Phorbol ester-induced stimulation of prostaglandin biosynthesis in human amnion cells

Eicosanoids and preterm labour

Products of arachidonic acid metabolism (eicosanoids, e.g. some prostaglandins and leukotrienes) have important roles in the maintenance of pregnancy, and certain diseases of pregnancy such as pregnancy-induced hypertension and the machanism(s) of parturition both at term and before term. The volume of literature describing these last relationships dictates that the present review has to be focused rather than global in nature. Only studies of preterm labour in women and the use of human tissues will be discussed in detail despite the limitations in experimental designs that are imposed on such studies. Emphasis will be placed on studies of cyclo-oxygenase and to a lesser extant lipoxygenase pathways of arachidonic acid metabolism mentioning only briefly the pathways for catabolism of these eicosanoids. It should be noted also that eicosanoids from the epoxygenase pathways and those not derived from arachidonic acid will not be discussed here. The review of literature will not be comprehensive but rather selective in order to focus on specific issues of importance or controversy. In developing concepts of regulation I have emphasized studies with amnion since this tissue has received most attention experimentally. The significance of the eicosanoids in the mechanisms of labour at term and before will be described primarily in a section in which I have attempted to deleneate those regulatory mechanisms that are considered most significant in, or specific to, pregnancy and parturition. Studies of labour at term will be freely interspersed with studies specific to preterm labour since the latter are limited, and we need a ‘strandard’ for comparison; moreover, results from one series of studies helps the development of concepts for the other. Finally, the reader is directed to several excellent reviews that concentrate on areas not emphasized in this review.1–7

Endocrinology of labour

Preterm labour, defined as delivery before 37 weeks of completed pregnancy, continues to present a major problem in clinical obstetrics and remains the major contributory factor to the perinatal mortality and morbidity statistics. While it is now possible, with recent advances in neonatal care, to take infants delivered very prematurely and provide them with the lifelines that will ensure their ultimate discharge from the neonatal intensive care nursery, the cost of this form of management – in terms both of health care funds and of emotion – is extraordinarily high. Hence there remains a strong rationale for attempting to understand the underlying biochemistry and physiology of labour in order to develop methods of recognizing the patient in true preterm labour, and of developing better strategies to prevent or to manage this condition. In the best of our neonatal intensive care settings, survival of the infant born at 28–30 weeks’ gestation, or greater than 1500 grams, may be greater than 90%. Thus, the clinical management strategy may be directed more towards sustaining intrauterine life for 4–6 weeks in those patients presenting in preterm labour before this time in order to gain time for intrauterine maturation of these fetuses before they are delivered to the tertiary care NICU setting.

Regulation of prostaglandin H synthase-2 in chorion and decidual cells

The regulation of chorio-decidual prostaglandin biosynthesis has important implications for our understanding of the mechanisms of human parturition. It has been known for many years that prostaglandin H synthase (PGHS) is a key enzyme in prostaglandin biosynthesis but recently an inducible form (PGHS-2) has been identified that is separate from the constitutive form (PGHS-1). We have evaluated whether substances known to stimulate prostaglandin biosynthesis in chorio-decidua act via PGHS-2. Human chorion and decidual cells were grown to confluence and treated for up to 16 h with interleukin 1 beta 10 ng/ml), epidermal growth factor (EGF) (10 ng/ml) or phorbol 12-myristate 13-acetate (PMA) (10(-7) M). Microsomal protein was isolated, separated by gel electrophoresis and PGHS-2 amounts determined using an antibody specific for PGHS-2. All three test agents caused an increase in PGHS-2 levels in chorion cells (189%-288%) and decidual cells (153%-541%). Hence, induction of PGHS-2 is one of the mechanisms by which several substances can elevate the rate of prostaglandin biosynthesis.

Cyclosporin A inhibits prostaglandin E2 production by fetal amnion cells in response to various stimuli

Use of cyclosporin A as part of an immunosuppressive regimen in pregnant transplant patients is not uncommon. Although successful pregnancies have been reported with the use of various immunosuppressive agents including cyclosporin A, the concern for fetal outcome still remains. Our purpose was to evaluate the effects of immunosuppressive cyclosporin A on prostaglandin E2 (PGE2) production by human fetal amnion. Amnion cells were isolated from term placentae obtained at elective cesarean section before the onset of labor. Cells were grown to confluence and then incubated for 16 hours with cyclosporin A (1-1000 ng/ml) in the presence and absence of interleukin 1 beta (IL-1 beta, 1 ng/ml), phorbol 12-myristate 13-acetate (PMA, 10(-7) M) and ionomycin (0.5 microM). PGE2 was measured by radioimmunoassay and cellular protein determined. IL-1 beta, PMA and ionomycin all stimulated amnion cell PGE2 production as expected. However, these stimulatory actions were attenuated by at least 50% when cells were co-incubated with cyclosporin A (1000 ng/ml). Concentrations of cyclosporin A tested included the therapeutic range (250-1000 ng/ml). Our results indicate that cyclosporin A does not stimulate amnion cell PGE2 production and is probably unrelated to preterm labor and delivery in allograft recipients.

Prostaglandin H synthase-2 in human gestational tissues: regulation in amnion

Using reverse transcriptase-polymerase chain reaction we have established that mRNAs for prostaglandin H synthases 1 and 2 (PGHS-1 and PGHS-2) are present in amnion, chorion and decidua from women both at term before and after the onset of labour and from women at 28-35 weeks of gestation before the onset of labour. By Western blot analyses we have demonstrated that epidermal growth factor, interleukin 1 beta and phorbol 12-myristate 13-acetate all increase PGHS-2 amounts in amnion cells. The degree of stimulation caused by these substances (218-311 per cent) is less than the increase in prostaglandin production usually generated (five- to 10-fold). Hence we believe that these substances may have multiple sites of action in the pathways of arachidonic acid metabolism.

Interleukin-1 beta-stimulated prostaglandin synthesis by human decidual cells is independent of protein kinase C

Basal prostaglandin E2 (PGE2) synthesis by human decidual cells was stimulated by phorbol myristate acetate (PMA) which activates protein kinase C. Staurosporine, which is an inhibitor of protein kinase C in most systems, also increased basal PGE2 synthesis. Further work is needed to explain this finding, as another inhibitor of protein kinase C, H7, inhibited PGE2 production under similar culture conditions. Interleukin-1 beta (IL-1 beta)-stimulated PGE2 synthesis was potentiated by coincubation with PMA or staurosporine, indicating that IL-1 beta and protein kinase C increase decidual PGE2 synthesis through different mechanisms. Desensitization of the decidual cells for 24 h with PMA did not affect IL-1 beta-stimulated PGE2 synthesis. The complex roles of protein kinase C in regulating decidual prostaglandin synthesis require further investigation, but it is clear that the effects of IL-1 beta are not mediated by protein kinase C.

Regulation of intrauterine prostaglandin biosynthesis: interactions between protein kinase C and interleukin 1 beta

Activation of protein kinase C with phorbol esters stimulates prostaglandin (PG) biosynthesis in many cell types whereas down-regulation of protein kinase C can suppress stimulatory responses. Interleukin-1 beta (IL-1 beta) can stimulate PG production by intrauterine tissues and may play a significant part in the mechanisms of preterm labor associated with intrauterine infection. Hence we have evaluated the effects of staurosporine and H7 (inhibitors of protein kinase C) on IL-1 beta stimulation of amnion, chorion and decidual prostaglandin E2 (PGE2) production. Staurosporine and H7 alone were without effect on PGE2 production by any cell type. However with minor exceptions both protein kinase C inhibitors enhanced the stimulatory actions of IL-1 beta on PGE2 production by all three cell types. Hence we believe that protein kinase C is closely linked to the regulation of intrauterine PG biosynthesis and that these links may have multiple layers of complexity.

Protein kinase A interactions with prostaglandin biosynthesis at the chorio-decidual interface

Activation of the enzyme adenylate cyclase or treatment with dibutyryl cyclic AMP (dbcAMP) stimulates prostaglandin biosynthesis in vitro and in vivo. Prior activation of adenylate cyclase has been shown to inhibit the stimulation of amnion cell prostaglandin E2 (PGE2) biosynthesis by substances such as epidermal growth factor (EGF) and phorbol 12-myristate 13-acetate (PMA). Little is known, however, concerning the effects of activation of the adenylate cyclase system on basal and stimulated prostaglandin biosynthesis in human chorion and decidual cells. Interleukin-1 beta (IL-1 beta), EGF, ionomycin (iono), and PMA are known to stimulate prostaglandin E2 production in human chorion and decidual cells. Hence, we have evaluated the effects of co-treatment of chorion and decidual cells with dbcAMP in the presence and absence of EGF, PMA, IL-1 beta, and iono on prostaglandin production. dbcAMP alone stimulated chorion and decidual PGE2 production. Coincubation of dbcAMP with all four test stimulants resulted in a further enhancement of decidual PGE2 production that was often more than additive. Thus activation of adenylate cyclase can have effects on prostaglandin production that have specificity with respect to tissue source, presence of other stimulants and relative time of exposure of the tissues to each of the substances involved.

Tumor necrosis factor alpha stimulates amnion prostaglandin biosynthesis primarily via an action on fatty acid cyclooxygenase

The purpose of this study was to determine how tumor necrosis factor alpha (TNF alpha) stimulates prostaglandin E2 production in human amnion. Amnion cells were isolated from term placentae and grown to confluence in culture. Incubations were conducted in quadruplicate wells for 16 hours with TNF alpha and protein synthesis inhibitors cycloheximide and actinomycin D, or arachidonic acid, acetylsalicylic acid (ASA), or staurosporine or H7 which inhibit protein kinase C activity. Prostaglandin E2 (PGE2) was measured by radioimmunoassay and cellular protein determined. The stimulatory action of TNF alpha on amnion PGE2 production was blocked by protein synthesis inhibitors, and the addition of arachidonic acid always enhanced the stimulatory properties of TNF alpha. TNF alpha consistently induced more rapid recovery from ASA treatment, and protein kinase C inhibition attenuated the stimulatory effects of TNF alpha. These results suggest that the stimulatory action of TNF alpha on amnion PGE2 production is likely at the level of induction of fatty acid cyclooxygenase activity and is partially dependent upon activation of protein kinase C.

Oxytocin receptors and prostaglandin release in rabbit amnion

Besides stimulating uterine myometrial and mammary myoepithelial cell contraction, oxytocin (OT) causes the release of prostaglandins (PGs) from uterine endometrium/decidua and amnion cells. Lacking information about OT receptors eliciting PG release, we don't know how they are related to OT receptors involved in smooth muscle contraction. The amnion offers great potential for characterizing OT receptors associated with PG release, as the amount of iodinated OT antagonist ([125I]OTA) bound to rabbit amnion membranes during labor is among the greatest of any tissue yet studied, reaching about 10 pmol/mg membrane protein. The relative affinities of several OT analogues for binding sites on amnion membranes are the same as those on decidual membranes. There are differences in the ligand profile between amnion and myometrium, but they could be due to the additional presence of vasopressin receptors on myometrial membranes. An increase in the sensitivity of PGE2 release from amnion cells in culture to OT and analogues accompanies the rise in OT receptor concentration at the end of gestation. Increases in [125I]OTA binding in vivo can be mimicked with cultured amnion cells by addition of agents that elevate intracellular cAMP levels. Based on the time course and inhibition of the increase with cycloheximide, cAMP might induce OT receptor gene expression. The increase also is reflected by a marked elevation in the covalent labeling of a 50-kDa electrophoretic band with a photoactivated derivative of [125I]OTA. Because of the homogeneity of cell types in the amnion, the ease of culturing amnion cells, and the high concentration of OT receptors that can be induced, this tissue should be very useful in characterizing OT receptors associated with PG synthesis.

Protein kinase A activators inhibit agonist induced prostaglandin production in human amnion

Prostaglandin (PG) production by human amnion has been postulated to have a role in the onset of labor. Previous work by ourselves and others has demonstrated that oxytocin, phorbol esters and epidermal growth factor (EGF) increase PGE2 production in human amnion cells by activation of the Phospholipase C/Protein Kinase C (PKC) cascade system. The present study was undertaken to determine the effect of prior activation of the Adenylate Cyclase cascade system upon subsequent stimulation of PGE2 production by oxytocin, phorbol 12-myristate-13-acetate (PMA) or EGF in amnion cells and membrane discs. Isoproterenol, forskolin and dibutyryl cyclic adenosine monophosphate (dbcAMP) were utilized to activate the Adenylate Cyclase system at the receptor, enzyme and second messenger level. In control amnion cells, oxytocin, PMA and EGF each provoked dose dependent increases in PGE2 production. In cells preincubated with dbcAMP, forskolin or isoproterenol, agonist stimulated PGE2 production was markedly (50-90%) inhibited (p < 0.01). Inhibition was dose dependent upon preincubator concentrations. Maximal inhibition by adenylate cyclase activators occurred with 2-4 h of preincubation. In membrane discs, forskolin preincubation also inhibited oxytocin, PMA and EGF stimulation of PGE2 production. Activation of the Adenylate Cyclase system in human amnion cells or membrane discs inhibits the subsequent action of potent stimulators of PGE2 production in human amnion.

An endothelial cell model for the investigation of the molecular regulation of fetal vascular tone

Human umbilical vessels are not innervated, and hence regulation of tone in these vessels must come from locally derived vasoactive substances such as prostacyclin. To evaluate the regulation of prostacyclin production by human umbilical vein endothelial cells, we incubated confluent cultures of these cells with various concentrations of inflammatory mediators (endotoxin, interleukin-1 beta, and tumor necrosis factor), protein kinase C agonists (phorbol 12-myristate 13-acetate, phorbol 12,13-dibutyrate), and calcium ionophores (A-23187 and ionomycin). Human umbilical vein endothelial cells were prepared from term pregnancies, and confluent cultures were incubated with test substances for 16 hours. Prostacyclin was measured as its metabolite 6-keto-prostaglandin F1 alpha by radioimmunoassay. Concentration-related increases in 6-keto-prostaglandin F1 alpha production were observed in response to endotoxin, cytokines, phorbol esters, and calcium ionophores. We conclude that human umbilical vein endothelial cell prostacyclin production is influenced by several intracellular messengers and that human umbilical vein endothelial cells may provide a useful in vitro model for investigating the physiology and pathophysiology of umbilical vessel vascular tone.

Regulation of chorion laeve prostaglandin E2 production by epidermal growth factor, protein kinase C activation and calcium

The effects of epidermal growth factor (EGF), phorbol 12-myristate 13-acetate (PMA), A23187, and ionomycin on prostaglandin production by chorion laeve cells in culture for 3 days and 10 days were tested. Experiments were conducted at day 3 because at this time the cultures became confluent and again at day 10 because changes have been observed in the biochemical properties of these cells with time in culture. At 3 days of culture the cells did not respond to EGF but at 10 days EGF (10 ng/ml) induced a significant increase in prostaglandin E2 production. PMA (10(-9) to 10(-6) M) induced a significant increase in PGE2 production at both times in culture. The calcium ionophores, A23187 and ionomycin, were less effective in eliciting a response at either time in culture. Only A23187 (1 microM) induced a significant increase in PGE2 production at day 10 of culture. These data suggest that the presence of functional EGF receptors may increase with time in culture. Furthermore, activation of the protein kinase C pathway in the chorion laeve stimulates prostaglandin biosynthesis. On the other hand, chorion laeve cell prostaglandin biosynthesis is not responsive to increases in intracellular calcium induced by mobile ion carriers such as the ionophores used in this study.

Epidermal growth factor and the regulation of amnion prostaglandin biosynthesis

The production of prostaglandins by amnion is a key factor in the mechanism of human parturition yet the regulation of prostaglandin biosynthesis in amnion is poorly understood. Hence, we have investigated the regulation of epidermal growth factor (EGF) stimulation of prostaglandin biosynthesis in human amnion cells. This stimulatory action is inhibited by cycloheximide or actinomycin D at high concentrations, but enhanced at much lower concentrations of these protein synthesis inhibitors. An amnion-produced prostaglandin inhibitor or immediate early gene action may explain these effects. Pretreatment with phorbol esters (inhibition of protein kinase C activity) reduces basal prostaglandin production and attenuates the stimulatory action of EGF on prostaglandin biosynthesis. Hence, amnion prostaglandin biosynthesis is dependent partly on protein kinase C activity.

Evidence of a role for protein kinase C in epidermal growth factor-induced prostaglandin E2 synthesis in amnion cells

Human amnion cells synthesize and release prostaglandin E2 in response to epidermal growth factor. The protein kinase C activator, phorbol 12-myristate, 13-acetate also stimulates amnion cell prostaglandin E2 synthesis. We used a human amnion cell line (WISH) to conduct in vitro experiments to investigate a potential role of protein kinase C in the signal transduction pathway leading to epidermal growth factor-induced prostaglandin E2 production. Pretreatment of cultured amnion cells with a low, nonstimulating dose of phorbol 12-myristate, 13-acetate potentiated the action of epidermal growth factor in causing prostaglandin E2 production as measured by radioimmunoassay. The protein kinase C-selective inhibitor staurosporine inhibited epidermal growth factor-induced prostaglandin E2 production, further suggesting a role for protein kinase C in epidermal growth factor action. Experiments were conducted in which amnion cells were rendered protein kinase C-deficient by chronic exposure to phorbol ester, which has been shown to down-regulate the enzyme. In these cells, epidermal growth factor caused prostaglandin E2 synthesis at levels comparable to native (non-protein kinase C-deficient) cells. We conclude that protein kinase C plays a more modulatory than direct role in the epidermal growth factor signal transduction cascade that leads to prostaglandin E2 production by amnion cells. We propose a bifurcating transduction scheme in which, under conditions of protein kinase C inactivation, epidermal growth factor alone causes prostaglandin E2 synthesis. When protein kinase C is activated by as yet unknown endogenous substances, the epidermal growth factor responsiveness of the amnion cells is greatly enhanced. This pathway could have important implications in a feed-forward mechanism regulating the level of prostaglandin E2 production during the onset of labor.

Modulation of phospholipase A2 activity by the tumour promoters phorbol esters and teleocidin

The effects of tumour promoters, namely phorbol esters and teleocidin, on the activity of porcine pancreatic phospholipase A2 (PLA2) was investigated by using a system of small unilamellar vesicles composed of dipalmitoyl-phosphatidylcholine (DPPC). DPPC vesicles encapsulating Quin 2 (Quin 2/DPPC vesicles) were suspended in a medium containing Ca2+. The addition of PLA2 to Quin 2/DPPC vesicles increased the fluorescence intensity of Quin 2. This increase was due to chelation of Quin 2 with Ca2+, which resulted from an increase in the permeability of the phospholipid bilayer caused by the hydrolytic activity of PLA2. The tumour promoters phorbol 12-myristate 13-acetate (PMA) and teleocidin, at low concentrations, enhanced PLA2 activity at temperatures below the phase-transition temperature of the membrane, but, in contrast, high concentrations of the tumour promoters suppressed PLA2 activity. Phorbol 12-myristate (PM) also had a similar effect on PLA2 activity. PMA and PM disturbed the membrane structure markedly, which was indicated by the enhanced leakage of carboxyfluorescein (CF) from DPPC vesicles encapsulating CF. On the other hand, phorbol 12,13-didecanoate and 4 alpha-phorbol 12,13-didecanoate, which did not disturb the membrane structure to the same extent, had an insignificant effect on PLA2 activity. It is therefore concluded that PLA2 catalyses the hydrolysis of phospholipids in bilayer vesicles which contain a moderate degree of structural defects. However, the effects of tumour promoters on PLA2 activity was not related to their potencies as inflammatory and tumour-promoting agents.

Characterization of prostaglandin production in amnion-derived WISH cells

This study was undertaken to characterize prostaglandin production and its regulation in the human amnion-derived WISH cell line. Epidermal growth factor, tumor growth factor-alpha, tumor growth factor-beta, human interleukin-1, tumor necrosis factor, phorbol 12-myristate 13-acetate, phorbol 12,13-dibutyrate, 4 alpha-phorbol 12,13 didecanoate, and dexamethasone were tested for their ability to modulate prostaglandin production in WISH cells. Quantitatively, the major prostaglandin produced in WISH cells was prostaglandin E2. Treatment with epidermal growth factor, tumor growth factor-alpha, tumor necrosis factor, interleukin-1, phorbol 12,13-dibutyrate, and phorbol 12-myristate 13-acetate resulted in a concentration-dependent stimulation of WISH cell prostaglandin E2 production; tumor growth factor-beta and the inactive phorbol ester analog 4 alpha-phorbol 12,13 didecanoate had no effect. Dexamethasone treatment resulted in concentration-dependent inhibition of prostaglandin E2 production by WISH cells. WISH cells responded in a qualitatively similar manner to that previously observed in primary cultures of human amnion with the exception of the response to dexamethasone. On the basis of the findings of this investigation, we suggest that WISH cells may be a useful model for studying some but not all aspects of the regulation of arachidonic acid release and prostaglandin E2 formation in amnion. WISH cells may also be used to evaluate the mechanisms that link regulation of immune function and arachidonic acid metabolism.