Molecular evidence of functional progesterone withdrawal in human myometrium

Nat Commun. 2016 May 25:7:11565. doi: 10.1038/ncomms11565.

Abstract

Progesterone suppresses uterine contractility acting through its receptors (PRA/B). The mechanism by which human labour is initiated in the presence of elevated circulating progesterone has remained an enigma since Csapo first theorized of a functional withdrawal of progesterone in 1965. Here we report that in vitro progesterone-liganded nuclear PRB forms a complex including JUN/JUN homodimers and P54(nrb)/Sin3A/HDAC to repress transcription of the key labour gene, Cx43. In contrast, unliganded PRA paradoxically activates Cx43 transcription by interacting with FRA2/JUND heterodimers. Furthermore, we find that while nuclear progesterone receptor (PR) is liganded during human pregnancy, it becomes unliganded during both term and preterm labour as a result of increased expression of the progesterone-metabolizing enzyme 20α HSD and reduced nuclear progesterone levels. Our data provide a mechanism by which human labour can occur in the presence of elevated circulating progesterone and suggests non-metabolizable progestogen might represent an alternative new therapeutic approach to preterm birth prevention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Connexin 43 / metabolism*
  • Dimerization
  • Female
  • HEK293 Cells
  • Humans
  • Hydroxysteroid Dehydrogenases / metabolism
  • Labor, Obstetric / metabolism*
  • Mice
  • Myometrium / metabolism*
  • Obstetric Labor, Premature / metabolism
  • Oncogene Proteins v-fos / metabolism
  • Pregnancy
  • Progesterone / metabolism*
  • Proto-Oncogene Proteins c-jun / metabolism
  • Receptors, Progesterone / metabolism*
  • Transcription Factor AP-1 / metabolism
  • Transcriptional Activation

Substances

  • Connexin 43
  • Oncogene Proteins v-fos
  • Proto-Oncogene Proteins c-jun
  • Receptors, Progesterone
  • Transcription Factor AP-1
  • progesterone receptor A
  • progesterone receptor B
  • Progesterone
  • Hydroxysteroid Dehydrogenases