1
|
Kumari R, Saha BC, Onkar A, Ambasta A, Kumari A. Management of glaucoma in pregnancy - balancing safety with efficacy. Ther Adv Ophthalmol 2021; 13:25158414211022876. [PMID: 34263134 PMCID: PMC8243098 DOI: 10.1177/25158414211022876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Glaucoma and pregnancy is an uncommon combination, but it constitutes a very challenging situation for the treating doctor. The challenge is not only controlling the intraocular pressure and preventing glaucoma progression in the mother, but also having to deal with her mental stress and anxiety regarding the safety of her child. The situation is further worsened by the lack of definite guidelines as to how to deal with such patients. Relative rarity of glaucoma in this population restricts any large prospective randomized clinical trials or any large systematic studies. Moreover, none of the existing anti-glaucoma medications is absolutely safe in pregnancy. Current practice patterns depend on some case reports, a few observational studies and a few animal studies that attempt at determining the safety and efficacy of the available medicines. These are then prescribed on the basis of their relative safety in any particular stage of pregnancy or lactation. Newer medications that were released recently in 2018, such as Vyzulta and Rhopressa, presently have limited data to support their safety for use during pregnancy. Laser trabeculoplasty, conventional filtration surgery (of course without anti-metabolites), and minimally invasive glaucoma surgery represent a few non-pharmacological management options. Surgical procedures such as trabeculectomy and tube-shunts or collagen matrix implants, and newer minimally invasive glaucoma surgery procedures such as the gelatin stents are currently being explored and may prove to be viable solutions for severe glaucoma during pregnancy, although they too have their own inherent drawbacks. Management of glaucoma during pregnancy and lactation requires careful consideration of the disease status, gestational stage, US Food and Drug Administration classification and guidelines, and potential benefits and limitations of the various therapeutic modalities. This review focuses on the importance of a multidisciplinary team approach, starting with preconception planning and counseling, determining the treatment options depending on the stage of glaucoma and of pregnancy, and emphasizes the involvement of the patients, their obstetrician, and pediatrician through active discussion regarding the various medical, laser, or surgical modalities currently available or under exploration for use during pregnancy and lactation. The ultimate aim is to achieve an optimal balance between the risks and benefits of any type of intervention, and to customize treatment on an individual basis in order to achieve the best outcomes for both mother and fetus.
Collapse
Affiliation(s)
- Rashmi Kumari
- Assistant Professor, Department of
Ophthalmology, Indira Gandhi Institute of Medical Sciences, House no. O/13,
Ashiyana Nagar Phase 1, Patna 800025, Bihar, India
| | - Bhawesh Chandra Saha
- Department of Ophthalmology, All India
Institute of Medical Sciences Patna, Patna, India
| | - Abhishek Onkar
- Department of Ophthalmology, All India
Institute of Medical Sciences Deoghar, Deoghar, India
| | - Anita Ambasta
- Regional Institute of Ophthalmology, Indira
Gandhi Institute of Medical Sciences, Patna, India
| | - Akanchha Kumari
- Department of Ophthalmology, All India
Institute of Medical Sciences Patna, Patna, India
| |
Collapse
|
2
|
Poupart J, Hou X, Chemtob S, Lubell WD. Application of N-Dodecyl l-Peptide to Enhance Serum Stability while Maintaining Inhibitory Effects on Myometrial Contractions Ex Vivo. Molecules 2019; 24:molecules24224141. [PMID: 31731725 PMCID: PMC6891598 DOI: 10.3390/molecules24224141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/01/2019] [Accepted: 11/07/2019] [Indexed: 11/16/2022] Open
Abstract
N-Alkylation and N-acylation of the prostaglandin-F2α allosteric modulator l-PDC31 were performed to install various alkyl, PEG and isoprenoid groups onto the l-enantiomer of the peptide. Among the different bio-conjugates studied, the N-dodecyl analog reduced prostaglandin-F2α-induced mouse myometrium contractions ex vivo. Furthermore, N-dodecyl-l-PDC31 exhibited improved stability in a mouse serum assay, likely due to protection from protease degradation by the lipid chain.
Collapse
Affiliation(s)
- Julien Poupart
- Département de Chimie, Pavillon Roger Gaudry, Université de Montréal, CP 6128 and Succursale Centre-ville, Montréal, QC H3C 3J7, Canada;
| | - Xin Hou
- Centre de recherches du Centre Hospitalier Universitaire Sainte-Justine, Montréal City, QC H3T 1C5, Canada; (X.H.); (S.C.)
| | - Sylvain Chemtob
- Centre de recherches du Centre Hospitalier Universitaire Sainte-Justine, Montréal City, QC H3T 1C5, Canada; (X.H.); (S.C.)
| | - William D. Lubell
- Département de Chimie, Pavillon Roger Gaudry, Université de Montréal, CP 6128 and Succursale Centre-ville, Montréal, QC H3C 3J7, Canada;
- Correspondence: ; Tel.: +1-514-343-7339
| |
Collapse
|
3
|
Aktas S, Un I, Omer Barlas I, Ozturk AB, Ilkay Karagul M. Evaluation of the Rho A/Rho-kinase pathway in the uterus of the rat model of polycystic ovary syndrome. Reprod Biol 2019; 19:45-54. [PMID: 30704840 DOI: 10.1016/j.repbio.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/21/2018] [Accepted: 01/23/2019] [Indexed: 01/03/2023]
Abstract
The aim of this study was to investigate the expression of RhoA/Rho-kinase in the uterus and the effect of Rho-kinase inhibitors on uterine contractions of dehydroepiandrosterone (DHEA) induced polycystic ovary syndrome (PCOS) rats. Forty-four female Sprague-Dawley (21 days old) rats divided into three groups: The control group (n = 14, any procedure was not performed), vehicle group (n = 14, 0.2 ml of sesame oil, subcutaneous injection, 20 days) and PCOS group (n = 16, DHEA 6 mg/100 g in 0.2 ml of sesame oil, subcutaneous injection, 20 days). The myometrium thickness and uterine wet weight were assessed. The mRNA and protein expressions of Rho A, the effect of Rho-kinase inhibitors (fasudil and Y-27632) on KCl, carbachol, and PGF2α induced contractions were evaluated in the uterus. In the PCOS group, the myometrium thickness and uterine wet weight significantly increased compared to the control group and vehicle group. The mRNA expression level and the immunoreactive score of Rho A, ROCK 1, ROCK 2 were similar in all groups. In the PCOS group, KCl, carbachol, and PGF2α induced uterine contractions significantly increased compared to the control group and vehicle group. Fasudil and Y-27632 significantly inhibited KCl, carbachol, and PGF2α induced uterine contractions in all groups. In conclusion, the expression of Rho A, ROCK 1, ROCK 2 not changed although myometrium thickness, uterine wet weight and the contractile responses of uterus increased in the PCOS group. The results suggest that the Rho-kinase inhibitors effectively suppressed increased contractions in the PCOS group they might be potential therapeutic agents.
Collapse
Affiliation(s)
- Savas Aktas
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey.
| | - Ismail Un
- Department of Medical Pharmacology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Ibrahim Omer Barlas
- Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Ayla Batu Ozturk
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Meryem Ilkay Karagul
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| |
Collapse
|
4
|
Jagla CAD, Scott CE, Tang Y, Qiao C, Mateo-Semidey GE, Yudowski GA, Lu D, Kendall DA. Pyrimidinyl Biphenylureas Act as Allosteric Modulators to Activate Cannabinoid Receptor 1 and Initiate β-Arrestin-Dependent Responses. Mol Pharmacol 2018; 95:1-10. [PMID: 30322873 DOI: 10.1124/mol.118.112854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/12/2018] [Indexed: 01/14/2023] Open
Abstract
Cannabinoid receptor 1 (CB1) is a G-protein-coupled receptor that is abundant in the central nervous system. It binds several compounds in its orthosteric site, including the endocannabinoids, arachidonoyl ethanolamide (anandamide) and 2-arachidonoyl glycerol, and the plant-derived Δ9-tetrahydrocannabinol, one of the main psychoactive components of marijuana. It primarily couples to Gi/o proteins to inhibit adenylate cyclase activity and typically induces downstream signaling that is Gi-dependent. Since this receptor is implicated in several maladies, such as obesity, pain, and neurodegenerative disorders, there is interest in developing therapeutics that selectively target this receptor. Allosteric modulators of CB1 offer one new approach that has tremendous therapeutic potential. Here, we reveal receptor- and cellular-level properties consistent with receptor activation by a series of pyrimidinyl biphenylureas (LDK1285, LDK1288, LDK1305, and PSNCBAM1), including promoting binding of the agonist CP55940 with positive cooperativity and inhibiting binding of the inverse agonist SR141716A with negative cooperativity, demonstrated via radioligand binding studies. Consistent with these findings, the allosteric modulators induced cellular internalization of the receptor and recruitment of β-arrestin 2 in human embryonic kidney cell line 293 cells monitored with confocal and total internal reflective fluorescence microscopy, respectively. These allosteric modulators, however, caused G-protein-independent but β-arrestin 1-dependent phosphorylation of the downstream kinases extracellular signal-regulated kinase 1/2, mitogen-activated protein kinase, and Src, shown by immunoblotting studies. These results are consistent with the involvement of β-arrestin and suggest that these allosteric modulators induce biased signaling.
Collapse
Affiliation(s)
- Caitlin A D Jagla
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Caitlin E Scott
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Yaliang Tang
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Changjiang Qiao
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Gabriel E Mateo-Semidey
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Guillermo A Yudowski
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Dai Lu
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| | - Debra A Kendall
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (C.A.D.J., C.E.S., Y.T., D.A.K.); Department of Anatomy and Neurobiology (G.E.M.-S., G.A.Y.) and Institute of Neurobiology (G.E.M.-S., G.A.Y.), University of Puerto Rico, San Juan, Puerto Rico; and Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, Texas (C.Q., D.L.)
| |
Collapse
|
5
|
Toda A, Sawada K, Fujikawa T, Wakabayashi A, Nakamura K, Sawada I, Yoshimura A, Nakatsuka E, Kinose Y, Hashimoto K, Mabuchi S, Tokuhira A, Nakayama M, Itai A, Kurachi H, Kimura T. Targeting Inhibitor of κB Kinase β Prevents Inflammation-Induced Preterm Delivery by Inhibiting IL-6 Production from Amniotic Cells. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:616-29. [DOI: 10.1016/j.ajpath.2015.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 10/09/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
|
6
|
Hutchinson JL, Rajagopal SP, Yuan M, Norman JE. Lipopolysaccharide promotes contraction of uterine myocytes
via
activation of Rho/ROCK signaling pathways. FASEB J 2013; 28:94-105. [DOI: 10.1096/fj.13-237040] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- James L. Hutchinson
- Medical Research Council Centre for Reproductive HealthUniversity of EdinburghThe Queen's Medical Research InstituteEdinburghUK
| | - Shalini P. Rajagopal
- Medical Research Council Centre for Reproductive HealthUniversity of EdinburghThe Queen's Medical Research InstituteEdinburghUK
| | - Mei Yuan
- Medical Research Council Centre for Reproductive HealthUniversity of EdinburghThe Queen's Medical Research InstituteEdinburghUK
| | - Jane E. Norman
- Medical Research Council Centre for Reproductive HealthUniversity of EdinburghThe Queen's Medical Research InstituteEdinburghUK
| |
Collapse
|
7
|
Wakabayashi A, Sawada K, Nakayama M, Toda A, Kimoto A, Mabuchi S, Kinose Y, Nakamura K, Takahashi K, Kurachi H, Kimura T. Targeting interleukin-6 receptor inhibits preterm delivery induced by inflammation. Mol Hum Reprod 2013; 19:718-26. [PMID: 23969038 DOI: 10.1093/molehr/gat057] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Intrauterine infection is still a common trigger of preterm delivery (PTD) and also a determinant risk factor for the subsequent development of neurodevelopmental abnormalities in neonates. In this study, we examined the expressional pattern of various inflammatory cytokines such as interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) in placentae complicated with severe chorioamnionitis (CAM) and found that IL-6 is mainly expressed in macrophages in villous mesenchyme by immunohistochemical analysis with anti-CD-68 antibody. Using an experimental lipopolysaccharide (LPS)-induced PTD model, the therapeutic potential of targeting this cytokine was investigated. Anti-IL-6 receptor antibody (MR16-1) was delivered 6 h before LPS treatment. Mice in the MR16-1 group had a significantly lower rate of PTD (17%) than in the controls (53%, P = 0.026). As a result, MR16-1 treatment significantly prolonged the gestational period (control; 18.4 ± 1.7d, MR16-1; 19.8 ± 1.5d, P = 0.007) without any apparent adverse events on the mice and their pups. In primary human amniotic epithelial cells, pretreatment with a humanized anti-human IL-6 receptor antibody, tocilizumab, significantly inhibited the production of prostaglandin E2 induced by IL-6. In conclusion, IL-6 was strongly expressed mainly in macrophages in villous mesenchyme in placentae complicated with CAM. Anti-IL-6R antibody significantly decreased the rate of PTD in LPS-induced inflammatory model in mice, and inhibited PGE2 production from human primary amniotic epithelial cells. Targeting IL-6 signaling could be a promising option for the prevention of PTD and needs to be further explored for future clinical application.
Collapse
Affiliation(s)
- Atsuko Wakabayashi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Molecular pathways regulating contractility in rat uterus through late gestation and parturition. Am J Obstet Gynecol 2012; 207:76.e15-24. [PMID: 22727353 DOI: 10.1016/j.ajog.2012.04.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/18/2012] [Accepted: 04/30/2012] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Endogenous uterine agonists can activate numerous signaling pathways to effect increased force. Our objective was to assess expression of key constituents of these pathways, in alliance with contractile function, through late gestation and during term and preterm labor. STUDY DESIGN Using myography, we measured the response to 3 agonists compared with depolarization alone (K(+), 124 mEq/L) and calculated agonist/depolarization ratio. We measured gene expression using quantitative reverse transcription-polymerase chain reaction. RESULTS Contractile responsiveness to depolarization alone, oxytocin, or endothelin-1 increased during pregnancy compared with nonpregnant animals. The agonist/depolarization ratio did not change during uterine activation or parturition. Inhibition of rhoA-associated kinase decreased responses to oxytocin in all tissues, but significantly more during uterine activation. Expression of rhoA and rhoA-associated kinase was increased significantly in active labor at term or preterm. CONCLUSION The rhoA/rhoA-associated kinase pathway is a key regulator of uterine activation during labor and may be a useful target for the prevention of spontaneous preterm birth.
Collapse
|
9
|
Goupil E, Tassy D, Bourguet C, Quiniou C, Wisehart V, Pétrin D, Le Gouill C, Devost D, Zingg HH, Bouvier M, Saragovi HU, Chemtob S, Lubell WD, Claing A, Hébert TE, Laporte SA. A novel biased allosteric compound inhibitor of parturition selectively impedes the prostaglandin F2alpha-mediated Rho/ROCK signaling pathway. J Biol Chem 2010; 285:25624-36. [PMID: 20551320 DOI: 10.1074/jbc.m110.115196] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The prostaglandin F2alpha (PGF2alpha) receptor (FP) is a key regulator of parturition and a target for pharmacological management of preterm labor. However, an incomplete understanding of signaling pathways regulating myometrial contraction hinders the development of improved therapeutics. Here we used a peptidomimetic inhibitor of parturition in mice, PDC113.824, whose structure was based on the NH(2)-terminal region of the second extracellular loop of FP receptor, to gain mechanistic insight underlying FP receptor-mediated cell responses in the context of parturition. We show that PDC113.824 not only delayed normal parturition in mice but also that it inhibited both PGF2alpha- and lipopolysaccharide-induced preterm labor. PDC113.824 inhibited PGF2alpha-mediated, G(alpha)(12)-dependent activation of the Rho/ROCK signaling pathways, actin remodeling, and contraction of human myometrial cells likely by acting as a non-competitive, allosteric modulator of PGF2alpha binding. In contrast to its negative allosteric modulating effects on Rho/ROCK signaling, PDC113.824 acted as a positive allosteric modulator on PGF2alpha-mediated protein kinase C and ERK1/2 signaling. This bias in receptor-dependent signaling was explained by an increase in FP receptor coupling to G(alpha)(q), at the expense of coupling to G(alpha)(12). Our findings regarding the allosteric and biased nature of PDC113.824 offer new mechanistic insights into FP receptor signaling relevant to parturition and suggest novel therapeutic opportunities for the development of new tocolytic drugs.
Collapse
Affiliation(s)
- Eugénie Goupil
- Department of Medicine, McGill University Health Center Research Institute, Montréal H3A 1A1, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Lartey J, López Bernal A. RHO protein regulation of contraction in the human uterus. Reproduction 2009; 138:407-24. [DOI: 10.1530/rep-09-0160] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
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.
Collapse
|
11
|
Mitchell BF, Taggart MJ. Are animal models relevant to key aspects of human parturition? Am J Physiol Regul Integr Comp Physiol 2009; 297:R525-45. [PMID: 19515978 DOI: 10.1152/ajpregu.00153.2009] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Preterm birth remains the most serious complication of pregnancy and is associated with increased rates of infant death or permanent neurodevelopmental disability. Our understanding of the regulation of parturition remains inadequate. The scientific literature, largely derived from rodent animal models, suggests two major mechanisms regulating the timing of parturition: the withdrawal of the steroid hormone progesterone and a proinflammatory response by the immune system. However, available evidence strongly suggests that parturition in the human has significantly different regulators and mediators from those in most of the animal models. Our objectives are to critically review the data and concepts that have arisen from use of animal models for parturition and to rationalize the use of a new model. Many animal models have contributed to advances in our understanding of the regulation of parturition. However, we suggest that those animals dependent on progesterone withdrawal to initiate parturition clearly have a limitation to their translation to the human. In such models, a linear sequence of events (e.g., luteolysis, progesterone withdrawal, uterine activation, parturition) gives rise to the concept of a "trigger" mechanism. Conversely, we propose that human parturition may arise from the concomitant maturation of several systems in parallel. We have termed this novel concept "modular accumulation of physiological systems" (MAPS). We also emphasize the urgency to determine the precise role of the immune system in the process of parturition in situations other than intrauterine infection. Finally, we accentuate the need to develop a nonprimate animal model whose physiology is more relevant to human parturition. We suggest that the guinea pig displays several key physiological characteristics of gestation that more closely resemble human pregnancy than do currently favored animal models. We conclude that the application of novel concepts and new models are required to advance translational research in parturition.
Collapse
Affiliation(s)
- Bryan F Mitchell
- Department of Obstetrics & Gynecology, Heritage Medical Research Centre, University of Alberta, Edmonton, Alberta, Canada.
| | | |
Collapse
|
12
|
Taggart MJ, Morgan KG. Regulation of the uterine contractile apparatus and cytoskeleton. Semin Cell Dev Biol 2007; 18:296-304. [PMID: 17582796 PMCID: PMC2001260 DOI: 10.1016/j.semcdb.2007.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 05/03/2007] [Indexed: 01/16/2023]
Abstract
Parturition at term, the end stage of a successful pregnancy, occurs as a result of powerful, co-ordinated and periodic contractions of uterine smooth muscle (myometrium). To occur in a propitious manner, a high degree of control over the activation of a myometrial cell is required. We review the molecular mechanisms and structural composition of myometrial cells that may contribute to their increased contractile capacity at term. We focus attention on pathways that lead to the activation of filamentous networks traditionally labeled 'contractile' or 'cytoskeletal' yet draw attention to the fact that functional discrimination between these systems is not absolute.
Collapse
Affiliation(s)
- Michael J Taggart
- Maternal & Fetal Health Research Centre & Cardiovascular Research Group, University of Manchester, St Mary’s Hospital, Hathersage Road, Manchester, M130JH, UK, Tel: +44 161 276 5469, Fax: +44 161 276 6134, E mail:
| | - Kathleen G Morgan
- Health Sciences Department, Sargent College, Boston University, 635 Commonwealth Avenue, Boston MA 02215, USA, Tel: 617-353-7464, Fax: 617-353-7567, E-mail:
| |
Collapse
|
13
|
Lartey J, Smith M, Pawade J, Strachan B, Mellor H, López Bernal A. Up-regulation of myometrial RHO effector proteins (PKN1 and DIAPH1) and CPI-17 (PPP1R14A) phosphorylation in human pregnancy is associated with increased GTP-RHOA in spontaneous preterm labor. Biol Reprod 2007; 76:971-82. [PMID: 17301291 DOI: 10.1095/biolreprod.106.058982] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
RHO GTP-binding proteins are important regulators of actin-myosin interactions in uterine smooth muscle cells. Active (GTP-bound) RHOA binds to RHO-associated protein kinase (ROCK1), which inhibits the myosin-binding subunit (PPP1R12A) of myosin light chain phosphatase, leading to calcium-independent increases in myosin light chain phosphorylation and tension, which are termed "calcium sensitization." The RHO effector protein kinase N (PKN1) also increases calcium sensitization by phosphorylating the protein kinase C (PRKCB)-dependent protein CPI-17 (PPP1R14A) to inhibit the PPP1c subunit of myosin phosphatase. Moreover, other RHO proteins, such as RHOB, RHOD, and their effectors (DIAPH1 and DIAPH2), may modulate PKN1/ ROCK1 signaling to effect changes in myosin phosphatase activity and myosin light chain phosphorylation. The increases in contractile activity observed in term and preterm labor may be due to an increase in RHO activity and/or changes in RHO-related proteins. We found that the RHOA and RHOB mRNA levels in the myometrium were increased in pregnancy, although the expression levels of the RHOA and RHOB proteins did not change with pregnancy or labor. GTP-bound RHOA was increased in pregnancy, and this increase was significant in spontaneous preterm labor myometrium. PKN1 expression and PPP1R14A phosphorylation were dramatically increased in the pregnant myometrium. We also observed increases in DIAPH1 expression in spontaneous term and preterm labor myometrial tissues. The present study shows that human pregnancy is characterized by increases in PKN1 expression and PPP1R14A phosphorylation in the myometrium. Moreover, increases in GTP-bound RHOA and DIAPH1 expression may contribute to the increase in uterine activity in idiopathic preterm labor.
Collapse
Affiliation(s)
- J Lartey
- Clinical Sciences at South Bristol, Division of Obstetrics and Gynaecology, Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Dorothy Hodgkin Building, University of Bristol, Bristol BS1 3NY, United Kingdom
| | | | | | | | | | | |
Collapse
|
14
|
Shimizu S, Tahara M, Ogata S, Hashimoto K, Morishige K, Tasaka K, Murata Y. Involvement of nuclear factor-kB activation through RhoA/Rho-kinase pathway in LPS-induced IL-8 production in human cervical stromal cells. Mol Hum Reprod 2007; 13:181-7. [PMID: 17227815 DOI: 10.1093/molehr/gal113] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Interleukin-8 (IL-8) is a chemokine that recruits and activates neutrophils in stromal tissue and plays an essential role in cervical ripening. Nuclear factor-kB (NF-kB) is known to be important for the up-regulation of IL-8 gene expression. We examined the molecular mechanisms responsible for NF-kB activation in IL-8 production in cervical stromal cells. Lipopolysaccharide (LPS) and IL-1beta stimulated IL-8 production by cervical stromal cells in a dose-dependent manner. Pretreatment of cervical stromal cells with inhibitors of RhoA (C3 transferase exoenzyme), Rho-kinase (Y-27632) or NF-kB (BAY11-7082) effectively blocked LPS-induced IL-8 release. In contrast, IL-1beta-induced IL-8 production was significantly blocked by BAY11-7082, but not by C3 transferase exoenzyme or Y-27632. Pull-down assays showed that LPS activated RhoA, but IL-1beta caused only a lower level of activation. Transfection of the cervical stromal cells with RhoA small interfering RNA (siRNA) inhibited LPS-stimulated IL-8 production, whereas IL-1beta-induced IL-8 production was not significantly inhibited by knockdown of RhoA with siRNA. Using an NF-kB transcription reporter vector, luciferase assays demonstrated that incubation with LPS or IL-1beta induced the activation of NF-kB in cervical stromal cells. Activation of NF-kB by LPS was inhibited by treatment with C3 exoenzyme, Y-27632 or RhoA siRNA. However, inhibition of the RhoA/Rho-kinase pathway did not attenuate the activation of NF-kB by IL-1beta. These results suggest that LPS-induced IL-8 production is accompanied by enhanced NF-kB activation through the RhoA/Rho-kinase pathway in human cervical cells.
Collapse
Affiliation(s)
- Shoko Shimizu
- Osaka University Graduate School of Medicine, Department of Obstetrics and Gynecology, Osaka, Japan
| | | | | | | | | | | | | |
Collapse
|
15
|
Lartey J, Gampel A, Pawade J, Mellor H, Bernal AL. Expression of RND proteins in human myometrium. Biol Reprod 2006; 75:452-61. [PMID: 16554414 DOI: 10.1095/biolreprod.105.049130] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
RHO GTPases are key regulators of the actin cytoskeleton and stress fiber formation. In the human uterus, activated RHOA forms a complex with RHO-associated protein kinase (ROCK) which inhibits myosin light chain phosphatase (PPP1R12A), causing a calcium-independent increase in myosin light chain phosphorylation and tension (Ca2+ sensitization). Recently discovered small GTP binding RND proteins can inhibit RHOA and ROCK interaction to reduce calcium sensitization. Very little is known about the expression of RND proteins in the human uterus. We tested the hypothesis that the uterine quiescence observed during gestation is mediated by an increase in RND protein expression inhibiting RHOA-ROCK-mediated PPP1R12A phosphorylation. Immunohistochemistry and immunoblotting were used to determine RHOA and RND protein expression and localization in nonpregnant, pregnant nonlaboring, and laboring patients at term and patients in spontaneous preterm labor. Changes in protein expression estimated by densitometry between different patient groups were measured. A significant increase of RND2 and RND3 protein expression was observed in pregnant relative to nonpregnant myometrium associated with a loss of PPP1R12A phosphorylation. RND transfected myometrial cells demonstrated a dramatic loss of stress fiber formation and a "rounding" phenotype. RND upregulation in pregnancy may inhibit RHOA-ROCK-mediated increase in calcium sensitization to facilitate the uterine quiescence observed during gestation.
Collapse
Affiliation(s)
- J Lartey
- Division of Obstetrics and Gynaecology, Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Clinical Sciences at South Bristol, University of Bristol, Bristol, BS1 3NY, United Kingdom
| | | | | | | | | |
Collapse
|