Welsh Toni N, Hirst Jonathan J, Palliser Hannah, Zakar Tamas
Department of Obstetrics and Gynaecology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Mothers and Babies Research Centre, New Lambton Heights, New South Wales, Australia.
School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia; Mothers and Babies Research Centre, New Lambton Heights, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
PLoS One. 2014 Aug 26;9(8):e105253. doi: 10.1371/journal.pone.0105253. eCollection 2014.
Progesterone withdrawal is essential for parturition, but the mechanism of this pivotal hormonal change is unclear in women and other mammals that give birth without a pre-labor drop in maternal progesterone levels. One possibility suggested by uterine tissue analyses and cell culture models is that progesterone receptor levels change at term decreasing the progesterone responsiveness of the myometrium, which causes progesterone withdrawal at the functional level and results in estrogen dominance enhancing uterine contractility. In this investigation we have explored whether receptor mediated functional progesterone withdrawal occurs during late pregnancy and labor in vivo. We have also determined whether prostaglandins that induce labor cause functional progesterone withdrawal by altering myometrial progesterone receptor expression. Pregnant guinea pigs were used, since this animal loses progesterone responsiveness at term and gives birth in the presence of high maternal progesterone level similarly to primates. We found that progesterone receptor mRNA and protein A and B expression decreased in the guinea pig uterus during the last third of gestation and in labor. Prostaglandin administration reduced while prostaglandin synthesis inhibitor treatment increased progesterone receptor A protein abundance. Estrogen receptor-1 protein levels remained unchanged during late gestation, in labor and after prostaglandin or prostaglandin synthesis inhibitor administration. Steroid receptor levels were higher in the non-pregnant than in the pregnant uterine horns. We conclude that the decreasing expression of both progesterone receptors A and B is a physiological mechanism of functional progesterone withdrawal in the guinea pig during late pregnancy and in labor. Further, prostaglandins administered exogenously or produced endogenously stimulate labor in part by suppressing uterine progesterone receptor A expression, which may cause functional progesterone withdrawal, promote estrogen dominance and foster myometrial contractions.
孕酮撤退对于分娩至关重要,但在分娩时母体孕酮水平无产前下降的女性和其他哺乳动物中,这一关键激素变化的机制尚不清楚。子宫组织分析和细胞培养模型提出的一种可能性是,足月时孕酮受体水平发生变化,降低了子宫肌层对孕酮的反应性,这在功能水平上导致孕酮撤退,并导致雌激素占主导地位,增强子宫收缩力。在本研究中,我们探讨了受体介导的功能性孕酮撤退是否在体内妊娠晚期和分娩期间发生。我们还确定了诱导分娩的前列腺素是否通过改变子宫肌层孕酮受体表达导致功能性孕酮撤退。使用了怀孕的豚鼠,因为这种动物在足月时失去孕酮反应性,并且在高母体孕酮水平下分娩,这与灵长类动物相似。我们发现,在妊娠最后三分之一期间和分娩时,豚鼠子宫中孕酮受体mRNA以及蛋白A和B的表达降低。给予前列腺素会使其降低,而前列腺素合成抑制剂治疗会增加孕酮受体A蛋白的丰度。在妊娠晚期、分娩期间以及给予前列腺素或前列腺素合成抑制剂后,雌激素受体-1蛋白水平保持不变。非孕子宫角中的类固醇受体水平高于孕子宫角。我们得出结论,孕酮受体A和B表达的降低是豚鼠在妊娠晚期和分娩期间功能性孕酮撤退的一种生理机制。此外,外源性给予或内源性产生的前列腺素部分通过抑制子宫孕酮受体A的表达来刺激分娩,这可能导致功能性孕酮撤退,促进雌激素占主导地位并促进子宫肌层收缩。