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Department of Physiology and Functional Genomics (J.G., C.E.S., C.E.W.), University of Florida College of Medicine, and Department of Pharmacodynamics (M.K.-W.), University of Florida College of Pharmacy, Gainesville, Florida 32610
Address all correspondence and requests for reprints to: Charles E. Wood, Ph.D., Professor and Chair, Department of Physiology and Functional Genomics, P.O. Box 100274, University of Florida College of Medicine, Gainesville, Florida 32610-0274. E-mail: cwood{at}phys.med.ufl.edu.
| Abstract |
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| Introduction |
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Recently, we proposed that prostaglandin generation within the fetal central nervous system is critical for the modulation of hypotension-induced fetal ACTH secretion (11, 12). Although the stimulation of fetal HPA axis in response to hypotension is modulated by prostaglandins, little is known about the dependency of ontogenetic preparturient increases in fetal HPA axis activity.
The present study was designed to test the hypothesis that the preparturient increase in fetal ACTH secretion is dependent upon fetal central nervous system prostaglandin synthesis mediated by the activity of prostaglandin endoperoxide synthase (PGHS)-2 [cyclooxygenase (COX)-2] in the fetal brain. We hypothesized that inhibition of PGHS-2 in the fetal brain would block the increase in fetal ACTH and cortisol secretion, and prolong gestation. The present study was designed to test this hypothesis.
| Materials and Methods |
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Fetal surgery
In studies 1 and 2, we used time-dated pregnant ewes carrying singleton and twin fetuses, respectively. Surgery was performed at least 5 d before in vivo study. In study 1, fetal gestational ages at surgery were 121–129 d in the control group and 123–134 d in the nimesulide-treated group. In study 2, fetuses were 119- to 125-d gestation at surgery. Ewes were fasted for 24 h before surgery. Each ewe was anesthetized with halothane (0.5–2.5%) in oxygen. The uterus was exposed via a midline incision, and one set of fetal hindlimbs was located. Through a small hysterotomy incision, a fetal hindlimb was delivered. The tibial artery was located and catheterized using a polyvinylchloride catheter (0.030-in. inner diameter, 0.050-in. outer diameter), with the catheter tip advanced to the subdiaphragmatic aorta. The procedure was repeated in the second hindlimb, to which an amniotic fluid catheter was sutured before returning to the amniotic space. The fetal head was located and delivered through a second uterine incision. A hysterotomy incision was made over the crown of the fetal head. After making a midline incision in the fetal scalp, the fetal skin was marsupialized with the uterus. A small hole was made in the skull 1-cm lateral to bregma; an 18-gauge hypodermic needle was used as a probe for identifying the depth of the lateral cerebral ventricle. A polyvinylchloride catheter (0.030-in. inner diameter, 0.050-in. outer diameter) was cut to a length equal to the depth of the lateral cerebral ventricle relative to the surface of the skull, and attached to an osmotic mini pump (2ML4 in study 1 and 2ML2 in study 2; ALZET Osmotic Pumps, DURECT Corp., Cupertino, CA) filled with either nimesulide or vehicle, then implanted sc in the neck. Incisions in the fetal skin and uterus were sutured. The surgery for study 2 was the same as for study 1, with the exception that the catheterization procedures were repeated in the twin fetus. After closure of the uterine incisions, fetal arterial and amniotic catheters were routed to the flank of the ewe and held in place with a disposable pocket and elastic bandage. Maternal incisions were closed in layers. During the postoperative period, fetal catheters and maternal flank incisions were cleaned daily with povidone solution, ewes were treated twice daily with ampicillin (Polyflex; Fort Dodge Laboratories, Fort Dodge, WI), and rectal temperatures of the ewes were measured. Use of this surgical procedure and postoperative treatment protocol is routine in our laboratory (13, 14).
Drug administration
Nimesulide was purchased from Cayman Chemical (Ann Arbor, MI). Each drug was stored at –20 C as a stock solution of 50 mg/ml in dimethylsulfoxide. Nimesulide was infused at a rate of 1 mg/d intracerebroventricularly (icv) in a 50%/50% mixture of water/dimethylsulfoxide vehicle. This dose was chosen based on the efficacy of acute iv administration of nimesulide in prior experiments (15). In experiments involving twins, one twin received a minipump containing nimesulide, and the other twin received a minipump containing vehicle alone.
Experimental protocol and sample collection
In study 1, starting 5 d after surgery, arterial blood samples (5 ml) were collected at 2-d intervals, anticoagulated in chilled K4-EDTA blood collection tubes (Vacutainer Systems; Becton Dickinson, Franklin Lakes, NJ), and kept on ice until centrifuged. In addition, 1 ml arterial blood was collected into a heparinized syringe and stored on ice for blood gas analysis. Blood samples were centrifuged at 3000 x g for 20 min at 4 C. Plasma was aliquotted and stored at –20 C until analysis for plasma hormone concentrations. PaO2, PaCO2, and pHa were measured using an ABL 77 blood gas analyzer (Radiometer, Copenhagen, Denmark). Blood sampling continued at this frequency until spontaneous parturition.
In study 2, starting 5 d after surgery, arterial blood samples (6 ml) and arterial blood gas samples (1 ml) were collected on a daily basis from each fetus and processed as in study 1. Data from the daily blood samples are not reported. On the final day of the experiment in study 2, a single blood gas sample and five serial arterial blood samples (at 5 min intervals) were collected (4 ml) from each fetus as described previously. Data from these samples are reported as the mean of values measured in the five samples. After the final blood collection, the ewes were euthanized with an overdose of sodium pentobarbital. The fetal brain was rapidly removed and dissected into the following regions: cerebral cortex, cerebellum, hippocampus, hypothalamus, brainstem, and pituitary. Tissue was placed into ribonuclease-free tubes and snap frozen in liquid nitrogen, then stored at –80 C until processed for mRNA and protein extraction.
RNA isolation and gene expression analysis
Before analysis each tissue was pulverized with a precooled Bio-Pulverizer, a trigger-style mortar and pestle (Bio-Spec Products, Bartlesville, OK). RNA extraction was performed using Trizol (Invitrogen Corp., Carlsbad, CA) according to the manufacturers recommendations. RNA was quantified by measuring absorbance at 260 nm and quality checked by running a denaturing agarose gel. Multiple aliquots of each sample were made and stored at –80 C.
For each sample, 2 µg total RNA was reverse transcribed using the High Capacity cDNA kit (Applied Biosystems, Foster City, CA), according to manufacturers instructions. Real-time PCR was performed as previously described (16). Sequences of probes and primers and the concentrations used are reported in Table 1
. Relative expression levels were calculated using the
Ct method (17). Fold-change expression was calculated by using 2–
Ct.
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Western blots were performed by loading 20 µg microsomal protein or whole cell homogenate in each lane of a 7.5% Tris-HCl polyacrylamide gel (Criterion Gel System; Bio-Rad Laboratories) in addition to a mass marker (Rainbow Molecular Mass Standard; Bio-Rad Laboratories), and a commercially available positive control for either ovine PGHS-1 or PGHS-2 (Oxford Biomedical, Oxford, MI). After transfer to nitrocellulose membrane, membranes were blocked for 1 h at room temperature with nonfat dry milk in Tris-buffered saline/1% Tween 20 at 2% for PGHS-1 and 3% for PGHS-2. Primary antibodies were diluted in the blocking buffer and incubated with the membrane for 1 h at room temperature. Polyclonal anti-PGHS-1 (1:2500, no. PG-16; Oxford Biomedical; PGHS-2) and monoclonal anti-PGHS-2 (1:1000, no. 160112; Cayman Chemical) were used to probe for PGHS-1 and -2, respectively. Peroxidase-conjugated secondary antibody was diluted in the blocking buffer and incubated with the membrane for 45 min at room temperature (PGHS-1: donkey antirabbit at 1:3000; PGHS-2: sheep antimouse at 1:3000, nos. NA934 and NA931, respectively; Amersham Biosciences Inc., Piscataway, NJ). Membranes were washed three times for 10 min in Tris-buffered saline/1% Tween 20 and developed using enhanced chemiluminescence reagent. Standard radiographic film was used to visualize the completed blot. Blots were analyzed using Quantity One software (Bio-Rad Laboratories). The results of the densitometry were expressed as relative OD units.
Hormone assays
Plasma concentrations of ACTH1–39, proopiomelanocortin (POMC), cortisol, prostaglandin E2 (PGE2), estradiol, and estradiol-3-sulfate were measured as previously described (19, 20, 21). Briefly, ACTH1–39 was measured using an immunoradiometric assay purchased from DiaSorin Inc. (catalog no.27130; Stillwater, MN), cortisol, estradiol, and estradiol-3-sulfate using enzyme immunoassay (EIA) kits from Oxford Biomedical (catalog nos. EA65 and EA70), POMC using an ELISA from IDS Corp. (catalog no. AC-71; Boldon, UK), and PGE2 using an EIA from Cayman Chemical (catalog no. 514010). The POMC assay measures both POMC and 22-kDa "proACTH." For simplicity, we will refer to the results of this assay as "POMC." Before assay, cortisol was extracted from plasma using ethanol, and PGE2 was extracted from plasma using ethyl acetate, as previously described (19, 21). Brain tissue concentrations of PGE2 were measured using the Cayman EIA after extraction of the prostanoid from homogenized tissue using eight volumes of ethyl acetate.
Statistics
Plasma hormone concentrations in study 1 were analyzed by two-way ANOVA, corrected for repeated measures in one dimension, days before parturition (22). The effect of nimesulide on the length of gestation was assessed using the Mantel-Cox test for survival analysis (23). Abundance of mRNA and protein for PGHS-1 and -2 in study 2 were analyzed by two-way ANOVA for repeated measures in both dimensions (brain region and nimesulide vs. control). The effect of nimesulide in each brain region was tested using simple effects contrasts. Plasma hormone concentrations in study 2 were analyzed by the paired t test (24).
| Results |
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Fetal plasma cortisol concentration did increase significantly (P < 0.001), and the pattern of fetal plasma cortisol in relation to parturition was not significantly different from that in the control group (P = 0.62 for interaction between group and days prepartum in two-way ANOVA).
Nimesulide prevented the preparturient increase in fetal plasma concentrations of PGE2. When analyzed by two-way ANOVA, there was a statistically significant group x time interaction (P = 0.001), and analysis by Bonferroni test reveals a statistically significant difference between values of PGE2 in the last blood sample before parturition (505 ± 140 and 1724 ± 172 pg/ml in control and nimesulide treatment groups, respectively).
Nimesulide treatment increased the length of gestation slightly but significantly (P = 0.007 by Mantel-Cox test; Fig. 2
). Parturition occurred on d 147.9 ± 0.3 in the nimesulide-treated fetuses and d 146.3 ± 0.3 in the vehicle-treated fetuses.
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| Discussion |
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There is a rich literature demonstrating the ability of PGE2 to increase fetal ACTH secretion. Injection of PGE2 iv increases fetal ACTH (28). The increase in PGHS activity in ovine placenta before parturition (29), and the well-documented increase in fetal plasma PGE2 concentrations before parturition (30), suggested the possibility that placental PGE2 stimulated fetal ACTH secretion, providing a route of communication between placenta and fetal hypothalamus. The potential role of placental PGE2 as a stimulus to ACTH was questioned in light of the demonstration that higher concentrations of PGE2 were required to stimulate ACTH secretion when delivered into carotid arterial blood (31). A subsequent study demonstrated that the increase in fetal ACTH secretion preceded the increases in plasma PGE2 concentration, casting further doubt on the possible cause-and-effect relationship between placental PGE2 and the preparturitional increase in fetal ACTH secretion (32). The present study affirms a role of PGE2 in the control of the ontogenetic increase in fetal ACTH secretion but demonstrates that the site of synthesis of the PGE2 is within the fetal brain. Interestingly, we cannot be sure that the final increase in cortisol and apparent increase in adrenal sensitivity that precedes parturition in the nimesulide-treated fetuses are not completely independent of brain PGHS-2 activity. Although we assume that the delivery of nimesulide from the osmotic minipumps was constant, we cannot be sure that the effective infusion rate was not reduced after several days or weeks in the minipumps at fetal body temperature.
A striking aspect of the present results is the dissociation between fetal ACTH and cortisol concentrations. The present results are consistent with a study by Poore et al. (33), in which ACTH was infused iv into hypophysectomized fetuses at rates designed to produce a constant plasma ACTH concentration. The results of that study demonstrated that, in the presence of constant fetal plasma ACTH concentrations (concentrations high enough to maintain adrenal viability and function), fetal plasma cortisol concentrations increase as they do in intact fetuses, and parturition is triggered on time. These results demonstrate that well-known changes in adrenal cortical function in the fetus, perhaps in combination with a non-ACTH adrenocorticotropic stimulus, are more important than the increase in hypothalamic or pituitary "drive" to the ontogenetic increase in cortisol secretion. This suggests that fetal ACTH serves two roles, one as an acute stimulus to cortisol secretion after stress, and the other as a trophic hormone that maintains adrenal function and responsiveness to other adrenocorticotropic stimuli. We speculate that the nimesulide-treated fetuses had slightly longer gestation length because the nimesulide inhibited the ACTH responses to the normal (and experiment-induced) stressors that sometimes hasten parturition in chronically catheterized fetal sheep (34).
Adrenal sensitivity to ACTH is a known influence on fetal plasma cortisol concentrations in the sheep fetus. Classical studies by several laboratories demonstrated adrenal growth and increased adrenal sensitivity to ACTH in late gestation (35, 36). The increase in adrenal mass is accompanied by an increase in steroidogenic responsiveness to ACTH, an increase in expression of key steroidogenic enzymes, and an increase in the expression of MC2 receptors (ACTH receptors) and steroidogenic acute regulatory protein in the adrenal cortex (37, 38, 39, 40). Acute changes in adrenal sensitivity are also important in the regulation of cortisol responses to stress (41). Although it is possible that there is a yet unidentified endocrine factor stimulating the adrenal, it is quite possible that efferent nerves innervating the adrenal cortex increase the adrenal responsiveness to ACTH in late gestation. In adult dogs, electrical stimulation of the thoracic splanchnic nerves increases the adrenal cortisol secretion rate independent of changes in plasma ACTH concentration or adrenal blood flow (42). In fetal sheep, section of the splanchnic nerves reduces the cortisol response to hypotension (43). It is possible that the late gestation increase in fetal cortisol secretion might be in part mediated by increased splanchnic nerve activity.
Our methodology in the present study gives us confidence that we did not simply fail to detect an increase in fetal ACTH secretion before parturition in study 1. We measured immunoreactive ACTH using a two-site immunoradiometric assay that has been validated for fetal sheep plasma by Myers et al. (44). In contrast with our previous ACTH RIA, this assay is not confounded by circulating concentrations of POMC, pro-ACTH, or fragments containing the ACTH11–24 epitope. We also used a two-site ELISA for POMC and pro-ACTH. This assay does not detect either ACTH1–39 or fragments of the mature peptide. The results of our experiments reveal that ACTH1–39 increases in catheterized but otherwise untreated fetal sheep, that there are concomitant increases in POMC of even larger magnitude, and that the intracerebroventricular infusion of nimesulide blocked the increase in both.
We are also confident that the nimesulide infusion blocked the action of PGHS-2 in the fetal brain, not the placenta. The nimesulide infusion did not reduce fetal plasma PGE2 concentrations (Table 2
), suggesting that the mechanism of the inhibition of ACTH was not the inhibition of placental PGHS activity. Leakage of significant amounts of this drug into the peripheral circulation would have inhibited placental PGHS-2 and, therefore, circulating PGE2 (21). The final increase in fetal plasma PGE2 concentration before spontaneous parturition was prevented in the nimesulide group. This is unlikely to be the result of direct inhibition of placental PGHS-2 activity; any effect of nimesulide on the enzyme activity in the placenta would have resulted in reduced fetal plasma PGE2 concentration throughout the infusion period (21). It is more likely that nimesulide interrupted the neuroendocrine cascade that stimulates parturition in this species.
As demonstrated in study 2, the intracerebroventricular infusion of nimesulide resulted in changes in tissue abundance of mRNA and protein for PGHS isoforms that are consistent with the interaction of the drug with PGHS-2. Nimesulide had no statistically significant effects on the abundance of PGHS-1 at either the mRNA or the protein level; all of the drug effects were observed in the abundance of PGHS-2 (Figs. 4
and 5
). Nimesulide increased the abundance of PGHS-2 protein and decreased the abundance of PGHS-2 mRNA. One possible interpretation of these results is that the drug bound to, and stabilized, PGHS-2 protein. PGHS is a "suicide inactivated" enzyme that is degraded after activity (45, 46). If the enzyme protein is autoregulated, a reduction in the rate of degradation might be reflected in a reduction in the mRNA abundance and a reduction in the rate of synthesis. The lack of effect of nimesulide on plasma POMC, ACTH, or cortisol in study 2 is consistent with the conclusion that PGHS-2 activity is important for the preparturient increase in HPA axis activity but appears to have little influence on the prior unstressed plasma concentrations of these hormones. The effect of nimesulide on plasma estradiol concentration is unexplained by changes in pituitary LH, FSH, or PRL mRNA.
We conclude that the activity of PGHS-2 in the ovine fetal brain is important as a mediator of the preparturient increase in fetal ACTH and POMC secretion that heralds parturition in this species. We also conclude that the increase in fetal plasma cortisol concentration at the end of gestation is at least partially mediated by an increase in fetal adrenal sensitivity to ACTH or other adrenocorticotropic factors. PGHS-2-mediated prostanoid generation within the fetal brain is a critical component of the neuroendocrine mechanisms controlling parturition in this species.
| Acknowledgments |
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| Footnotes |
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Disclosure Statement: The authors have nothing to disclose.
First Published Online May 1, 2008
Abbreviations: AVP, Arginine vasopressin; COX, cyclooxygenase; EIA, enzyme immunoassay; HPA, hypothalamus-pituitary-adrenal; icv, intracerebroventricularly; PGE2, prostaglandin estradiol; PGHS, prostaglandin endoperoxide synthase; POMC, proopiomelanocortin; PRL, prolactin.
Received January 28, 2008.
Accepted for publication April 24, 2008.
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C(T)) method. Methods 25:402–408[CrossRef][Medline]
5-
4-isomerase, tyrosine hydroxylase and phenylethanolamine N-methyl transferase in adrenal glands of sheep fetuses throughout gestation and neonates. J Reprod Fertil 96:127–134This article has been cited by other articles:
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C. E. Wood, M. Powers Fraites, and M. Keller-Wood Blockade of PGHS-2 inhibits the hypothalamus-pituitary-adrenal axis response to cerebral hypoperfusion in the sheep fetus Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2009; 296(6): R1813 - R1819. [Abstract] [Full Text] [PDF] |
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