RESUMEN
Prostaglandin E2 (dinoprostone) is largely used for labor induction. However, one-third of patients do not respond to treatment. One cause of this poor response may be associated with changes in regulation of prostaglandin E receptors (EP1-4). In this study, we investigated EP mRNA expression in the uterine cervix and lower uterine segment myometrium for term births. Biopsies were obtained from women with successful (responders) and failed (non-responders) dinoprostone labor induction, while women that underwent spontaneous labor were included as controls. EP1 mRNA was upregulated in the cervical tissue of women who did not respond to dinoprostone induction. In addition, in the myometrium, significantly higher levels of EP3 mRNA were observed in women treated with dinoprostone, independent of their responsiveness. Dinoprostone-responders presented 3.6-fold higher levels of EP3 mRNA expression than the spontaneous labor group. Significantly higher levels of EP3 mRNA in the myometrium of the dinoprostone-treated group indicated that dinoprostone may regulate the EP3 gene on the transcriptional level. These results highlight the relationship between EP gene expression and delivery and indicate that understanding the regulation of prostaglandin E receptors may lead to improved labor induction.
Asunto(s)
Dinoprostona/uso terapéutico , Trabajo de Parto Inducido/métodos , ARN Mensajero/biosíntesis , Subtipo EP1 de Receptores de Prostaglandina E/genética , Contracción Uterina/efectos de los fármacos , Adulto , Estudios de Casos y Controles , Cuello del Útero/efectos de los fármacos , Cuello del Útero/metabolismo , Femenino , Expresión Génica/efectos de los fármacos , Humanos , Miometrio/efectos de los fármacos , Miometrio/metabolismo , Embarazo , ARN Mensajero/genética , Subtipo EP1 de Receptores de Prostaglandina E/biosíntesis , Subtipo EP2 de Receptores de Prostaglandina E/biosíntesis , Subtipo EP2 de Receptores de Prostaglandina E/genética , Subtipo EP3 de Receptores de Prostaglandina E/biosíntesis , Subtipo EP3 de Receptores de Prostaglandina E/genética , Insuficiencia del TratamientoRESUMEN
The aim of the present study was to examine the role of oxytocin (OT) in the progesterone (P4) and prostaglandins (PGs) pathway to induce oocyte meiotic resumption. Cumulus-oocyte complexes were co-cultured with follicular hemisections for 15 h to determine the effects of different doses of OT or atosiban (ATO; oxytocin receptor antagonist) on oocyte meiotic resumption. In another experiment, we examined the effect of the interaction between P4, OT and PGs on the regulatory cascade of the oocyte meiotic resumption. Oxytocin at 1 µm was effective in inducing meiotic resumption in oocytes co-cultured with follicular cells (84.0%), not differing from the positive control group (74.4%). Atosiban inhibited in a dose-dependent manner the positive effect of OT on the meiotic resumption (27.6% metaphase I with 10 µm of ATO, which did not differ from the 25.5% of the negative control group). Furthermore, a third experiment showed that P4 was able to induce oocyte meiotic resumption, which was inhibited by ATO. However, the OT positive effect was not blocked by mifepristone (P4 antagonist), but was inhibited by indomethacin (a non-selective PTGS2 inhibitor). Collectively, these data suggest a sequential role of P4, OT and PGs in the induction of oocyte meiotic resumption.