Midtrimester abortion using intraamniotic prostaglandin F2α

Prostaglandin F_2α (PGF_2α) was instilled intraamnniotically in varying amounts and at different intervals in 40 patients in the second trimester of pregnancy. Using an F prostaglandin radioimmunoassay as a clinical tool, a regimen was developed in which 40 mg of PGF_2α were instilled in a single injection. Of 35 patients so treated, 26 aborted completely and 9 partially. The results compare favorably with those reported with hypertonic saline. The mean treatment-abortion interval among the 26 patients who received the high dose was 22.3 hours. The side effect rate was low and acceptable, and no effect was noted on blood clotting mechanisms.     

First trimester abortions induced by a single extraovular injection of prostaglandin F2α

The abortifacient effect of a single extraovular dose of 10mg PG F2α has been successfully demonstrated without additional therapy in first trimester pregnant patients. The immediate response to PG F2α was manifest as uterine pain which tapered off after about 2 hours. Slight uterine bleeding and decreased levels of plasma estradiol-17β and progesterone measured at 2 hours suggested an initial insult of PG F2α on the feto-placental unit. Subsequent reappearance of uterine activity and progressive cervical dilatation signaled effective therapy. Six patients out of 10 aborted completely in an average of 8.0 hours. The other 4 aborted their fetuses in 15.8 hours on the average but retained their placentae. Plasma steroid levels in the former group were decreased still further at the time of diagnostic curettage (22 hours); however, steroid levels remained unchanged in the latter group during the interval between 2 and 22 hours. These results suggest the possibility that, following the successful provocation of feto-placental insult by PG F2α, supplemental treatment with oxytocics might reduce instillation abortion time and increase the incidence of complete abortions.     

Prostaglandin induced early abortions in the bovine. Clinical outcome and endogenous release of prostaglandin F2α and progesterone

Peripheral blood plasma levels of progesterone and the main blood plasma metabolite of prostaglandin F_2α (15-keto-13, 14-dihydro-PGF_2α) were analysed in 12 heifers in which abortions were induced with a prostaglandin analogue (cloprostenol) at pregnancy stages from 39–146 days. All animals except one (treated on day 75 of pregnancy) aborted within 4 days following treatment.The peripheral plasma levels of progesterone decreased rapidly following the injection of cloprostenol. All heifers had shortlasting peaks of the prostaglandin metabolite in connection with luteal regression. In animals pregnant for less than 80 days this release ceased at the time of delivery of the fetuses, which were expelled within unruptured fetal membranes. Standing estrus was observed in connection with the expulsion of the fetuses. Two of the animals were mated at this estrus and became pregnant. In contrast, animals pregnant for more than 100 days released massive amounts of prostaglandin F_2α during a 2–5-days period post partum and had retained fetal membranes. No heat was observed in connection with these abortions. The animal that failed to abort showed no change in the prostaglandin metabolite levels.     

Decidual cell reaction induced by prostaglandin F2α in the mature oöphorectomized rat

Summary Sprague-Dawley rats were oöphorectomized and after a 2–3 week recovery period were given daily injections of progesterone (2.0 mg/0.1 ml) for six consecutive days. On the fourth day of progesterone treatment 0.2 mg of estradiol 17 was given in addition and the right uterine cornua were subjected to one of five experimental maneuvers. On the sixth day of progesterone treatment the uterine cornua were weighed and processed for light and electron microscopy. The weights of all left cornua (84.6 +- 3.7 mg) and the right cornua of PBS-injected (93.3 +- 11.5 mg) and sham operated uteri (83.6 +- 19.8 mg) were comparable. A significant increase (p<0.001) in weight was found in cornua that received PGF₂ (144 +- 6.7 mg), PGF₂ with mild local trauma (scratch) (146 +- 28.0 mg), and scratch alone (162 +- 12.7 mg). The majority of cornua treated by scratch alone, or by PGF₂ with or without scratch, showed a decidual cell reaction by light microscopy and had a significantly higher mitotic index than those treated with saline, or by sham operation. When specimens were evaluated for the presence of the OCR, the highest rank was found in tissues treated by scratch alone or by PGF₂ with or without scratch. Morphometric evaluation by light microscopy indicated that the extent of decidualization in PGF₂-treated tissue was comparable to that of scratchtreated tissue. Ultrastructural observation of PGF₂-treated tissue revealed that decidual cells closely resembled those treated with scratch. However, electron microscopic morphometry revealed that cells that responded to PGF₂ had higher volume and surface densities of organelles associated with metabolic activity than did cells responding to scratch alone. These results demonstrate that locally administered PGF₂ can initiate, in the hormonally prepared mature oöphorectomized rat, a DCR comparable to that induced by local trauma.     

On the mechanism of midtrimester abortions induced by the prostaglandin “impact”

Using Csapo's technique a single dose of 24.3±1.1mg PG F_2α had been delivered intraamniotically to 20 sedated 15.9±0.6 weeks pregnant patients, to provoke a “PG Impact” (PGI), a consequent progesterone (P) withdrawal and a conversion of the pharmacologically refractory normal pregnant uterus into a reactive organ. The side effects were occasional and acceptable and no further PG F_2α treatment was needed except in 4 cases (5–10mg). Only after the Oxytocin Test showed that the uterus is becoming reactive was 50mU/min oxytocin infused i.v., to facilitate the evolution of IUP to 93±3mm Hg and thus promote clinical progress. All the 20 patients aborted both the fetus and the placenta in 16.5±2.1 hours, but 8 women retained small placental residues to be removed by curettage. The Csapo Score was high, 92±2.As early as 3 hours after PGI, the plasma P levels already decreased significantly. They continued to decline throughout the IAT and reach a 72% withdrawal when the fetus was aborted. Fifteen patients, whose P-withdrawal was rapid aborted before the mean IAT, while those 5 women whose P-withdrawal was slow aborted after this time. Thus, the rate of P-withdrawal was directly, while parity and gestational age indirectly related to the IAT. Studies are in progress to elucidate further the abortifacient action of PG F_2α and through this knowledge promote predictable therapy.     

Prolactin Release induced by Prostaglandin F2α in Pregnant Rats

PROSTAGLANDIN (PGF2α) induces lactogenesis and advanced parturition when injected into pregnant rats¹. A luteolytic effect of PGF2α has also been demonstrated in pseudopregnant and pregnant rats^3,4, normal guinea-pig⁵, autotransplanted sheep ovary⁶ and pregnant hamster⁷. The decrease of plasma progesterone concentration before parturition^8–10 will trigger the release of prolactin and other hormones from the hypophysis and induce lactogenesis^11–13 which in the normal pregnant rat occurs around 12 h before parturition¹³.     

Pregnancy termination by prostaglandin F2α stimulates maternal behavior in the rat

Treatment with PGF_2α resulted in the termination of pregnancy in 16- and 19-day pregnant rats, but not in 10- or 13-day pregnant rats. Rats that aborted displayed a rapid onset of maternal behavior when tested with foster pups. Aborted rats also displayed sexual receptivity and ovulation: these phenomena resemble the sequence of events following hysterectomy on the same days of pregnancy. Both can be related to the events surrounding normal parturition in the rat. The results are interpreted as due to a pregnancy-induced deactivation of the factor in the uterus that prevents estrogen from stimulating maternal behavior in nonpregnant females. In the absence of this factor, the PGF_2α-induced rise in estrogen secretion facilitates maternal behavior and sexual behavior and induces ovulation.     

Experience with 276 intra-amniotic prostaglandin F2α induced midtrimester abortions

Induction of midtrimester abortion using 40 mg intra-amniotic prostaglandin F_2α was performed on 276 patients. Gestational age and fetal status had no effect on injection-to-abortion time while multiparity and the concomitant use of laminaria appeared to decrease the abortion time. The side effect and complication rates were acceptable and the results compare favorably with those of other midtrimester abortion techniques.     

Enzymatic formation of prostaglandin F2α in human brain

Prostaglandin (PG)E₂ 9-ketoreductase, which catalyzes the conversion of PGE₂ to PGF₂, was purified from human brain to apparent homogeneity. The molecular weight, isoelectric point, optimum pH, Km value for PGE₂, and turnover number were 34,000, 8.2, 6.5–7.5, 1.0 mM, and 7.6 min^–1, respectively. Among PGs tested, the enzyme also catalyzed the reduction of other PGs such as PGA₂, PGE₁, and 13,14-dihydro-15-keto PGF₂, but not that of PGD₂, 11-PGE₂, PGH₂, PGJ₂, or ¹²-PGJ₂. The reaction product formed from PGE₂ was identified as PGF₂, by TLC combined with HPLC. This enzyme, as is the case for carbonyl reductase, was NADPH-dependent, preferred carbonyl compounds such as 9,10-phenanthrenequinone and menadione as substrates, and was sensitive to indomethacin, ethacrynic acid, and Cibacron blue 3G-A. The reduction of PGE₂ was competitively inhibited by 9,10-phenanthrenequinone, which is a good substrate of this enzyme, indicating that the enzyme catalyzed the reduction of both substrates at the same active site. These results suggest that PGE₂ 9-ketoreductase, which belongs to the family of carbonyl reductases, contributes to the enzymatic formation of PGF₂ in human brain.Special issue dedicated to Dr. Sidney Udenfriend.     

Production of prostaglandin F2α by molecular breeding of an oleaginous fungus Mortierella alpina

Cyclooxygenases are responsible for the production of prostaglandin H₂ (PGH₂) from arachidonic acid. PGH₂ can be converted into some bioactive prostaglandins, including prostaglandin F_2α (PGF_2α), a potent chemical messenger used as a biological regulator in the fields of obstetrics and gynecology. The chemical messenger PGF_2α has been industrially produced by chemical synthesis. To develop a biotechnological process, in which PGF_2α can be produced by a microorganism, we transformed an oleaginous fungus, Mortierella alpina 1S-4, rich in triacylglycerol consisting of arachidonic acid using a cyclooxygenase gene from a red alga, Gracilaria vermiculophylla. PGF_2α was accumulated not only in the mycelia of the transformants but also in the extracellular medium. After 12 days of cultivation approximately 860 ng/g and 6421 µg/L of PGF_2α were accumulated in mycelia and the extracellular medium, respectively. The results could facilitate the development of novel fermentative methods for the production of prostanoids using an oleaginous fungus.     

Lysosomal Fragility induced by Prostaglandin F2α

PROSTAGLANDINS have been suggested as mediators of inflammatory reactions because they increase vascular permeability^1,2, are found in inflammatory exudates³, are released during antigen-antibody reactions⁴ and have leucotactic properties⁵. For this reason and because lysosomes have been assigned an important role in the pathogenesis of diverse tissue injury reactions⁶, we have studied the effect of prostaglandins on lysosomal fragility.     

Effect of prostaglandin F2α on anterior pituitary function in man

Five healthy adult men received iv PGF_2α at dosages of 0.05, 0.20 and 2.0 μg/kg/min for 30 min. There were no significant changes in serum FSH, LH or TSH levels. Serum GH and cortisol levels were slightly increased at the highest dosage. These responses were associated with, and presumably a result of, stressful side effects. Thus, PGF_2α cannot be used as a provocative test of pituitary hormone reserve.Prostaglandins (PG's) have recently been implicated in the release of a number of hormones from the anterior pituitary gland. The stimulation of GH release by PG's of the E series from incubated rat pituitary slices has been demonstrated. $\text{In vivo}$ stimulation by PGE₁ of ACTH in rats and of GH release in man has also been shown.The present study was undertaken in order to examine the efficacy of iv administration of PGF_2α as a provocative test of anterior pituitary hormone reserve in man. The responses in circulating levels of gonadotropins, TSH, GH, and cortisol (as an index of ACTH) were measured.     

Antiluteogenic effects of serial prostaglandin F2α administration in cycling mares

A single dose of PGF2α does not consistently induce luteolysis in the equine CL until at least 5 days after ovulation, leading to the erroneous assumption that the early CL is refractory to the luteolytic effects of PGF2α. We hypothesized that serial administration of PGF2α in early diestrus would induce a return to estrus similar to mares treated with a single injection in mid-diestrus, and fertility of the induced estrus would not differ. The objectives of the study were to evaluate the effects of the 2 approaches as reflected by: (1) concentrations of plasma progesterone; (2) interovulatory and treatment-to-ovulation intervals; (3) the proportion of mares pregnant after artificial insemination. The study consisted of a balanced crossover design in which 10 reproductively normal Quarter Horse Mares were exposed to 2 treatments on 2 consecutive reproductive cycles. At detected ovulation (Day 0), mares were randomly allotted to 1 of 2 treatment groups: I, mid-diestrus treatment, administration of a single 10-mg dose of dinoprost tromethamine (PGF2α) im on Day 10; II, early diestrus treatment, administration of 10-mg PGF2α im twice daily on Days 0, 1, and 2 and once daily on Days 3 and 4. Mares in estrus and with a follicle 35 mm or greater in diameter were artificially inseminated with at least 2 billion motile sperm from a fertile stallion. Pregnancy was defined as detection of a growing embryonic vesicle on 2 consecutive examinations approximately 14 days after ovulation. Serial plasma samples were collected throughout the study period, and concentration of plasma progesterone was determined by RIA. A mixed-model ANOVA for repeated measures was used to analyze hormonal data. Interovulatory and treatment-to-ovulation intervals were compared by a paired t test and fertility by a McNemar chi-square analysis. All mares in group I underwent luteolysis after PGF2α administration denoted by mean (±SD) concentration of plasma progesterone of 0.25 ± 0.21 ng/mL detected 2 days after treatment. In group II, mean concentration of plasma progesterone remained below 1.0 ng/mL during treatment and until the onset of the next estrus. The mean interovulatory interval in group I was 18.5 ± 2.0 days compared with 13.1 ± 3.7 days in group II (P < 0.01). Treatment-to-ovulation intervals were 8.5 ± 2.0 days and 13.1 ± 3.7 days for groups I and II, respectively (P < 0.05). In both groups, 9 of 10 mares were pregnant (P = 1.0). Serial PGF2α administration beginning at ovulation consistently prevented luteal function in 10 of 10 mares in the present study without adversely affecting pregnancy rate of post-treatment cycles.     

Tunicamycin inhibits prostaglandin F2α receptor-mediated phosphoinositide hydrolysis in cultured rat astrocytes

Effect of tunicamycin, an inhibitor of N-linked glycosylation, on prostaglandin (PG) F₂-stimulated phosphoinositide (PI) hydrolysis was examined in cultured rat astrocytes. Pretreatment of cultured astrocytes with tunicamycin (25–250 ng/ml) inhibited subsequent PGF₂ (1 M)-stimulated PI hydrolysis in concentration- and time-dependent manners. The inhibition completely recovered after removal of tunicamycin and re-incubation for 12 h. Tunicamycin pretreatment (100 ng/ml for 12 h) significantly blocked [³⁵S]methionine incorporation into cultured astrocytes, but cell viability was not affected under the condition. Inhibitors of processing of N-linked sugar chains such as bromoconduritol, 1-deoxymannojirimycin, and swainsonine had no effect on PI response to PGF₂. These observations suggest that PGF₂ receptor is N-linked glycosylated.     

Desensitization of prostaglandin F2α receptor-mediated phosphoinositide hydrolysis in cultured rat astrocytes

Desensitization of prostaglandin (PG) F₂ receptor-mediated phosphoinositide (PI) hydrolysis was investigated in cultured rat astrocytes. Prolonged exposure of astrocytes differentiated by dibutyryl cyclic AMP-treatment to PGF₂ caused the desensitization of subsequent PGF₂-induced PI hydrolysis. The desensitization was time- and PGF₂ dose-dependent; maximal decrease in the PI hydrolysis was observed after exposure to 10 M PGF₂ for 4 h and the degree of the desensitization was 31.7±2.7% of control. Pretreatment with either PGD₂ or PGE₂ also induced the desensitization of subsequent PGF₂-stimulated PI hydrolysis and conversely pretreatment of PGF₂ decreased the PI responses to PGD₂ and PGE₂. The desensitization prevented by phloretin and was reversible upon removal of the agonist. Protein synthesis inhibitors blocked the recovery of the desensitization. Treatment of the cells with phorbol 12-myristate 13-acetate had no effect on the desensitization. These results suggest that prolonged exposure of the astrocytes to PGF₂ caused the desensitization of the receptors.     

Doses of prostaglandin F2α effective for induction of parturition in goats

Twelve mixed breed does were injected with different doses of prostaglandin F₂α (PGF₂α) or saline on day 144 of gestation. Four each received single intramuscular injections of 5.0 or 2.5 mg PGF_2α, or 1.0 ml saline (controls). Systemic progesterone (P₄) concentrations were determined daily from day 144 until the day of kidding. Does receiving 5.0 mg PGF₂α, 2.5 mg PGF₂α, or saline kidded within mean (± SD) hours and range (hours) of 35 ± 8.6 and 28–48, 43 ± 11.8 and 29–57, and 111 ± 79.1 and 41–200, respectively. Mean (± SD) concentrations of P₄ (ng/ml) on the day of injection and on day 1 postinjection were 5.2 ± 2.6 and 0.7 ± 0.9, 5.3 ± 2.2 and 1.1 ± 1.0, and 6.4 ± 3.9 and 4.1 ± 2.6 for does receiving 5.0 mg PGF₂α, 2.5 mg PGF₂α, or saline, respectively. It was concluded that 5.0 mg and 2.5 mg PGF₂α effectively shortened the interval from injection to parturition, but that this interval was not as predictable as that previously reported with 20 mg PGF₂α.     

Biasing the prostaglandin F2α receptor responses toward EGFR-dependent transactivation of MAPK

The G protein-coupled prostaglandin F2α (PGF2α) receptor [F prostanoid (FP) receptor] has been implicated in many physiological events including cardiovascular, respiratory, immune, reproductive, and endocrine responses. Binding of PGF2α to FP receptor elicits inositol production and protein kinase C-dependent MAPK activation through Gα(q) coupling. Here we report that AL-8810, previously characterized as an orthosteric antagonist of PGF2α-dependent, Gα(q)-mediated signaling, potently activates ERK1/2 in a protein kinase C-independent manner. Rather, AL-8810 promoted ERK1/2 activation via an epidermal growth factor receptor transactivation mechanism in both human embryonic kidney 293 cells and in the MG-63 osteoblast-like cells, which express endogenous FP receptors. Neither AL-8810- nor PGF2α-mediated stimulation of FP receptor promoted association with β-arrestins, suggesting that MAPK activation induced by these ligands is independent of β-arrestin's signaling scaffold functions. Interestingly, the spatiotemporal activation of ERK1/2 promoted by AL-8810 and PGF2α showed almost completely opposite responses in the nucleus and the cytosol. Finally, using [(3)H]thymidine incorporation, we noted differential regulation of PGF2α- and AL-8810-induced cell proliferation in MG-63 cells. This study reveals, for the first time, the signaling biased nature of FP receptor orthosteric ligands toward MAPK signaling. Our findings on the specific patterns of ERK1/2 activation promoted by FP receptor ligands may help dissect the distinct roles of MAPK in FP receptor-dependent physiological responses.     

Coupling between cyclooxygenases and prostaglandin F2α synthase: Detection of an inducible,glutathione-activated,membrane-bound prostaglandin F2α-synthetic activity

Distinct functional coupling between cyclooxygenases (COXs) and specific terminal prostanoid synthases leads to phase-specific production of particular prostaglandins (PGs). In this study, we examined the coupling between COX isozymes and PGF synthase (PGFS). Co-transfection of COXs with PGFS-I belonging to the aldo-keto reductase family into HEK293 cells resulted in increased production of PGF_2α only when a high concentration of exogenous arachidonic acid (AA) was supplied. However, this enzyme failed to produce PGF_2α from endogenous AA, even though significant increase in PGF_2α production occurred in cells transfected with COX-2 alone. This poor COX/PGFS-I coupling was likely to arise from their distinct subcellular localization. Measurement of PGF_2α-synthetic enzyme activity in homogenates of several cells revealed another type of PGFS activity that was membrane-bound, glutathione (GSH)-activated, and stimulus-inducible. In vivo, membrane-bound PGFS activity was elevated in the lung of lipopolysaccharide-treated mice. Taken together, our results suggest the presence of a novel, membrane-associated form of PGFS that is stimulus-inducible and is likely to be preferentially coupled with COX-2.