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-induced rises in uterine blood flow in ovine
pregnancy
1 Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9063; and 2 Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55455
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ABSTRACT |
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Uterine blood flow (UBF) increases >30-fold
during ovine pregnancy. During the last trimester, this reflects
vasodilation, which may be due to placentally derived estrogens. In
nonpregnant ewes, estradiol-17
(E2
) increases UBF
>10-fold by activating nitric oxide synthase and large conductance
calcium-dependent potassium channels (BKCa). To determine
whether BKCa channels modulate basal and
E2
-induced increases in UBF, studies were performed in
near-term pregnant ewes with uterine artery flow probes and catheters
for intra-arterial infusions of tetraethylammonium (TEA), a selective
BKCa channel antagonist at <1 mM, in the absence or
presence of E2
(1 µg/kg iv). Uterine arteries were
collected to measure BKCa channel mRNA. TEA (0.15 mM)
decreased basal UBF (P < 0.0001) 40 ± 8% and
55 ± 7% (n = 11) at 60 and 90 min, respectively, and increased resistance 175 ± 48% without affecting
(P > 0.1) mean arterial pressure (MAP), heart rate, or
contralateral UBF. Systemic E2
increased UBF 30 ± 6% and heart rate 13 ± 1% (P
0.0001, n = 13) without altering MAP. Local TEA (0.15 mM)
inhibited E2
-induced increases in UBF without affecting
increases in heart rate (10 ± 4%; P = 0.006).
BKCa channel mRNA was present in uterine artery myocytes
from pregnant and nonpregnant ewes. Exponential increases in ovine UBF
in late pregnancy may reflect BKCa channel activation,
which may be mediated by placentally derived estrogens.
estradiol-17
; sheep; smooth muscle
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INTRODUCTION |
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PREGNANCY IS A UNIQUE PHYSIOLOGICAL state responsible for propagation of the species. Normal mammalian pregnancy is associated with increases in cardiac output and heart rate, a fall in systemic vascular resistance, and the redistribution of cardiac output (27). Uterine blood flow (UBF) increases from 3-5% of cardiac output to 20-25% at term, and it is the >30-fold rise in UBF that ensures normal fetal growth, development, and well-being (26, 27, 29). The rise in UBF occurs in three phases (34). The first is considered to be preimplantation and is due to vasodilation in all uterine tissues and endometrial neovascularization (25, 34). The second phase is associated with development and growth of the maternal and fetal placental circulations and, in the ovine species, is predominantly due to neovascularization and angiogenesis (26, 34, 44). The final phase occurs in the last third of gestation, during which time UBF rises exponentially, increasing three- to fourfold over 40 days (26, 27, 29, 34), and is essential for the increased delivery of oxygen and nutrients necessary for the parallel exponential increase in fetal size that occurs during this time (26, 29, 34). In morphometric studies, Teasdale (44) demonstrated this final rise in UBF in ovine pregnancy was predominantly due to progressive placental vasodilation, which is also likely to be true in women because there is no further anatomic development of the maternal placental circulation during the last trimester (26, 29). It also accounts for the marked redistribution of UBF previously observed (16, 28). The mechanisms responsible for uteroplacental vasodilation in the last third of pregnancy remain a mystery.
A growing body of evidence suggests that increases in vascular nitric
oxide (NO) synthase (NOS) and thus NO may play an important role in the
cardiovascular changes in pregnancy (41). Increases in
uterine artery NOS may also play a pivotal role in the uterine vascular
changes that normally occur in pregnancy (15, 41, 50),
whereas local vascular prostaglandins do not appear to be involved
(14, 19). For example, uterine cGMP synthesis increases
38-fold in pregnancy compared with the nonpregnant (30), and uterine artery endothelial NOS (eNOS) expression increases three-
to fourfold (15, 50). The increases in uterine artery NOS
expression may be due to increases in local placental estrogen synthesis because estradiol-17
(E2
) increases type
III (eNOS) and type I (neuronal NOS) NOS in the uterine arteries of
nonpregnant ewes (39, 46), which parallel increases in
uterine cGMP production and UBF (30, 39). Moreover,
E2
-induced increases in UBF are dose dependently
inhibited by local infusions of
NG-nitro-L-arginine
methyl ester (L-NAME), a nonspecific NOS
antagonist (30, 47). However, in pregnant ewes, short-term
L-NAME infusions decrease basal uteroplacental production
of cGMP without altering UBF (30). We recently reported
that systemic E2
not only increases uterine artery NOS
expression in nonpregnant ewes (39) but also increases the
opening potential of large conductance calcium-dependent potassium
channels (BKCa) in uterine artery myocytes
(35). Furthermore, local infusions of tetraethylammonium
chloride (TEA), a BKCa channel-selective antagonist at
submillimolar concentrations (3, 21, 22), dose dependently
inhibit E2
-mediated increases in UBF in nonpregnant ewes
(35). Thus while NO contributes to
E2
-induced vasodilation in nonpregnant ewes,
BKCa channel activation may be the final mediator. No one
has examined the role of BKCa channels in modulating basal
UBF in pregnancy or the E2
-induced vasodilation
previously observed in pregnant sheep (8, 33).
The purpose of the present investigation, therefore, was to
determine in near-term pregnant sheep whether 1)
BKCa channels are expressed in uterine artery myocytes,
2) local intra-arterial infusions of TEA alter basal UBF,
and 3) TEA modifies the uterine vasodilation that follows
systemic E2
administration. These data would provide
invaluable insights into the final cellular mechanisms responsible for
the uterine vasodilation essential for normal fetal growth and
well-being.
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METHODS |
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Animal model. The animal model used in these experiments has previously been described (30). In brief, time-dated pregnant ewes (n = 5) of mixed Western breed at 118-125 days gestation (term = 145 days) were fasted overnight but allowed access to water. In the morning, animals were given atropine sulfate intramuscularly, and a percutaneous jugular venous catheter was placed for administration of preanesthetic pentobarbital sodium and ketamine hydrochloride. Animals were intubated and surgically prepared; isoflurane (Mallinckrodt Veterinary; Mundelein, IL) and oxygen were given via a rebreathing anesthesia machine. The gravid uterus was isolated through a midline abdominal incision, and an electromagnetic flow probe (inner diameter 6.0 or 7.0 mm; Carolina Medical; King, NC) was implanted on the main uterine artery of each uterine horn proximal to the first bifurcation. Polyvinyl catheters containing heparinized saline (100 U/ml) were implanted retrograde 2 cm into a distal branch of the uterine artery of each uterine horn for the local intra-arterial infusion of drugs. The abdomen was closed, and polyvinyl catheters were implanted via a groin incision into the femoral artery and vein to the level of the abdominal aorta and mid vena cava, respectively. Animals received antibiotics on the day of surgery and the next 2 days, as well as banamine (Schering-Plough Animal Health; Union, NJ) for pain. All animals were allowed 5 days for postoperative recovery before studies were initiated. These studies were approved by the Institutional Review Board for Animal Research at the University of Texas Southwestern Medical Center at Dallas.
Experimental protocols. Two protocols were used in these studies. In the first protocol, we determined whether TEA (Sigma; St. Louis, MO), a selective inhibitor of BKCa channels at submillimolar concentrations (22), infused directly into the uterine circulation would alter basal UBF at different times during the last third of gestation. Studies were performed in five pregnant ewes between 123 and 149 days gestation (term = 145 ± 5 days) using each uterine horn if the uterine artery catheters were patent and the flow probes were functional. On the day of study, a continuous infusion of TEA was initiated via one uterine artery catheter after a 30-min control period and maintained for 90 min. The arterial concentration of TEA was estimated from the rate of TEA infused (in µg/min) divided by the baseline measurement of UBF (in ml/min) (30). From preliminary studies, it has been determined that a continuous TEA infusion, resulting in an estimated uterine arterial concentration of 0.15 mM, decreased UBF significantly but did not exceed 50%. All subsequent studies were performed using this dose because greater decreases in UBF would potentially alter uterine oxygen delivery and thus fetal well-being (29), and we wanted to compare the magnitude of its effects at different gestational ages. Continuous recordings of UBF, mean arterial pressure (MAP), and heart rate were initiated 30 min before the infusion of TEA and maintained until 90 min after stopping the infusion. The study was repeated at 24-48 h, and each animal was studied up to three times at different gestational ages to determine if gestational age-dependent alterations in the responses occurred, resulting in 11 experiments.
As in nonpregnant sheep, the uterine vascular bed of the pregnant ewe is responsive to the vasodilating effects of systemic infusions of E2
(1 µg/kg) as well as augmented increases in
endogenous placental estrogen, with blood flow gradually increasing 30 min after E2
administration and reaching maximum values
within 90-120 min (8, 33, 36, 37). The mechanisms
responsible for this response in pregnant ewes are unclear and have
received little attention. Thus, in the second protocol, we determined
whether local intra-arterial infusions of TEA would alter this response in pregnant ewes in the last trimester. Five intact pregnant ewes were
studied at different gestational ages between 123 and 149 days
gestation (term = 145 ± 5 days). After the presence of a maximum and reproducible UBF response to systemic E2
(1 µg/kg) was demonstrated, studies were initiated using
the last E2
response as a control. On the following
day, a continuous infusion of TEA, calculated to achieve an arterial
concentration of 0.15 mM (see above), was initiated via one uterine
artery catheter after a 30-min control period and maintained for 120 min. Thirty minutes after the local TEA infusion was initiated, a
systemic dose of E2
(1 µg/kg) was administered over
1-2 min via the femoral venous catheter as previously described
(33). Hemodynamic measurements were as described above and
were continuously monitored from 30 min before TEA to 90 min after the
TEA was stopped. UBF responses to E2
were subsequently
performed daily in the absence of TEA until responses were similar to
those seen before TEA treatment. Once UBF responses returned to control
levels, studies were repeated using the contralateral uterine horn. One
to three studies were performed in each animal at least 48 h apart
at different times in gestation to determine if there were gestational
age-dependent changes in the responses, resulting in 13 experiments
between 123 and 149 days gestation.
Hemodynamic measurements. MAP in the lower abdominal aorta was monitored continuously via a femoral arterial catheter connected to a pressure transducer (type 4-327-0109, Bell and Howell; Pasadena, CA). Heart rate was determined from the phasic signal derived from the arterial pressure monitor. UBF was monitored continuously with square-wave electromagnetic flowmeters (model FM501, Carolina Medical). All measurements were continuously recorded on a six-channel pen recorder (model 3000, Gould; Cleveland, OH). Uteroplacental vascular resistance (UVR) was calculated from MAP (in mmHg) divided by UBF (in ml/min).
RT-PCR.
At the termination of the above experiments, animals were euthanized
with intravenous pentobarbital sodium (125 mg/kg), and samples of the
third to fourth generation uterine artery were removed and placed in
cold sterile physiological saline. Similar samples were obtained from
nonpregnant ewes involved in other studies. With the use of sterile
methods, the adventitia was removed with sharp dissection, the vessel
was opened, and the endothelium was removed with a soft cotton swab as
previously described (39). Arteries were placed in liquid
nitrogen and stored at
80°C until assayed. At the time of assay,
arteries were suspended in liquid nitrogen and ground to powder with a
prechilled mortar and pestle. RNA was extracted using the guanidium
thiocyanate-phenol-chloroform method (Trireagent, Sigma). Samples were
then processed according to the reagent instructions, and the RNA was
dissolved in diethyl pyrocarbonate-treated water and stored at
70°C. Optical density was measured to determine the RNA
concentration. RNA (1 µg) was added to 11 µl of First Strand cDNA
Synthesis reagent (Pharmacia) with random hexamers as primers in a
final volume of 33 µl. Two microliters of this reverse transcript
reaction were added for each PCR. The oligonucleotide primers used to
amplify BKCa channel cDNA were based on the human sequence
(45) and were (forward) 5'-CTACTGGGATGTTTCACTGGTGT-3' and
(reverse) 5'-TGCTGTCATCAAACTGCATA-3', which yielded a product of
446 bp, consistent with that expected for human BKCa
channels. Identity was confirmed with sequence analysis.
Statistical analysis.
One-way ANOVA with multiple measures was used to determine whether
significant differences occurred in responses of UBF and hemodynamic
variables to treatment with either TEA infused locally or
E2
given systemically plus TEA at different gestational
ages. When the effects of increasing gestational were shown to be
nonsignificant (P > 0.05), one-way ANOVA with repeated
measures was used to determine whether changes in UBF and hemodynamic
measurements over time were significant. When significance was
P < 0.05, a Student-Newman-Keuls test was then used to
determine differences in responses between time periods for treatment
with TEA alone (protocol 1) and TEA plus E2
(protocol 2). Nonpaired and paired t-tests were
employed where appropriate. Data are presented as means ± SE.
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RESULTS |
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Effects of TEA on basal UBF.
Although five animals were studied, two to three experiments were
performed in each ewe at different gestational ages between 123 and 149 days gestation, resulting in 11 experiments. Because gestational age
had no significant effect (P > 0.1) on uterine vascular or systemic hemodynamic responses to local infusions of TEA
(all of which were calculated to achieve an arterial concentration of
0.15 mM), the data have been grouped for analysis. The basal hemodynamic data obtained before infusion of TEA are presented in Table
1 (protocol 1). These data are
consistent with previously published values for pregnant ewes studied
during this period of pregnancy (27). There was no
significant effect of the local intra-arterial infusion of TEA on
either MAP or heart rate (P
0.1, ANOVA) at any age.
However, UBF in the treated uterine horn began to fall within 3-5
min after the local TEA infusion was started and achieved an apparent
steady-state response by 45-60 min of infusion in each study (Fig.
1). During the period of the apparent
steady-state response at 60 and 90 min of TEA infusion, UBF decreased
(P < 0.0001, ANOVA) an average of 40 ± 8% and
55 ± 7% (Fig. 2), respectively.
There was no significant difference in the magnitude of responses at
this time. When the TEA infusion was stopped, UBF did not change
significantly until 60- and 90-min postinfusion, increasing to an
average of 335 ± 64 ml/min at 90-min post-TEA (Fig. 2). Of note,
values remained 23 ± 7% less than that observed before TEA
(P < 0.0001, ANOVA). There was no significant effect
of TEA on UBF in the contralateral uterine horn at any gestational age
(Fig. 2; P = 0.1, ANOVA). The fall in UBF was mirrored
by a reciprocal rise in UVR (Fig. 3),
which was >100% of baseline values and did not differ significantly after 30 min of TEA infusion (P > 0.05, ANOVA). While
UVR began to fall soon after the local TEA infusion was stopped, the
values remained significantly greater than control levels throughout the study period. As with UBF, contralateral UVR was unchanged at each
gestational age studied (data not shown). All hemodynamic measurements
returned to pre-TEA values within 24 h.
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Effects of TEA on E2
-induced vasodilation.
Estrogen is a potent uterine vasodilator in pregnant ewes, increasing
UBF 30-40% (29, 33). The mechanisms responsible for
this vasodilation have not been studied. In nonpregnant sheep, TEA at
submillimolar concentrations dose dependently decreases UBF responses
to E2
, demonstrating that BKCa channels
contribute to E2
-induced uterine vasodilation
(35). Thus we investigated the effects of local
intra-arterial TEA infusions on E2
-induced vasodilation
in pregnant ewes during the third trimester. The effect of a systemic
dose of E2
(1 µg/kg) on UBF is illustrated in Fig.
4A. There is a 20- to 30-min
delay, followed by a gradual rise in UBF that peaks and plateaus within
90-120 min. Eleven studies were performed in five ewes at
different times between 123 and 149 days gestation. There was no
evidence of a significant gestational age-mediated effect on the
response to E2
during the period of pregnancy studied
(P > 0.1); therefore, the data have been grouped for
analysis. Systemic E2
administration alone had no effect
on MAP (Table 2). However, 90 min after
E2
infusion, heart rate increased 10%
(P < 0.0001) and UBF increased ~20%
(P < 0.0001, ANOVA) in both uterine horns. This was
paralleled by a reciprocal fall in UVR in both uterine horns (Table 2).
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, we performed studies to determine whether local
intra-arterial TEA infusions modified these responses. In preliminary
experiments, a local TEA infusion, achieving a calculated arterial
concentration of 0.15 mM, completely inhibited the
E2
-induced rise in UBF in the treated uterine horn (Fig.
4B). Therefore, subsequent studies were performed using this
intra-arterial TEA concentration at different times in gestation to
assess any gestational age-related affects. There was no difference in
the responses related to gestational age, and the data have been
grouped for analysis. The basal hemodynamic data obtained before TEA
are consistent with those previously reported for this period of ovine
gestation (Table 1, protocol 2). As described above,
baseline UBF gradually fell after starting the local TEA infusion (Fig.
4B), decreasing 24 ± 7% within 30 min (Fig.
5B; P < 0.0001). This was associated with a reciprocal rise in ipsilateral UVR
(P = 0.0002) but no significant change in either MAP or
heart rate before E2
administration (Table 1, protocol 2). UBF in the treated uterine horn was unchanged
at 90 min post-E2
plus TEA, remaining 28 ± 5.2%
below baseline UBF versus the 30 ± 5.8% rise in UBF seen in the
previous day after E2
alone (Figs. 4 and 5). Sixty
minutes after TEA was stopped, UBF in the treated horn remained below
basal values (P < 0.0001). UVR remained elevated 90 min after E2
administration compared with the
significant fall that was observed with E2
alone the day
before (Fig. 6). UVR remained
significantly increased 30 and 60 min after TEA was stopped, 0.328 ± 0.6 versus 0.320 ± 0.06 mmHg · min · ml
1, respectively. UBF in the
untreated uterine horn increased 12 ± 5% (P = 0.03) at 90 min after E2
administration versus the 23%
rise seen the previous day, suggesting that a small amount of TEA may
have crossed into the contralateral uterine vascular bed via bridging
arteries. Heart rate increased 10% 90 min after E2
plus
TEA (P = 0.006), whereas MAP did not differ from that seen before E2
infusion. Within 24 h, the uterine
vascular responses to systemic E2
did not differ from
those seen before TEA treatment, demonstrating reversible inhibition.
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Presence of the BKCa channel.
Third and fourth generation uterine arteries were collected from four
ewes at the completion of the studies, and the endothelium was removed
to determine whether BKCa channels were expressed in the
arterial smooth muscle. These samples included arteries from pregnant
sheep at 107 and 145 days gestation and nonpregnant ewes exposed or not
exposed to E2
for 6 days as recently described (39). RT-PCR yielded a 446-bp fragment in vascular
smooth muscle from all four animals (Fig.
7), which was highly homologous to the
human sequences of the same molecule (45). The
observations in the nonpregnant ewes were consistent with patch-clamp
studies recently reported from this laboratory (35).
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DISCUSSION |
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The pattern of the >30-fold rise in UBF occurring in ovine
pregnancy is well described (26, 27, 29, 34), but the
mechanisms involved remain unclear. Existing evidence suggests this
exponential increase in UBF during the last two-thirds of pregnancy
results from vascular growth and angiogenesis during placentation and subsequent vasodilation (26, 29, 34, 44). Furthermore, placentally derived estrogens may mediate uteroplacental vasodilation by activating existing NOS enzyme or increasing NOS expression in
uterine artery endothelium and/or smooth muscle (8, 15, 30, 33,
39). We (35, 39) recently reported that E2
not
only increases uterine artery NOS in the endothelium and smooth muscle
but also enhances BKCa channel activation in uterine artery myocytes, and both NO and BKCa channels contribute to the
E2
-induced uterine vasodilation. In the present
investigation, we demonstrated the presence of BKCa channel
mRNA in uterine artery myocytes from nonpregnant and pregnant ewes,
confirming recent studies in the former using patch-clamp methods
(35). Moreover, we provided new evidence that
BKCa channels are responsible for maintaining a substantial
proportion of the observed uteroplacental vasodilation normally seen at
term and that BKCa channel activation contributes to the
E2
-induced increases in UBF in pregnant sheep. These
observations, therefore, provide the first molecular evidence of how
UBF progressively increases during normal pregnancy and evidence,
albeit indirect at present, that placental estrogens are involved.
Potassium channels regulate basal arterial tone and the myotropic responses to various agonists through the hyperpolarization of smooth muscle membranes, which inactivates Ca+2 entry through potential-gated channels and results in vasorelaxation (for reviews, see Refs. 21 and 22). Because pregnancy is associated with a fall in systemic vascular resistance and attenuated systemic pressor responses to several vasoconstrictors (3, 12, 27, 28), it stands to reason that potassium channels may be the final mediator responsible for these alterations (18). At least four potassium channels are expressed in arterial vascular smooth muscle (22); however, only two have been studied in pregnancy: the ATP-sensitive potassium (KATP) channel and the BKCa channel (4, 11). In these studies it was evident that enhanced channel activity contributes to the systemic vascular changes associated with normal gestation, e.g., the fall in systemic and regional vascular resistances, and the attenuated pressor responses to several vasoconstrictors.
The uterine vascular bed also demonstrates a marked fall in vascular
resistance and attenuated responses to several vasoconstrictors during
pregnancy (12, 19, 27, 28). The decrease in basal UVR is
not due to vasodilating prostaglandins, because intra-arterial and
systemic indomethacin infusions do not alter basal UBF or UVR
(14, 19). Furthermore, short-term intra-arterial infusions of L-NAME decrease the uterine synthesis of cGMP in
pregnant ewes but do not significantly alter basal UBF or UVR, despite
a greater than twofold increase in uterine artery NOS expression
(15, 30). Although BKCa channels are expressed
in uterine artery myocytes from nonpregnant ewes, they are not involved
in maintaining basal uterine vascular tone (35). This was
obtained from the observation that, in intact nonpregnant ewes,
arterial concentrations of TEA of
1.0 mM, which are selective for
blocking BKCa channels (3, 21, 22), do not
alter basal UBF or UVR, findings consistent with patch-clamp studies
(35) and studies in normotensive Wistar-Kyoto rats
(38). We now report that TEA, at an arterial concentration of 0.15 mM, decreases basal UBF ~50% and increases UVR within minutes in near-term pregnant ewes. Furthermore, the response is
similar throughout the last 3 wk of gestation and reversible within
hours. This dose of TEA is well below the 50% inhibitory dose reported
in vitro (22). Higher doses were not examined because we
did not wish to disturb fetal well-being by further decreasing UBF and
uterine oxygen delivery, which occurs when UBF falls >50%
(29). Charybdotoxin and iberiotoxin, also BKCa channel-selective antagonists (22), were not used because
of their cost and the potential for irreversible or prolonged binding. In human uterine arteries, TEA enhances in vitro vascular reactivity (10, 23); however, the concentrations used exceeded 1 mM, making channel selectivity unclear. In studies performed at a similar
time in pregnant guinea pigs, i.e., 84% of gestation, systemic
glibenclamide [a selective KATP antagonist
(22)] infusions increased MAP and systemic vascular
resistance but did not alter total UBF (11). Although the
nonplacental portion of UBF fell modestly, placental blood flow was
unaffected, suggesting that KATP channels are not expressed
in the guinea pig placental vasculature and are not responsible for
placental vasodilation. In nonpregnant ewes, glibenclamide does not
alter basal or E2
-induced increases in UBF (unpublished
results). Although the distribution of UBF was not measured in the
present study, 85-90% of UBF in term ewes is placental (16,
28). Thus the maximum blood flow to nonplacental tissues
in the treated uterine horn was 60-70 ml/min, yet TEA decreased
unilateral UBF
200 ml/min. It is very likely, therefore, that the
placental vascular bed was affected, providing the first evidence that
BKCa channels play a prominent role in regulating basal
placental vascular tone and may be responsible for the vasodilation and
exponential rise in UBF in the last third of ovine gestation.
Although BKCa channel mRNA was observed in uterine artery
myocytes by RT-PCR, it was of interest that expression may have actually decreased in the last third of pregnancy (Fig. 7). However, one must be cautious in making this conclusion from the preliminary data presented because it is known that uterine hypertrophy occurs in
ovine pregnancy (1, 9) and we made no attempt to quantify BKCa channel mRNA in the present report. We also noted in
these preliminary studies that E2
had no obvious effect
on BKCa channel mRNA in uterine artery smooth muscle from
nonpregnant ewes. This, however, is not surprising because we
(35) reported a 70-fold increase in BKCa
channel activity within 30 min in myocytes studied with patch-clamp
techniques, a time too short for channel upregulation. Thus it is
possible that BKCa channel expression is quantitatively unchanged in pregnancy, but activity alone is increased. Studies to
address this are presently underway.
Estrogen, a potent vasodilator in several vascular beds in humans and
in other species including sheep (17, 29), has its greatest effect in reproductive tissues and, in particular, in the
uterine vascular bed (29, 32, 33). Most studies of
estrogen have used nonpregnant females. However, E2
also
increases UBF in pregnant sheep in a pattern resembling that in
nonpregnant ewes (33). Furthermore, stimulated increases
in endogenous placentally derived estrogens increase UBF in a pattern
resembling that seen after exogenous E2
treatment,
suggesting that placental estrogens may regulate UBF during pregnancy
(36, 37). However, the mechanism responsible for
estrogen-induced vasodilation in pregnant animals has not been studied.
We confirmed the effects of E2
on UBF in the present
study. As in nonpregnant ewes, UBF began to rise 30 min after
E2
infusion, suggesting a nongenomic mechanism may be
involved. This is supported by the observation that actinomycin does
not inhibit the effects of E2
on UBF (24)
and recent observations that E2
increases eNOS activity
in vitro within 2-5 min in a biphasic manner (40). In
nonpregnant sheep, the acute rise in UBF parallels increases in uterine
cGMP (30) and is associated with enhanced NOS activation
or expression (39, 46, 47); this, however, has not been
studied in pregnant animals. In nonpregnant ewes, BKCa
channels in uterine artery myocytes are activated by E2
independent of the endothelium and appear to interact with increasing
NOS activity to contribute to and mediate E2
-induced vasodilation (35). We demonstrated that BKCa
channels are expressed in uterine artery myocytes from pregnant ewes
and that a TEA dose below the 50% inhibitory dose for
E2
-induced vasodilation in nonpregnant ewes
(35) will inhibit the UBF responses to E2
in pregnant animals. The untreated uterine horn was minimally affected,
and the systemic responses to E2
were unchanged, with heart rate increasing 10% (13, 33). Because 0.15 mM TEA
is selective for BKCa channels, and it is probable that
smooth muscle exposure was even less, it is unlikely another potassium
channel was inhibited (22). It is notable that the same
local dose of TEA in nonpregnant ewes decreased E2
responses ~20%; but, when infused with L-NAME, TEA
resulted in complete inhibition (30, 35). Because
increases in uterine cGMP follow E2
exposure in pregnant
and nonpregnant ewes (30), we propose that the acute rise
in UBF in both groups is mediated, at least in part, by activating smooth muscle guanylyl cyclase by enhancing NOS activity and
phosphorylating BKCa channels via a cGMP-dependent kinase
(7, 35, 49). There also may be a direct effect of NO on
the BKCa channel (2). Both hypotheses will
need to be explored in future studies. Nonetheless, it is clear in
pregnant ewes that additional BKCa channel activation follows E2
exposure, and this contributes to
E2
-induced rises in UBF. These observations also provide
new insights into the potential role of the increase in placental
estrogen synthesis on UBF that occurs with the onset of parturition
(29).
In the present study, we provided new insights into the physiological role of BKCa channels in vascular smooth muscle. It was assumed previously that BKCa channels primarily regulated myogenic tone via a negative feedback mechanism (3, 21, 22), which required membrane depolarization induced by increases in intracellular Ca+2 or transmural pressure derived from increases in arterial blood pressure. This caused BKCa channel hyperpolarization of smooth muscle membranes, inactivation of potential-gated Ca+2 channels, vascular relaxation, and maintenance of blood flow. It is now obvious that estrogen activates BKCa channels in coronary and uterine myocytes in vivo and in vitro independent of elevations in myogenic tone (7, 35, 48, 49). We have provided the first evidence that BKCa channels contribute to both chronic and acute vasodilation in the uterine vascular bed in pregnancy. Furthermore, this may be independent of changes in potential-gated Ca+2 channels, because these channels demonstrate decreased activity in uterine arteries from pregnant sows (42, 43). Alternatively, the inactivation of potential-gated Ca+2 channels may be due to the negative feedback of hormonally activated BKCa channels (3, 22). Although our data suggest that placentally derived estrogens may regulate BKCa channel activity in placental vascular smooth muscle, it is possible that increases in UBF augment BKCa channel activation. This and other issues will be addressed in future studies as they impact our understanding of how placental blood flow is regulated in pregnancy and how new strategies may be developed for the treatment of pregnancies associated with fetal growth restriction due to abnormalities of UBF.
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ACKNOWLEDGEMENTS |
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We thank Mary Nero for assistance in the preparation of this manuscript.
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FOOTNOTES |
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This study was supported by National Institute of Child Health and Human Development Grant HD-08783.
Address for reprint requests and other correspondence: C. R. Rosenfeld, Dept. of Pediatrics, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390 (E-mail: crosen{at}mednet.swmed.edu).
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Received 6 October 2000; accepted in final form 28 March 2001.
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