Vasoactive intestinal polypeptide in tissues of the human female reproductive tract

Peripheral amplification of sweating--a role for calcitonin gene-related peptide

Neuropeptides are the mediators of neurogenic inflammation. Some pain disorders, e.g. complex regional pain syndromes, are characterized by increased neurogenic inflammation and by exaggerated sudomotor function. The aim of this study was to explore whether neuropeptides have a peripheral effect on human sweating. We investigated the effects of different concentrations of calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and substance P (SP) on acetylcholine-induced axon reflex sweating in healthy subjects (total n = 18). All substances were applied via dermal microdialysis. The experiments were done in a parallel setting: ACh alone and ACh combined with CGRP, VIP or SP in various concentrations were applied. Acetylcholine (10(-2) m) always elicited a sweating response, neuropeptides alone did not. However, CGRP significantly enhanced ACh-induced sweating (P < 0.01). Post hoc tests revealed that CGRP in physiological concentrations of 10(-7)-10(-9) m was most effective. VIP at any concentration had no significant effect on axon reflex sweating. The duration of the sweating response (P < 0.01), but not the amount of sweat, was reduced by SP. ACh-induced skin blood flow was significantly increased by CGRP (P < 0.01), but unaltered by VIP and SP. The results indicate that CGRP amplifies axon reflex sweating in human skin.

Peptide histidine valine (PHV) is present and biologically active in the human female genital tract

The occurrence of vasoactive intestinal polypeptide (VIP), peptide histidine methionine (PHM) and peptide histidine valine (PHV) in the human female genital tract was studied by means of radioimmunoassay in combination with gel chromatography. In addition, the effect of PHV on genital smooth muscle activity was investigated in vitro and compared to that of VIP. Immunoreactive VIP, PHM and PHV were present in all regions of the human female genital tract, the highest concentrations being measured in the vagina and the uterine cervix. The peptides displayed similar regional distribution and as expected from the structure of the VIP precursor molecule in which the examined peptides are contained, the molar ratio of VIP to the total PHM/PHV immunoreactivity was close to 1:1. In all regions PHV constituted 50-70% of the total PHM/PHV immunoreactivity indicating that the dibasic conversion site after PHM was uncleaved. VIP and PHV were found to be equipotent relaxants of the smooth muscle from the Fallopian tube and the myometrium. The present study indicates that PHV like PHM and VIP may act as a neurotransmitter in the human female genital tract and thus participate in the local nervous control of the reproductive functions.

Increased plasma levels of vasoactive intestinal polypeptide in pre-eclampsia

OBJECTIVE

To investigate the plasma vasoactive peptide (VIP) levels in pregnancies complicated by pre-eclampsia.

DESIGN

A prospective clinical study.

SETTING

University Department of Obstetrics, Tromsø, Norway.

SUBJECTS

18 women with untreated gestational proteinuric hypertension between 32 and 40 weeks gestation (13 primigravid) and 8 women with normal pregnancies of similar gestational age.

INTERVENTIONS

Fasting blood samples on two occasions, 10 min apart.

MAIN OUTCOME MEASURES

Plasma VIP measured by radioimmunoassay.

RESULTS

Mean maternal plasma VIP was 13.9 (SEM 1.7) pmol/l in those with pre-eclampsia and 4.4 (SEM 0.5) pmol/l in normal pregnancies (P less than 0.0001).

CONCLUSION

The increased levels of VIP in pre-eclampsia may represent a powerful compensatory mechanism to restore vascular perfusion of various organs, including the uterus and placenta.

The effect of vasoactive intestinal peptide (VIP) on the contractile activity of human uterine smooth muscle

1. In the present study we examined the in vitro effect of vasoactive intestinal peptide (VIP) on spontaneous contractions in both inner and outer layers of non-pregnant human myometrium. A dose-dependent relaxation was observed, but with a marked difference in sensitivity to VIP between the two layers, with an IC50 value of 1 x 10(-8) and 1 x 10(-5) mol L in the outer and inner layers, respectively. 2. We also established that VIP did not directly stimulate the adenylate cyclase activity. The only slight stimulations were observed in non-initial rate conditions. The maximal response of this indirect effect was obtained for VIP concentrations between 1 x 10(-9) and 1 x 10(-8) mol/L and this occurred to the same extent (an approximately 1.4-fold increase) in both layers. However this response is specific, since structurally related peptides such as glucagon, gastric inhibitory polypeptide (GIP), secretin, or human growth hormone-releasing factor (hGRF) had no effect in our preparations. 3. Autoradiographic studies revealed that specific VIP binding sites were located on the vascularization of the intermediate vascular layer and on arterioles and venules distributed in the inner and outer myometrial layers. They were also present in the endometrium, but not on smooth muscle cells of either layer. 4. Such observations could provide evidence for another signal transduction pathway to mediate the biological effect of VIP. An additional intermediate step on the vascularization distributed in all of the muscle cannot be excluded.

Immunohistochemical localization of calcitonin gene-related peptide and bombesin/gastrin-releasing peptide in nerve fibers of the rat, guinea pig and pig female genital organs

The localization and distribution of calcitonin gene-related peptide (CGRP) and bombesin/gastrin-releasing peptide (GRP) immunoreactivity were studied in the rat, guinea pig and pig female genital organs with indirect immunohistochemical technique. In the rat, guinea pig and pig, CGRP and GRP immunoreactivities were localized in nerve fibers of the uterus, ovary and oviduct. Generally, CGRP-immunoreactive nerve fibers were intensely stained, while GRP-immunoreactive nerve fibers exhibited moderate immunoreactivity. The number of GRP-immunoreactive nerve fibers in these organs was lower in comparison with that of CGRP-immunoreactive nerve fibers. The pattern of distribution of these nerve fibers was very similar in different genital organs of all species studied. In the uterus of rat, guinea pig and pig, CGRP- and GRP-immunoreactive nerve fibers and nerve bundles were observed in the muscular membrane and around blood vessels. Some delicate CGRP- and GRP-immunoreactive nerve fibers were also present in the submucous layer of the uterus. In the oviduct, CGRP- and GRP-immunoreactive nerve fibers were seen in the muscular membrane, around blood vessels and in the submucous layer. In the ovary, CGRP- and GRP-immunoreactive nerve fibers were distributed in medullary stroma, in close contact with blood vessels and between follicles of different stages of development.

Regulatory peptides in the mammalian urogenital system

By immunocytochemistry a number of the gut/brain peptides have been demonstrated in nerve fibers of the mammalian urogenital tract. These peptides are localized to large vesicles in nerve terminals of afferent fibers or efferent nerves innervating blood vessels, non-vascular smooth muscle, lining epithelium and glands. There is evidence that some neuropeptides (VIP, NPY) participate in the local non-cholinergic, non-adrenergic nervous control of smooth muscle activity and blood flow, while other peptides (substance P, CGRP) seem to be sensory transmitters. It is likely that impaired function of the peptidergic nerves is involved in sexual dysfunction such as male impotence.

Gastrointestinal regulatory peptides during oxytocin infusion in post-term pregnancies

The plasma concentrations of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide (VIP), insulin, secretin, somatostatin, motilin, pancreatic polypeptide (PP) and gastric inhibitory polypeptide (GIP), as well as blood glucose, were measured in eight healthy women before, during and after oxytocin infusion in post-term pregnancies. Plasma VIP increased significantly (P less than 0.01) during oxytocin infusion. Plasma secretin showed a significant (P less than 0.05) decrease during oxytocin infusion. Plasma somatostatin remained unchanged during oxytocin infusion, but thereafter a significant (P less than 0.05) increase occurred. Both plasma motilin and plasma PP showed a non-significant increase during oxytocin infusion with sustained levels thereafter. No changes were found for plasma insulin, GIP and blood glucose.

Changes in oviductal VIP content induced by sex steroids and inhibitory effect of VIP on spontaneous oviductal contractility

The content of vasoactive intestinal polypeptide (VIP) in rabbit oviducts was determined using a radioimmunoassay technique. Treatment with oestrogen (polyestradiolphosphate) alone for 5 days caused a significant increase in oviductal VIP content, whereas addition of progesterone during the last 3 days of an 8 day polyestradiol-phosphate treatment resulted in a return of VIP content to control levels. The effect of VIP on oviductal smooth muscle contractility was investigated using an in vitro system. It was found that VIP caused a reduction of spontaneous contractile activity in doses as low as 10(-10) M and this reduction in motor activity was strictly dose dependent with an ED50 value similar to that reported for the VIP activity on rabbit myometrial smooth musculature.

Digoxin inhibition of relaxation induced by prostacyclin and vasoactive intestinal polypeptide in small human placental arteries

Small chorionic plate arteries were obtained from human placentae following normal vaginal delivery. Tubal vascular preparations were dissected, mounted in organ baths, and their isometric tension was recorded. Digoxin (10(-6) M) caused a rise in basic tension, reaching a maximum of 17 per cent of contractions induced by potassium (124 mM) depolarization. Pretreatment with digoxin did not significantly influence the concentration-dependent contractile responses to 5-hydroxytryptamine and prostaglandin F2 alpha (PGF2 alpha). In preparations contracted with PGF2 alpha, cumulative addition of prostacyclin (PGI2) and vasoactive intestinal polypeptide (VIP) produced concentration dependent relaxations. Digoxin (10(-8) to 10(-6) M) inhibited and finally abolished these relaxant effects of PGI2 and VIP in a concentration-dependent fashion. Pretreatment by digoxin (10(-8) to 10(-6) M) diminished the relaxant effect of sodium nitroprusside, but the effect was less pronounced than that on PGI2- and VIP-induced relaxation. As PGI2 and VIP may be of importance for the maintenance of a low resistance of the fetal placental vascular bed, the finding that digoxin decreases the vasodilating effects of these agents might imply effects on placental resistance of cardiac glycosides when used in late human pregnancy.

Peptide-immunoreactive nerves in the mammalian female genital tract

Vasoactive intestinal polypeptide, substance P, neuropeptide Y and peptide histidine isoleucine immunoreactivities have been demonstrated in the female genitalia of rat, cat, mouse and guinea-pig using immunocytochemistry and radioimmunoassay. They were localized to nerves. Each type of immunoreactive nerve showed a distinct pattern of distribution, though all were associated to some degree with blood vessels and smooth muscle. Vasoactive intestinal polypeptide-immunoreactive and neuropeptide Y-immunoreactive nerves were the most abundant. Higher concentrations of peptides were detected in the female genitalia of the mouse than those of the other species studied. Vasoactive intestinal polypeptide-immunoreactive nerves were particularly concentrated in the cervix (89.1 +/- 17.2 pmol/g, mean +/- S.E.M.) and the uterus (57.4 +/- 14.8 pmol/g) of the mouse, while neuropeptide Y immunoreactivity was more abundant in the Fallopian tube of the mouse (31.6 +/- 11.8 pmol/g) and the vagina of the rat (38.6 +/- 4.8 pmol/g) than in other regions. Separate populations of ganglion cells in the paracervical ganglia were found to contain vasoactive intestinal polypeptide and neuropeptide Y immunoreactivities. Peptide histidine isoleucine-immunoreactive and vasoactive intestinal polypeptide-immunoreactive nerves were similarly distributed, but the former were much less frequent. Substance P-immunoreactive nerves were seen mainly beneath the epithelium of the vagina and were, in general, more numerous in the guinea-pig than in other species. The significance of these peptide-immunoreactive nerves in the female genital organ remains to be determined.

Demonstration of paracervical ganglion origin for the vasoactive intestinal peptide-containing nerves of the rat uterus using retrograde tracing techniques combined with immunocytochemistry and denervation procedures

The origin of the abundant vasoactive intestinal peptide (VIP)-immunoreactive nerves in the uterus has not been fully determined. In this study, a fluorescent dye, True Blue was injected into the uterus of rat and 6 days later, neuronal cell bodies of the paracervical ganglion were found to be labelled by this dye. Some of these labelled ganglion cells were also found to contain VIP immunoreactivity by immunocytochemistry. When the preganglionic pelvic and/or hypogastric nerves of rats were sectioned, the VIP-immunoreactive nerves in the uteri were not depleted, indicating that these nerves did not originate from the splanchnic ganglion, dorsal root ganglion or the spinal cord. Therefore it is concluded that VIP-immunoreactive nerves in the uterus originate from the paracervical ganglion.

Vasoactive intestinal polypeptide (VIP) inhibits neurally evoked smooth muscle activity of rat uterine cervix in vitro

VIP inhibits the spontaneous motor activity (including tone) in isolated preparations of uterine cervix from oophorectomized rats, but has no direct effect on preparations from estrogen-treated animals. Electrical field stimulation of nerves in the tissue evokes a contractile response that is inhibited by VIP in a concentration-dependent manner. The neuronal link probably involves a cholinergic mechanism, since the contraction is blocked by atropine. The results suggest the presence of VIP receptors both in cholinergic nerves and in smooth muscle cells of the rat uterine cervix.

Localisation and measurement of VIP in the genitourinary system of man and animals

VIP is present in the genitourinary system of man and animals. In man the highest concentrations are found in the penis, the uterus and vagina and in the urinary bladder. VIP nerves heavily innervate the erectile tissue of the male external genitalia, the uterine smooth muscle and blood vessels, the seromucous glands of the cervix, and the lamina propria and vaginal epithelium. In the urinary bladder, VIP nerves are located beneath the transitional epithelium, in the lamina propria and in the smooth muscle. Other areas well innervated by VIP nerves include the prostate, seminal vesicles and vasa deferentia. Chemical (phenol- and 6-OHDA) or surgical (hypogastric or pelvic nerve section) extrinsic denervation fail to deplete the genitourinary system of its VIP content, supporting the view that VIP-containing nerves originate from local ganglion cells. Indeed, neuronal cell bodies containing VIP are seen in the paracervical ganglia of the female genitalia, the para- or intramural bladder ganglia and scattered through the base of the cavernosum body, the neck of the bladder and the prostate. The finding of elevated levels of VIP in the local circulation after induced penile erection in man and mammals and the ability of VIP to relax the detrusor muscle of the bladder suggests that the peptide may be involved in penile erection and bladder relaxation, as does the marked VIP depletion in the penis or bladder in patients suffering from diabetic impotence or bladder instability.

Vasoactive intestinal polypeptide as a neurotransmitter in the female genital tract

Vasoactive intestinal polypeptide (VIP) has been demonstrated in nerve fibers of the female genital tract localized in synaptic vesicles. The VIP-containing nerve fibers seem to innervate nonvascular smooth muscle, blood vessels, and epithelial cells. Evidence is accumulating that VIP fulfills a number of the classical criteria to be a neurotransmitter in the female genital tract. It is likely that VIP is the mediator of genital functions, which are controlled by noncholinergic, nonadrenergic nerve fibers. VIP seems to play a role in the local nervous control of uterine smooth muscle, e.g., opening of the uterotubal junctions, and to be involved in vasodilatation in the uterus as wells as the vagina. In conclusion, a third or peptidergic division of the autonomic nervous system seems to participate in the nervous control of reproduction.

Vasoactive intestinal polypeptide (VIP) increases vaginal blood flow and inhibits uterine smooth muscle activity in women

The human vagina and uterus are heavily innervated by VIP-containing nerve fibres. In the present study, we have measured vaginal blood flow, transmucosal oxygen tension and uterine smooth muscle activity during stepwise intravenous infusion of vasoactive intestinal polypeptide (VIP) (0, 100, 300, 900 pmol kg-1 h-1) in non-pregnant women. Vaginal blood flow was measured by the heat clearance technique, transmucosal oxygen tension by an O2-electrode and uterine activity by a micro-tip pressure catheter in the uterine cavity. Arterial blood pressure, pulse frequency and the concentration of VIP in peripheral venous blood were monitored. VIP induced a concentration-dependent increase in vaginal blood flow. The transmucosal oxygen tension was not significantly changed by VIP. The maximum dose of VIP decreased systolic as well as diastolic blood pressure and increased pulse frequency. VIP inhibited uterine activity. These findings suggest that VIP participates as a neurotransmitter in the control of genital physiological responses.

Nervous release of vasoactive intestinal polypeptide from the feline uterus: pharmacological characteristics

1. The release of the neuropeptide, vasoactive intestinal polypeptide (VIP), from the uterus in response to electrical stimulation of the hypogastric and pelvic nerves was examined in non-pregnant anaesthetized cats. 2. Efferent stimulation of the pelvic nerve caused an increase in the release of VIP, which was unaffected by atropine and adrenoceptor antagonists, but completely abolished by hexamethonium. 3. Efferent stimulation of the hypogastric nerves induced a marked increase in the release of VIP, which was blocked by hexamethonium. After atropine and adrenoceptor blockade the nervously induced VIP response was undiminished and accompanied by an increase in uterine venous blood flow. 4. The results suggest that the VIP-containing neurones in the uterus are intrinsic under preganglionic influence of pelvic and hypogastric nervous activity. It is proposed that VIP is a neurotransmitter in the feline uterus involved in non-cholinergic, non-adrenergic mechanisms such as the uterine vasodilation observed after hypogastric nerve stimulation.

Vasoactive intestinal polypeptide and the female genital tract: relationship to reproductive phase and delivery

Recently, vasoactive intestinal polypeptide (VIP) has been localized in nerve fibers in the human female genital tract. In the present investigation, the effect and concentration of VIP was studied in uterine tissue from pregnant and nonpregnant women, and the plasma concentration of VIP was measured in relationship to diurnal rhythm, intake of food, menstrual cycle, pregnancy, labor, age, and sexual arousal. In vitro VIP inhibited the contractions of the nonpregnant but not of the pregnant uterus. The median concentration of VIP in myometrium from pregnant women (less than 0.1 pmole/gm) was significantly lower than that in myometrium from nonpregnant women (1.6 pmoles/gm). The venous plasma concentrations of VIP during labor (10.5 to 13.0 pmoles/L) were significantly higher than those during pregnancy (2.0 to 5.0 pmoles/L) and the menstrual cycle of VIP increased significantly during sexual arousal, from 4.0 to 8.5 pmoles/L. The median arterial and venous concentrations in the umbilical cord (12.5 and 14.5 pmoles/L, respectively) were significantly higher than the concentration in maternal peripheral venous blood (5.2 pmoles/L). The plasma concentrations of VIP were not related to intake of food, diurnal rhythm, menstrual cycle, or age. The conclusion is that the function of VIP may be related to pregnancy, delivery, and sexual stimulation.

Vasoactive intestinal polypeptide (VIP): effect on rabbit uterine smooth muscle in vivo and in vitro

The effect of vasoactive intestinal polypeptide (VIP) on uterine smooth muscle electrical and mechanical activity in non-pregnant estradiol-treated rabbits was investigated using in vivo and in vitro methods. The studies were performed on spontaneous, oxytocin-, carbachol-, and prostaglandin-42 alpha-induced activity. VIP had a dose-related inhibitory effect on both myoelectrical and mechanical activity. The concentration needed for 50% inhibition (ID50) was 2 x 10(-10) mol VIP . 1(-1) (in vivo), an 6 x 10(-8) mol VIP . 1(-1) (in vitro). This inhibition was unaffected by the presence of atropine (10(-5) mol . 1(-1)), propranolol (10(-5)), phentolamine (10(-5)), naloxone (10(-5)), apamin (10(-5)), and tetrodotoxin (10(-5)). These findings indicate that VIP may act via a specific receptor on the smooth muscle and supports the hypothesis that VIP may be a neurotransmitter involved in the local nervous control of uterine smooth muscle activity.

Increased myometrial blood flow evoked by vasoactive intestinal polypeptide in the non-pregnant goat

1. The effect of vasoactive intestinal polypeptide (VIP) on myometrial blood flow was evaluated in anaesthetized goats. A solution of VIP, or vehicle alone, was infused into the right internal iliac artery for a period of 10 min. The myometrial blood flow in both uterine horns was measured from the third to the seventh min of the infusion by the gas clearance technique after local injection of (133)xenon in 10 mul. saline solution. Blood samples were collected from both utero-ovarian veins 5 min from the onset of the infusion and the plasma concentration of VIP determined by radio-immunoassay.2. During infusion of vehicle before VIP, myometrial blood flow was of the same magnitude in both uterine horns, i.e. 0.06-0.12 ml./min per g. The blood flow of the right horn increased to 0.20-0.39 ml./min per g during infusion of VIP (300 p-mole/min) in the ipsilateral artery, whilst that of the left horn rose to 0.13-0.26 ml./min per g. The effect was sometimes observed to last for more than 40 min.3. Increased myometrial blood flow was observed with infusion rates down to 3 p-mole/min. Once a response to VIP had been provoked, however, the vasculature sometimes became refractory to further stimulation.4. The plasma concentration of VIP increased in both utero-ovarian veins during unilateral infusion of the peptide.5. Methylene blue given through the infusion catheter stained tissue in both uterine horns, further evidencing that their blood supply is not entirely separate.6. Uterine motility was observed to diminish during the VIP infusions.7. During infusion of VIP (300 p-mole/min) heart rate rose from 146 +/- 6 to 158 +/- 7 beats/min. No significant change occurred in arterial blood pressure.8. It is concluded that the increase in blood flow is due to a local response and that, since VIP has been demonstrated in uterine nerve endings, it may act as a neuro-transmitter mediating vasodilatation in the uterus.

The differential distribution of vasoactive intestinal polypeptide in the normal human female genital tract

VIP-like immunoreactive material is present in the female reproductive tract, with a distinct pattern of distribution. The highest concentrations of extractable material and immunoreactive nerve fibres were found in the cervix and vagina. In the cervix these fibres were seen below the surface epithelium and around cervical glands as well as in association with blood vessels and smooth muscle bundles. In the vagina the nerve fibres were most abundant in th superficial regions of the lamina propria. Scattered fibres were also present in the rest of the uterus and in the fallopian tubes. Chromatographic evidence indicates that this VIP-like material is of a similar molecular size to that extracted from other organs. Possible roles for VIP in the regulation of myometrial activity and of cervical and vaginal dilation and secretion are proposed.