Calcitonin gene related peptide, adrenomedullin and adrenomedullin2 function in uterine artery during human pregnancy
Abstract Rationale Calcitonin gene-related peptide (CGRP) and its family members adrenomedullin (ADM) and adrenomedullin2 (ADM2) also known as Intermedin support vascular adaptions in rat pregnancy. Objective To assess the relaxation response of uterine artery (UA) for CGRP, ADM, and ADM2 in non-pregnant and pregnant women and identify the involved mechanisms. Findings 1) Segments of UA from non-pregnant women that were pre-contracted with U46619 (1μM) in-vitro are insensitive to the hypotensive effects of CGRP, ADM and ADM2, 2) CGRP, ADM, and ADM2 (0.1nM – 100nM) dose-dependently relax UA segments from pregnant women with efficacy for CGRP>ADM=ADM2 , 3) The relaxation responses to CGRP, ADM and ADM2 are differentially affected by the inhibitors of nitric oxide (NO) synthase (L-NAME), adenylyl cyclase (SQ22536), apamin and charybdotoxin, 4) UA smooth muscle cells (UASMC) express mRNA for calcitonin receptor-like receptor (CRLR) and receptor activity modifying protein (RAMP)1 and RAMP2 but not RAMP3, 5) Receptor heterodimer comprised of CRLR/RAMP1 and CRLR/RAMP2 but not CRLR/RAMP3 is present in UA, 6) soluble fms-like tyrosine kinase (sFLT-1) and TNF-α treatment decrease the expression of RAMP1mRNA (p< 0.05) in UASMC and, 7) sFLT-1 treatment impairs the association of CRLR with all the three peptides while TNF-α inhibits the interaction of CGRP but not ADM or ADM2 with CRLR in UASMC (p< 0.05). Conclusions Relaxation sensitivity of UA for CGRP, ADM and ADM2 is increased during pregnancy via peptide specific involvement of NO system and endothelium derived hyperpolarizing factors, and vascular disruptors such as sFLT-1 and TNFα adversely impact their receptor system in UASMC.