Buhimschi Catalin S, Garfield Robert E, Weiner Carl P, Buhimschi Irina A
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT 06520, USA.
Am J Obstet Gynecol. 2004 Jan;190(1):268-74. doi: 10.1016/j.ajog.2003.07.006.
Cyclic nucleotide phosphodiesterases (PDEs) are a diverse enzyme group with multiple regulatory properties and wide tissue distribution. Such activity includes cyclic adenosine (cAMP) and guanosine monophosphate (cGMP) breakdown. The type 5 isoform (PDE-5, cGMP specific) is the target of specific antagonists (ie, sildenafil, Viagra). We tested the hypothesis that PDE-5 is present in rat myometrium and modulates myometrial activity.
Full-thickness uterine wall was collected from nonpregnant (n=3) and pregnant Sprague-Dawley rats on days 10 (n=4), 17 (n=6), 22 nonlabor (n=5), and 22 during term labor (TL, n=4). Preterm labor (PTL, n=3) was induced in some animals on day 16 with 15 mg/kg mifepristone (RU 486). Tissue samples were prepared for Western blotting using a monoclonal antibody against rodent PDE-5. In a second series, cumulative doses of sildenafil (0.005, 0.05, 0.5, 5 mg/kg, intraperitoneal) were administered and the effect on uterine contractility recorded in vivo during term (TL, n=7) and preterm labor (PTL, n=6). Saline solution-injected rats provided temporal control. Uterine contractility was estimated from intrauterine pressure (IP) measured electronically with a sensor tip pressure catheter. Heart rate was recorded simultaneously using electrodes attached to the chest and connected to the same data acquisition system.
PDE-5 immunoreactivity was present in the nonpregnant rat uterus and at all gestational times studied, although the expression was unaffected by either pregnancy or the state of labor (preterm or term). A dominant antibody-specific band was identified at 86 kd in the uterine samples, contrasting with lung where the 100-kd PDE-5 isoform was most abundant. Two additional lower molecular weight (55 and 32 kd) bands were also identified as antibody specific. Despite the lack of change in PDE-5 during pregnancy, sildenafil reduced IP during TL and PTL beginning at 0.5 mg/kg. The highest dose of sildenafil reduced IP during both TL and PTL by 45% and 59% of baseline, respectively (two-way analysis of variance, P<.01). This effect was not accompanied by changes in heart rate.
PDE-5 is constitutively present in the rat uterine wall. There was no observed change in the PDE-5 protein expression throughout pregnancy. In contrast to the lung, the uterus expresses an 80-kd PDE-5 isoform. Sildenafil in pharmacologic doses inhibits mechanical uterine activity and might be of benefit if selectively used for treatment of preterm labor.
环核苷酸磷酸二酯酶(PDEs)是一组具有多种调节特性且广泛分布于组织中的酶。其活性包括环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP)的分解。5型同工酶(PDE - 5,特异性作用于cGMP)是特定拮抗剂(即西地那非,伟哥)的作用靶点。我们检验了PDE - 5存在于大鼠子宫肌层并调节子宫肌层活性这一假说。
从非孕(n = 3)以及妊娠第10天(n = 4)、17天(n = 6)、22天未临产(n = 5)和22天足月临产(TL,n = 4)的妊娠Sprague - Dawley大鼠中采集全层子宫壁。部分动物在第16天用15 mg/kg米非司酮(RU 486)诱导早产(PTL,n = 3)。使用抗啮齿动物PDE - 5的单克隆抗体制备组织样本用于蛋白质印迹分析。在第二个系列实验中,腹腔注射累积剂量的西地那非(0.005、0.05、0.5、5 mg/kg),并记录其对足月(TL,n = 7)和早产(PTL,n = 6)时子宫收缩力的影响。注射生理盐水的大鼠作为时间对照。通过用传感器尖端压力导管电子测量子宫内压力(IP)来估计子宫收缩力。使用连接到胸部并与同一数据采集系统相连的电极同时记录心率。
在非孕大鼠子宫以及所有研究的妊娠时期均存在PDE - 5免疫反应性,尽管其表达不受妊娠或分娩状态(早产或足月产)的影响。在子宫样本中鉴定出一条86 kd的主要抗体特异性条带,与之形成对比的是,在肺中100 kd的PDE - 5同工型最为丰富。另外两条分子量较低(55和32 kd)的条带也被鉴定为抗体特异性条带。尽管妊娠期间PDE - 5没有变化,但西地那非从0.5 mg/kg开始可降低足月产和早产时的子宫内压力。西地那非的最高剂量分别使足月产和早产时的子宫内压力降低至基线的45%和59%(双向方差分析,P <.01)。这种作用并未伴有心率变化。
PDE - 5在大鼠子宫壁中持续存在。在整个妊娠期间未观察到PDE - 5蛋白表达的变化。与肺不同,子宫表达一种80 kd的PDE - 5同工型。药理剂量的西地那非可抑制子宫机械活动,如果选择性用于治疗早产可能有益。