Pregnancy is usually associated with various gastrointestinal (GI) complaints such as
nausea, vomiting, reduced colonic activity resulting in varying degrees of constipation, and
various gastric emptying disorders (1,2,3). There is an
accumulating body of evidence to suggest that the myoelectric and motor activities of the GI
smooth muscle are disturbed during pregnancy. In support of this suggestion, it has been
found that pregnancy is associated with decreased gallbladder contractivity (4, 5), lowered
esophageal sphincter pressure (6,7,8), reduced gastric emptying
(9, 10), and
reduced small intestinal (11) and colonic transit
times (12). However, the exact molecular mechanisms
for such pregnancy-associated GI disorders are still poorly understood.Progesterone and estrogen are significantly elevated in the serum of pregnant females.
These hormones play central roles in the maintenance of pregnancy and the initiation of
parturition by modulating myometrial contractility and excitability. In addition, recent
studies have shown that sex hormones target other body organs besides the myometrium, such
as the GI tract, bladder, and blood vessels (13,14,15).Functionally, progesterone affects mammalian cells by both genomic and non-genomic
mechanisms. The genomic actions of progesterone are mediated via two sub-nuclear receptors,
A and B, which act as transcription factors (16).
Genomic actions of progesterone on the GI smooth muscle might explain some disturbances that
complicate pregnancy and female functional disorders. For example, it has been shown that
progesterone signaling regulates G protein expression level in female slow transit chronic
constipation, which correlates with an over-expression of progesterone receptors (17).The mechanisms responsible for the non-genomic effects of progesterone are not fully
understood. Non-genomic effects of progesterone have been defined as those occurring within
10 min of exposure (18, 19). It has been proposed that progesterone interacts with plasmalemmal
receptors and might lead to rapid activation of tyrosine kinases and phospholipases (20), mitogen-activated protein kinase (MAPK) (21), or inhibition of membrane transport systems (22). Furthermore, the types of changes induced by the
non-genomic actions may be tissue specific, as diverse effects have been demonstrated in
muscle, neural, endocrine, and reproductive cells (22,23,24).Physiologically, smooth muscle is an important component of the GI tract and maintenance of
its normal contractile behavior is essential for proper GI functions. Rho kinase II, a
serine/threonine kinase, is an important downstream effector of the small G protein RhoA
that has been found to be important in developing smooth muscle tone by maintaining the
level of myosin light chain (MLC20) phosphorylation, —the essential step in
smooth muscle contraction (25). The importance of the
RhoA/Rho kinase pathway has been demonstrated in the pathogenesis of cardiovascular
disorders and as a target in the development of new drugs such as fasudil, a Rho kinase
inhibitor (25, 26). Exploring changes in Rho/Rho kinase pathway expression and activity in GI
smooth muscle during pregnancy and the effect of this on muscle contractility could be an
important step for a better understanding of the GI complaints that accompany pregnancy.Although numerous studies have examined the effect of progesterone on GI smooth muscle, its
effect on gastric Rho kinase II has not been explored. Therefore, the present study was
designed to investigate the non-genomic action of progesterone on the Rho kinase pathway in
smooth muscle cells of the stomach. Because progesterone may affect various types of gastric
cells, studying the role of progesterone on a single cell type in a multicellular
preparation could be difficult. For this reason, this study was performed on single smooth
muscle cells freshly isolated from the stomach of rat. Insights into the molecular basis of
abnormal smooth muscle function will prove invaluable in the treatment of GI motility
disorders associated with pregnancy.
Materials and Methods
Male Sprague Dawley (SD) rats were provided by the animal house of Jordan University of
Science and Technology (JUST). Male rats were used in this study to avoid possible
confounding influence from differing circulating progesterone levels in cycling female rats.
All procedures were approved by the Animal Care and Use Committee (ACUC) at JUST. Male SD
rats (6 weeks of age, 200–250 g) were sacrificed by an overdose of ether.Assays were performed using a Rho kinase II assay kit (Cell Biolabs, INC., CA, USA), a Rho
kinase II ELISA kit (Cusabio Biotech, Newark, DE, USA) and a Dc protein assay kit (Bio-Rad,
Hercules, CA, USA). The Anti-calponin antibody (ab46794) was purchased from Abcam,
Cambridge, MA, USA. The 500-μm Nitex mesh was purchased from Amazon. All remaining materials
were purchased from Sigma, St Louis, MO, USA. Progesterone was dissolved and diluted in 99%
ethanol while acetylcholine (ACh) was dissolved in distilled water.
Preparation of dispersed gastric smooth muscle cells
Smooth muscle cells were isolated from the circular muscle layer of the rat stomach by
sequential enzymatic digestion, filtration, and centrifugation as described previously
(27, 28).
Briefly, strips of circular muscle from the stomach were dissected and incubated at 31 °C
for 30 min in HEPES medium containing 120 mM NaCl, 4 mM KCl, 2.0 mM CaCl2,
2.6 mM KH2PO4, 0.6 mM MgCl2, 25 mM HEPES, 14 mM glucose,
2.1% Eagle's essential amino acid mixture, 0.1% collagenase, and 0.01% soybean trypsin
inhibitor. The tissue was continuously gassed with 100% oxygen during the entire isolation
procedure. After the partly digested strips were washed twice with 50 ml of enzyme-free
medium, the muscle cells were allowed to disperse spontaneously for 30 min. The cells were
harvested by filtration through 500-μm Nitex mesh and centrifuged twice at 350 g for
10 min to eliminate broken cells and organelles. The cells were counted in a hemocytometer
and it is estimated that 95% of the cells excluded trypan blue. All the experiments were
done within 2–3 h of cell dispersion.
Identification of smooth muscle cells
The smooth muscle identity of rat gastric muscle cells was verified by
immunohistochemical staining of paraffin-embedded rat smooth muscle using ab46794 at 1/100
dilution with anti-calponin antibody.
Progesterone treatment
Aliquots (0.4 ml) of dispersed gastric smooth muscle cells were prepared. Aliquots were
randomly distributed into either control or treatment groups. Aliquots which were
designated for progesterone treatment were incubated with progesterone (1 µM) for 10 min
in the presence or absence of ACh.
Measurement of Rho kinase II activity
Rho kinase II activity was analyzed by an enzyme immunoassay, using Cell Biolabs' 96-well
Rho kinase II activity assay kit. Experiments were done according to the manufacture's
protocol, using 10 µl of protein lysate. The total starting protein concentration for
every sample was 1 mg/ml.
Measurement of Rho kinase II expression
Muscle cells were solubilized in Triton X-100-based lysis buffer plus protease and
phosphatase inhibitors (100 µg/ml phenylmethanesulfonylfluoride (PMSF), 10 µg/ml
aprotinin, 10 µg/ml leupeptin, 30 mM sodium fluoride and 3 mM sodium vanadate). After
centrifugation of the lysates at 20,000 g for 10 min at 4 °C, the protein
concentrations of the supernatant were determined with a Dc protein assay kit from
Bio-Rad. Samples of equal amounts of proteins were quantitated by ELISA according to the
manufacturers' instructions.
Analysis of data
Each experiment was performed on gastric smooth muscle cells that were harvested from six
rats. Statistical analysis of all experiments was performed using Prism 5.0 software,
GraphPad Software, San Diego, CA. For Rho kinase activity experiments, a one-way analysis
of variance (ANOVA) was performed. Where the ANOVA was statistically significant, it was
followed by Fisher's post-hoc analysis to determine the significance of differences
between experimental groups. For the Rho kinase expression experiments, an unpaired
student t-test was used to reveal significant differences between the
compared groups. A P<0.05 was required for statistical significance in
all the experiments. All data are shown as mean ± standard error of the mean (S.E.M).
Results
Smooth Muscle Identity
The smooth muscle identity of rat gastric muscle cells was verified by
immunohistostaining with anti-calponin antibody. The results showed that greater than 95%
of cells stained positive for calponin (Fig.
1).
Fig. 1.
Immunohistochemical staining of paraffin-embedded rat smooth muscle using ab46794
at 1/100 dilution. Scale bar represents 50 μm.
Immunohistochemical staining of paraffin-embedded rat smooth muscle using ab46794
at 1/100 dilution. Scale bar represents 50 μm.
Rho kinase II activity
Treatment of freshly dispersed muscle cells with 0.1 μM ACh, a Gαq/13-coupled receptor
agonist, for 10 min increased Rho kinase I—the smooth muscle predominant isoform (29)— activity above basal level
(P<0.05, n=6). Importantly, incubation of gastric
smooth muscle cells with 1 µM progesterone significantly inhibited ACh-stimulated Rho
kinase II activity (P<0.05, n=6). Interestingly,
progesterone had no effect on basal Rho kinase II activity (P>0.05,
n=6) (Fig. 2).
Fig. 2.
Effect of progesterone incubation (1 μM for 10 min) on the basal and ACh-induced
(ACh; 0.1 μM) activity of Rho kinase II in isolated rat gastric smooth muscle cells.
Rho kinase II activity is expressed as multiples of the control levels (fold
change). Progesterone didn't affect the basal Rho kinase activity (second column).
ACh significantly augmented Rho kinase II activity (third column). Progesterone
treatment significantly inhibited ACh-induced Rho kinase II activity (fourth
column). Values shown are representative of at least four independent experiments
performed in triplicate. (*, P<0.05 vs. control; †, P<0.05 vs. ACh, by two-way
ANOVA followed by Bonferroni multiple comparison test).
Effect of progesterone incubation (1 μM for 10 min) on the basal and ACh-induced
(ACh; 0.1 μM) activity of Rho kinase II in isolated rat gastric smooth muscle cells.
Rho kinase II activity is expressed as multiples of the control levels (fold
change). Progesterone didn't affect the basal Rho kinase activity (second column).
ACh significantly augmented Rho kinase II activity (third column). Progesterone
treatment significantly inhibited ACh-induced Rho kinase II activity (fourth
column). Values shown are representative of at least four independent experiments
performed in triplicate. (*, P<0.05 vs. control; †, P<0.05 vs. ACh, by two-way
ANOVA followed by Bonferroni multiple comparison test).
Rho kinase II expression
To determine whether progesterone had any effect on Rho kinase II expression profile we
examined the expression level of Rho kinase II protein in control and progesterone-treated
cells by ELISA. Despite the lower agonist-stimulated Rho kinase II activity in
progesterone-treated cells compared to control, the expression of Rho kinase II protein
was not different in both groups of cells (P>0.05,
n=6) (Fig. 3). Consistent with the indifferent expression level of Rho kinase II protein, basal
Rho kinase II activity was similar in both groups (P>0.05,
n=6) (Fig. 2).
Fig. 3.
Effect of progesterone incubation (1 μM for 10 min) on the expression levels of
Rho kinase II protein in rat isolated gastric smooth muscle cells. Rho kinase II
protein expression level is expressed as ng/g of total protein. Rho kinase II
protein expression was not affected by progesterone treatment. Values shown are
representative of at least four independent experiments performed in triplicate.
(P>0.05 by unpaired t test).
Effect of progesterone incubation (1 μM for 10 min) on the expression levels of
Rho kinase II protein in rat isolated gastric smooth muscle cells. Rho kinase II
protein expression level is expressed as ng/g of total protein. Rho kinase II
protein expression was not affected by progesterone treatment. Values shown are
representative of at least four independent experiments performed in triplicate.
(P>0.05 by unpaired t test).
Discussion
It is well-known now that pregnancy is commonly associated with GI complaints such as
nausea, vomiting, and improper gastric emptying of solids and liquids. Recent research has
reported disturbances in the myoelectric, mechanical, and motor properties and activities of
the GI smooth muscle during pregnancy (4,5,6,7,8,9,10,11,12). Still, the
precise mechanism for such gut effects is poorly understood. In this study we found that
progesterone treatment for 10 min rapidly decreased the ACh-induced activity level of Rho
kinase II in rat gastric smooth muscle cells without affecting Rho kinase II expression.
Based on these findings, we propose that this rapid progesterone inhibitory effect may
contribute to the change in gastric motility during pregnancy.This rapid hormonal effect on Rho kinase II represents mostly non-genomic action of
progesterone, as the short incubation time of the hormone would not allow changes in protein
expression levels to occur (18, 19). Our expression data negate an effect for short progesterone
treatment on Rho kinase II protein levels. In support of these findings, basal Rho kinase II
activity was not affected by progesterone incubation. Indeed, several previous reports have
indicated that progesterone induces rapid, within 10 min, non-genomic effects in a variety
of tissue types. For example, Bielefeldt et al. (22)
found, using a human intestinal smooth muscle cell line, that progesterone reduced calcium
currents consistent with blocking the L-type calcium channel. Both of these effects occurred
very rapidly (within 1 min) and were not blocked by progesterone antagonists, which would
impede genomic actions of progesterone and other progestins (19, 22). In addition, Xio et al. (30) reported that progesterone transiently inhibited
calcium release from storage sites of colonic muscle cells and blocked the contraction to
cholecystokinin (CCK-8) and neurokinin A (NKA). Moreover, a group of researchers showed in a
well-designed experiment that cell-impermeant albumin-conjugated progesterone decreased
thromboxane A2 receptor agonist-stimulated vascular smooth muscle calcium responses (31). This conjugated progesterone is believed not to
rapidly cross the cell membrane and thus acts extracellulary. These findings might explain
the rapid vasodilator action of progesterone in the primate coronary artery and isolated
vascular smooth muscle. In spermatozoa, progesterone was also found to increase
intracellular calcium levels by acting on a distinct non-genomic cell surface receptor. It
is thought that this rapid effect of progesterone initiates the acrosomal reaction (19). These data strongly suggest the existence of an
independent surface membrane progesterone receptor distinct from the classical nuclear
progesterone receptor that is part of the transcription-activating superfamily. Furthermore,
a progesterone binding membrane protein was isolated and cloned from porcine coronary artery
muscle cells (32). Such a protein might be also
expressed in the smooth muscle of other organs such as the stomach and could provide a
possible explanation for the observed rapid non-genomic effects of progesterone on gastric
Rho kinase II. Whether progesterone mediates its non-genomic action via affecting other
membrane receptors such as G protein receptors is unknown so far.Rho kinase II, the predominant Rho kinase expressed in smooth muscle, has been found to be
important in developing smooth muscle tone by maintaining the level of MLC20
phosphorylation, the essential step in smooth muscle contraction (25). There is an accumulating body of evidence from previous reports to
support a genomic inhibitory effect of progesterone on the contractility of smooth muscle in
various organs such as the stomach (33), colon (12, 33), and
gallbladder (34). This hormone effect might
contribute to gastric dysmotility during pregnancy. Most importantly, progesterone was shown
to induce rapid relaxation of KCl-induced contraction of rat aortic rings that was not
mediated by gene transcription mechanisms. This relaxant effect of progesterone on aortic
rings was partially dependent on endothelial NO production (35).A non-genomic effect of progesterone on gastric smooth muscle contractility has not been
investigated before. This study has shown for the first time that Rho kinase II is a target
for rapid progesterone action in isolated smooth muscle cells of the stomach. Indeed,
studying progesterone-mediated changes in the Rho kinase pathway activity and thus muscle
contractility in the GI tract could be an important step for a better understanding of the
GI complaints that accompany pregnancy. In conclusion, our results indicate that
progesterone inhibited Rho kinase II activity in gastric smooth muscle cells occurs via
non-genomic actions. Knowing the importance of the enzyme Rho kinase II in maintaining
smooth muscle contraction and in support of the previous reports of progesterone action in
the GI tract, we suggest that progesterone could affect the contractile activity of gastric
smooth muscle cells in rats by inhibiting the Rho kinase II pathway. Future contraction
studies using selective Rho kinase II inhibitors such as Y27632 and different concentrations
of progesterone might further reinforce these findings.
Supportive foundations
This work was supported by Jordan University of Science &
Technology, Irbid, Jordan (Grant Number 172/2012).
Conflict of interest
The authors declare that they have no conflict of interest.
Authors: Othman A Al-Shboul; Ayman G Mustafa; Amal Abu Omar; Ahmed N Al-Dwairi; Mohammad A Alqudah; Mona S Nazzal; Mahmoud A Alfaqih; Rami A Al-Hader Journal: Biomed Rep Date: 2018-10-18
Authors: Othman A Al-Shboul; Mona S Nazzal; Ayman G Mustafa; Ahmed N Al-Dwairi; Mohammad A Alqudah; Amal Abu Omar; Mahmoud A Alfaqih; Mohammad I Alsalem Journal: Exp Ther Med Date: 2018-07-04 Impact factor: 2.447