI: 10.1186/s12958-015-0129-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/24/2015] [Indexed: 12/23/2022] Open
Abstract
Over a third of women of childbearing age in the United States are obese, and during pregnancy they are at increased risk for delayed labor onset and slow labor progress that often results in unplanned cesarean delivery. The biology behind this dysfunctional parturition is not well understood. Studies of obesity-induced changes in parturition physiology may facilitate approaches to optimize labor in obese women. In this review, we summarize known and proposed biologic effects of obesity on labor preparation, contraction/synchronization, and endurance, drawing on both clinical observation and experimental data. We present evidence from human and animal studies of interactions between obesity and parturition signaling in all elements of the birth process, including: delayed cervical ripening, prostaglandin insensitivity, amniotic membrane strengthening, decreased myometrial oxytocin receptor expression, decreased myocyte action potential initiation and contractility, decreased myocyte gap junction formation, and impaired myocyte neutralization of reactive oxygen species. We found convincing clinical data on the effect of obesity on labor initiation and successful delivery, but few studies on the underlying pathobiology. We suggest research opportunities and therapeutic interventions based on plausible biologic mechanisms.
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Affiliation(s)
- Nicole S Carlson
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Teri L Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, & Diabetes, College of Nursing, University of Colorado School of Medicine, 12801 E. 17th Ave, MS 8106, Aurora, CO, 80045, USA.
| | - K Joseph Hurt
- Department of Obstetrics & Gynecology, Divisions of Maternal-Fetal Medicine & Reproductive Sciences, University of Colorado School of Medicine, 12700 East 19th Ave, MS 8613, Aurora, CO, 80045, USA.
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