The constitutively active orphan G-protein-coupled receptor GPR39 protects from cell death by increasing secretion of pigment epithelium-derived growth factor

GPR39 is a constitutively active orphan G-protein-coupled receptor capable of increasing serum response element-mediated transcription. We found GPR39 to be up-regulated in a hippocampal cell line resistant against diverse stimulators of cell death and show that its overexpression protects against oxidative and endoplasmic reticulum stress, as well as against direct activation of the caspase cascade by Bax overexpression. In contrast, silencing GPR39 rendered cells more susceptible to cell death. An array analysis of transcripts induced by GPR39 revealed up-regulation of RGS16 (inhibitor of G-protein signaling 16), which suggested coupling to Galpha(13) and induction of serum response element-mediated transcription by the small GTPase RhoA. In line with this, co-expression of GPR39 with RGS16, dominant-negative RhoA, or serum response factor abolished cell protection, whereas overexpression of the serum response factor protected from cell death. Further downstream the signaling cascade, GPR39 overexpression leads to increased secretion of the cytoprotective pigment epithelium-derived growth factor (PEDF). Medium conditioned by cells overexpressing GPR39 contained 4-fold more PEDF, and when stripped off it lost most but not all of its protective properties. We conclude that GPR39 is a novel inhibitor of cell death, which might represent a therapeutic target with implications for processes involving apoptosis and endoplasmic reticulum stress like cancer, ischemia/reperfusion injury, and neurodegenerative disease.

[Psychologic effects of traumatic live deliveries]

OBJECTIVES

Traumatically experienced childbirth can lead to serious psychological disturbances postpartum. Dependent upon objective and subjective factors, some women may even develop the symptomatology of a posttraumatic stress disorder (PTSD). The aim of a pilot study was the evaluation of the frequency of traumatically experienced childbirth, of the effects of these traumatic experiences and possible risk factors for the development of PTSD.

STUDY DESIGN

976 women, who had given birth at the Bonn University Women's Hospital during 1997/1998, were retrospectively questioned regarding their experiences with pregnancy, childbirth and postpartum. 46 women, who described relevant psychological symptoms after childbirth, were personally interviewed.

RESULTS

424 women returned the completed questionnaire. 17.2% of the women reported anxiety postpartum, 9.4% depressive symptoms, 12% a mental re-experience of delivery within the first weeks postpartum, 3.8% were still suffering from these intrusions at the time of the study. In the first weeks after labor, nightmares were reported in 3.1%. In 4 cases, the full criteria for a PTSD were met. In 10 further cases, a subsyndromal form of this disorder was found. The case analysis showed that the development of PTSD symptoms was influenced by factors such as expectations, need for control, sense of shame and previous traumatic experiences.

CONCLUSIONS

Psychological symptoms postpartum were reported frequently. Traumatically experienced childbirth can be responsible for specific short-term or long-term symptoms. In individual cases, a PTSD can develop after a traumatic delivery with long-term negative consequences for the health and mental condition of the mother, the mother-child-relationship and the desire for further pregnancy. In such cases, a specific psychotherapeutic treatment is always necessary.