Gestational changes in the utilization of intracellularly stored calcium in the myometrium of guinea-pigs

Are animal models relevant to key aspects of human parturition?

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.

Preterm labour. Myometrial function in prematurity

The primary function of the uterus during gestation is to harbour the growing conceptus in a largely quiescent environment. Upon maturation of the fetus to a point sufficient for extrauterine survival, the uterus must remodel itself sufficiently to generate forceful contractions during labour. During preterm delivery, the process of remodelling of the myometrium occurs early due to a number of different causes, although the underlying basis for myometrial contraction remains the same. This review summarises the anatomical, physiological and molecular basis for contraction. We describe the fibre structure of the human uterus and how this relates to the spread of electrical excitation during a contraction. The process of excitation within a single myometrial cell is described, as well as how this relates to contraction. We then focus on how excitation-contraction coupling is modulated by intercellular communication, pharmacomechanical-coupling and hormonal milieu. Lastly, we consider the actions of the commonly accepted uterine agonists oxytocin, prostaglandin F(2alpha), and prostaglandin E(2), and the tocolytic ritodrine.

Long-term hypoxia alters calcium regulation in near-term ovine myometrium

Previous studies showed that long-term hypoxia (LTH) during pregnancy alters myometrial contractility. The present study was designed to test the hypothesis that LTH during pregnancy suppresses myometrial contractility in sheep by affecting the calcium signaling cascade. Pregnant sheep were maintained at high altitude (3820 m) from Day 30 to Day 139 of gestation, when the animals were killed for collection of myometrial tissue. Tissue was also collected from age-matched, normoxic controls. Circular and longitudinal layers were separated, and strips from each layer were mounted in a muscle bath. After pretreatment with 10(-8) M oxytocin, the strips were exposed to increasing half- or quarter-log doses of nifedipine (L-type calcium-channel blocker), ruthenium red, ryanodine (blockers of inositol 1,4,5-trisphosphate-insensitive calcium stores), or 2-nitro-4-carboxyphenyl-N,N-diphenylcarbamate (NCDC; phospholipase C inhibitor). Area under the contraction curve was analyzed, and pD(2) (log of concentration yielding 50% of maximum response) values and maximum relaxation responses were calculated. The maximum relaxation response to nifedipine was increased in both longitudinal (P < 0.01) and circular (P < 0.05) myometrial layers from LTH compared to control tissue, whereas no difference was observed in response to ruthenium red or ryanodine. The maximum relaxation response to NCDC was lower in the LTH circular layer (P < 0.05). Together, these data are indicative of an increase in the dependence of ovine uterine smooth muscle on extracellular calcium influx through the L-type, voltage-gated calcium channels following LTH. This appears to occur not through an increase in L-type calcium channels but, rather, through a possible decline in importance of the oxytocin-induced, phospholipase C-mediated pathway, resulting in a greater proportion of extracellular calcium contributing to contraction. Layer-dependent differences also exist between the circular and longitudinal myometrium in response to phospholipase C inhibition.

Changes in the mechanisms involved in uterine contractions during pregnancy in guinea-pigs

1. The mechanisms involved in contraction in guinea-pig myometrium were compared at mid- and late pregnancy. Tension was recorded simultaneously with either membrane potential or cytoplasmic calcium ([Ca2+]i) in strips exposed briefly to prostaglandin F2alpha (PGF). 2. PGF-induced increases in tension were underpinned by action potentials followed by sustained depolarization and biphasic increases in [Ca2+]i at mid- (peak, 879 +/- 199 nM; sustained, 298 +/- 35 nM, n = 11) and late pregnancy (peak, 989 +/- 302 nM; sustained 178 +/- 33 nM, n = 8). 3. At mid- and late pregnancy, nifedipine (10-6 M) reduced (a) the PGF-induced increase in tension to 84 and 35 %, (b) the level attained during the depolarization by 2 and 12 mV and (c) the peak rise in [Ca2+]i to 42 and 17 %. The sustained rises in [Ca2+]i were resistant to nifedipine. 4. In Ca2+-free solution (containing 1 mM EGTA), PGF elicited an increase in tension that was 26 % of that in 2.5 mM Ca2+ and an increase in [Ca2+]i (24 % of the sustained level) at mid-pregnancy but no increase in tension or [Ca2+]i at term. 5. At both stages of pregnancy, PGF decreased the level of [Ca2+]i required to elicit increases in tension comparable to those evoked by high K+o. The slope of the tension-[Ca2+]i curves were steeper in mid- than in late pregnancy. 6. In conclusion, at mid-pregnancy, the contractile response of the guinea-pig myometrium to PGF involves Ca2+ influx through L-type voltage-operated Ca2+ channels (VOCCs) and by receptor-operated mechanisms, release of Ca2+ from intracellular stores, and an increase in the sensitivity of the contractile apparatus to Ca2+. At term the situation is different: a modest increase in the sensitivity of the contractile apparatus to Ca2+ persists and there is a major reliance on Ca2+ influx through VOCCs.

Intracellular calcium stores and agonist-induced contractions in isolated human myometrium

OBJECTIVE

We hypothesized that the release of calcium from intracellular stores contributes to the contractions produced by the agonists oxytocin, carbachol, and prostaglandin F(2 )(alpha ) in human myometrium.

STUDY DESIGN

Strips of myometrium were obtained at cesarean section and hysterectomy. The strips were loaded with the calcium-sensitive dye Indo-1 to enable simultaneous measurement of tension and intracellular calcium levels. Agonist-induced responses in the presence and absence of extracellular calcium were studied.

RESULTS

Strips of myometrium were obtained from 48 women not in labor undergoing cesarean section and 6 women not pregnant undergoing hysterectomy. An increase in intracellular calcium level after agonist stimulation invariably preceded an increase in tension. Intracellular calcium level returned to baseline before myometrial relaxation. Oxytocin, carbachol, and prostaglandin F(2)(alpha) all gave both force and intracellular calcium responses in the absence of extracellular calcium, although both these responses were only 26% to 40% of the maximal response when extracellular calcium was present.

CONCLUSIONS

Release of calcium from internal stores induced by oxytocin, carbachol, and prostaglandin F(2)(alpha) may contribute to agonist-induced myometrial force production.

Hyperpolarization and slowing of the rate of contraction in human uterus in pregnancy by prostaglandins E2 and f2alpha: involvement of the Na+ pump

1. The effects of prostaglandins E2 (PGE) and F2alpha (PGF) on membrane potential and isometric tension and cytoplasmic free calcium concentration ([Ca2+]i) and tension were studied in strips of uterine smooth muscle obtained from women undergoing Caesarean delivery at term and during established labour. 2. Prostaglandins (PGs) evoked a biphasic response. The excitatory component consisted of depolarization of the membrane, which initiated spike action potentials, an increase in [Ca2+]i and tension development. The membrane remained depolarized at -19 +/- 1 mV for about 2 min, then repolarized abruptly, [Ca2+]i promptly returned to basal levels, and tension development ceased. 3. This component of the response to PGE or PGF was followed by a slow hyperpolarization which reached -85 +/- 2 mV (n = 22) at term and -70 +/- 2 mV (n = 9) during labour, and during which spontaneous action potentials and tension development did not occur. 4. Nifedipine (10-6 M) abolished spontaneous activity, abolished PG-induced action potentials and reduced the increase in [Ca2+]i (9 +/- 3 %, n = 6), the depolarization (10 +/- 1 mV, n = 14), the tension (2 +/- 1 %, n = 14) and the hyperpolarization (9 +/- 1 mV, n = 14, at term). 5. A variety of K+ channel blockers were without effect on the peak amplitude of the PG-induced hyperpolarization but the latter did not occur in the presence of ouabain (10-6 M) or in K+-free or low-Na+ solutions, suggesting an involvement of the Na+-K+-ATPase pump. 6. In conclusion, a substantial dependence on Ca2+ influx through voltage-operated Ca2+ channels accounts for the importance of membrane potential in regulating contractions in human uterine smooth muscle. The classical excitatory effect of PGE and PGF is followed by hyperpolarization involving the Na+-K+-ATPase pump. The hyperpolarization restricts the response to a single contraction and decreases the frequency of subsequent contractions. The amplitude of the hyperpolarization decreases during labour, allowing contraction frequency to increase. Its persistence at this time ensures complete relaxation between each single robust contraction, preventing spasm of the uterus that would restrict blood flow to the fetus during delivery.

Ethanol and parturition: a role for prostaglandins

A common pattern of birth defects was reported in children born to alcoholic women over 20 years ago. Shortly thereafter the constellation of defects became known as the Fetal Alcohol Syndrome, and reports from around the world served to acknowledge the pervasiveness of the disorder. Simultaneously with the clinical reports, animal models were developed to characterize the full spectrum of the teratogenic effects of ethanol. Not only did these animal models serve to define the actions of ethanol on fetal growth and development at the molecular pharmacological, neuroanatomical, and behavioral level, but unintentionally, they have resulted in renewed scientific interest in the effects of ethanol on pregnancy and parturition itself. The purpose of this review is twofold. First we will consolidate and summarize data from both clinical and basic research that pertains to ethanol and parturition. These data will demonstrate that ethanol consumption during pregnancy results in both delayed as well as premature delivery depending upon the pattern of consumption and timing of exposure. With these data as a background, the second objective will be to present a theoretical case for prostaglandins as possible mediators of ethanol-induced effects on the onset of parturition.

Agonist mobilization of sarcoplasmic reticular calcium in smooth muscle: functional coupling to the plasmalemmal Na+/Ca2+ exchanger?

There is a close association of peripheral sarcoplasmic reticulum (SR), containing IP3 receptors, and regions of the plasma membrane enriched in the Na+/Ca2+ exchanger in smooth muscle. We have tested the possibility in rat uterine smooth muscle that Ca2+ released from the SR is preferentially removed from the cytosol by the Na+/Ca2+ exchanger. In Ca(2+)-free solution, carbachol stimulation of myometria of non-pregnant rats resulted in transient increases in [Ca2+]i and force due entirely to the release of SR Ca2+. Inhibition of Na+/Ca2+ exchange by removal of extracellular Na+ did not alter the agonist-induced transients suggesting that Na+/Ca2+ exchange was not involved in the removal of SR released Ca2+. However, in myometria of pregnant rats, Na+/Ca2+ exchange inhibition resulted in changes in the agonist-induced [Ca2+]i transient profiles. The peak amplitude, duration and integral of carbachol-induced [Ca+]i transients were enhanced in Ca(2+)-free/Na(+)-free solution without significantly affecting force transients. The lower rate of decay of [Ca2+]i transients in Na(+)-free solution leads us to suggest that up to 35% of the SR released Ca2+ may be extruded by the Na+/Ca2+ exchanger in myometria of pregnant rats. Thus, in uterine smooth muscle, there is a gestational-dependent coupling of SR releasable Ca2+ and plasmalemmal Na+/Ca2+ exchange activity.

Effects of cyclopiazonic acid on rhythmic contractions in uterine smooth muscle bundles of the rat

1. We studied the effects of cyclopiazonic acid (CPA) on rhythmic contractions and on Ca2+ uptake by the intracellular stores in longitudinal muscle strips of the rat uterus at 30 degrees C. 2. Oxytocin (1 microM) in Ca(2+)-free solution induced a transient rise in the intracellular Ca2+ concentration ([Ca2+]i) and contraction after Ca2+ loading of the stores in high-K(+)- and Ca(2+)-containing solution. CPA inhibited oxytocin-induced Ca2+ release and contraction, the half and full inhibitory concentrations of CPA being 0.3 and 10 microM, respectively. In contrast, addition of CPA after Ca2+ loading exerted no significant inhibitory effects. 3. Oxytocin (10 nM) applied in Ca(2+)-containing solution induced rhythmic increases in both force and [Ca2+]i. CPA (10 microM) had no effect on oxytocin-induced rhythmic contractions. 4. At a high concentration (300 microM), CPA inhibited the rhythmic contractions induced by 10 nM oxytocin; the frequency and the peak height were decreased, and in many bundles contractions were completely abolished. These inhibitory effects were reversed after CPA washout. 5. CPA (300 microM) inhibited the rate of rise of [Ca2+]i due to depolarization induced by high-K(+)-containing solution. 6. These results suggest that low concentrations of CPA inhibit the loading of Ca2+ into intracellular stores in intact tissue strips, and that the Ca2+ stores are not directly involved in the uterine rhythmic contractions. It is also suggested that a high concentration of CPA inhibits the mechanism that is responsible for the generation of rhythmic contractions as well as voltage-dependent Ca2+ channels.

Uterine contraction and physiological mechanisms of modulation

Control of the smooth muscle in the uterus (the myometrium), is of vital importance during pregnancy and parturition. It is therefore understandable that several physiological mechanisms (neuronal, hormonal, metabolic, and mechanical) play a role in the control of myometrial activity. As our knowledge of the mechanism of uterine contraction has increased much in recent years, it is now possible to begin to explain, in some detail, how the contractile activity may be modulated. A detailed account of the mechanism of contraction in the uterus is therefore given, followed by examples of modulation of this process for each of the four physiological methods listed above. Examples have been chosen to illustrate either general or particular mechanisms of modulation. The goal of many working in this field is to understand these processes and thus prevent preterm labor and uterine dysfunction in term labor, which are still significant clinical problems.

Gestational change in Na+ and Ca2+ channel current densities in rat myometrial smooth muscle cells

The change of Na+ and Ca2+ channel currents during gestation was investigated using the whole cell voltage-clamp method on single smooth muscle cells freshly isolated from the longitudinal layer of pregnant rat uterus. The current-voltage relationships for both the Na+ and Ca2+ currents did not change during gestation. The threshold voltage, the voltage at the peak inward current, and the reversal potential (extrapolated) were virtually identical. The averaged current densities of Ca2+ channel were almost unchanged between days 9 and 21; this value at day 5 was somewhat lower. In contrast, the averaged current density of fast Na+ channels increased markedly in the myometrium during gestation: from 0 at day 5 to 0.19 +/- 0.16 at day 9, to 0.56 +/- 0.13 at day 14, to 0.90 +/- 0.13 at day 18, and to 0.86 +/- 0.14 pA/pF at day 21. This almost linear increase in the averaged density of fast Na+ channels during gestation occurs because of an increase in the fraction of cells which possessed fast Na+ channels. These results suggest that the role of fast Na+ channels in myometrial activity becomes more and more important as term approaches. We suggest that the fast Na+ current may be involved in spread of excitation.

Pregnancy suppresses G protein coupling to phosphoinositide hydrolysis in guinea pig myometrium

The regulatory factors controlling uterine contractile activity during pregnancy remain unclear, although pathways modulating intracellular Ca2+ and prostaglandin production play an important role. Because excitatory hormones raise myometrial Ca2+ levels and prostaglandin output through increasing phosphoinositide hydrolysis, regulation of G protein coupling to phospholipase C activation could be a key site for control. To measure the functional activity of this signaling pathway, we measured formation of [3H]inositol phosphates from prelabeled guinea pig myometrial membranes in response to G protein activation by guanosine 5'-[gamma-thio]triphosphate (GTP gamma S) and fluoride. Although these agents stimulated a three- to fivefold increase in phosphoinositide phospholipase C activity in nonpregnant myometrium, at 46-47, 53-60, and 66-69 days of pregnancy (full term 67 +/- 2 days) this response fell by 43-83%. Moreover, the half-maximal effective dose (ED50) for GTP gamma S action was increased from 8.11 +/- 0.91 nM (n = 5) in the nonpregnant state to 307.4 +/- 142.3 (n = 9) and 209.7 +/- 155.1 nM (n = 8) at 53-60 and 66-69 days, respectively. Because phospholipase C levels displayed only a limited fall (28%) whether measured by direct Ca2+ activation or by immunoblotting, this study indicates a considerable suppression of G protein functional coupling to myometrial phosphoinositide hydrolysis throughout late gestation. Such a desensitization is likely to contribute to reports of diminished contractile sensitivity during pregnancy and to reflect an essential regulatory event in the processes maintaining uterine quiescence in pregnant guinea pig.

Induction of prolonged excitability in myometrium of pregnant guinea-pigs by prostaglandin F2 alpha

1. Electrical and mechanical responses to prostaglandin F2 alpha (PGF) were studied in circular myometrium, with or without endometrium, during the first 3 weeks of gestation of the guinea-pig. 2. Muscle strips from which endometrium had been removed became inexcitable within 30-40 min of isolation from the animal such that action potentials and contraction could not be initiated by depolarizing current steps. Raising the concentration of potassium in the perfusing solution resulted in a small contraction. 3. In these preparations PGF induced complex action potentials that consisted of spikes and a prolonged plateau of depolarization. Each action potential was associated with a large phasic contraction. 4. Contractions induced by PGF are unlikely to result predominantly from release of calcium from intracellular stores since the ability of the agonist to evoke a response was reduced by some 97% in the absence of external calcium or in the presence of calcium channel blockers. 5. When preceded by a brief exposure to PGF, the contractile response to high potassium was enhanced to equal that in response to PGF. Enhancement persisted for approximately 30 min after removal of PGF and was not dependent upon the presence of external calcium. 6. Muscle strips with intact endometrium contracted spontaneously for hours. Each contraction was associated with a complex action potential, both of which were abolished by indomethacin. 7. It is concluded that PGF transforms inexcitable calcium channels in the membrane of the smooth muscle cells of the circular myometrium into excitable ones. The study also suggests that endogenous prostaglandin of endometrial origin may prevent the 'run-down' of channels in vivo.