Riemer R K, Heymann M A
Department of Surgery, University of California, San Francisco 94143-0118, USA.
Pediatr Res. 1998 Nov;44(5):615-27. doi: 10.1203/00006450-199811000-00001.
The uterus is unique among smooth muscular organs in that, during pregnancy, it undergoes profound, largely reversible, changes orchestrated by the ovarian hormones. These changes facilitate uterine adaptation to the stretch induced by the growing fetus such that a state of myometrial contractile quiescence can be maintained. This quiescent state usually is maintained until fetal development is sufficient for extrauterine life, at which point unknown mechanisms precipitate conversion to a highly contractile state. Throughout pregnancy, signaling mechanisms for myometrial contractility are altered--first to promote quiescence and then again to promote contractions. The mechanisms responsible for these changes are only partially understood. This review attempts to summarize salient features of many of the changes in uterine contractile signaling and the current state of ongoing investigations of their mechanisms. We have also highlighted some newer information and concepts from nonuterine tissues, which we believe may provide insight into the control of uterine smooth muscle function. Some detail has been omitted, and can be found in the many excellent reviews cited. We hope that this discussion may stimulate the interests of other investigators. The diverse areas of inquiry offer hope that this decade will lead to a fuller understanding of myometrial function and the development of vastly improved approaches for the control of preterm labor.
子宫在平滑肌器官中独具特色，在于在妊娠期间，它会经历由卵巢激素精心编排的深刻且在很大程度上可逆的变化。这些变化有助于子宫适应胎儿生长所引发的拉伸，从而维持子宫肌层收缩静止状态。这种静止状态通常会维持到胎儿发育足以适应宫外生活时，此时未知机制会促使其转变为高度收缩状态。在整个妊娠期间，子宫肌层收缩的信号传导机制会发生改变——首先促进静止，然后再次促进收缩。导致这些变化的机制仅得到部分理解。本综述试图总结子宫收缩信号诸多变化的显著特征以及当前对其机制研究的现状。我们还强调了来自非子宫组织的一些新信息和概念，我们认为这些可能为子宫平滑肌功能的控制提供见解。部分细节已省略，可在引用的众多优秀综述中找到。我们希望此次讨论能激发其他研究者的兴趣。众多不同的研究领域带来了希望，即这十年将促成对子宫肌层功能更全面的理解，并开发出控制早产的大幅改进方法。
