Calcitonin is a progesterone-regulated marker that forecasts the receptive state of endometrium during implantation.

Previous studies established that in the rat, the uterus can accept a developing blastocyst for implantation only during a limited period of time on day 5 of gestation, termed the receptive phase. Our previous studies showed that the expression of calcitonin, a peptide hormone that regulates calcium homeostasis, is induced in rat uterus between days 3-5 of gestation and is switched off once the implantation process has progressed to day 6. In the present study, we analyze in detail how the expression of calcitonin messenger RNA (mRNA) in the uterus is regulated by the steroid hormones progesterone and estrogen and explore the possibility that calcitonin may serve as a potential marker of uterine receptivity. We demonstrate by in situ hybridization that calcitonin mRNA is synthesized specifically in the glandular epithelial cells between days 3-5 of pregnancy. Interestingly, calcitonin synthesis is also induced in these cells during pseudopregnancy, indicating that this peptide hormone is produced in the endometrium in response to maternal, rather than embryonic, signals. We also demonstrate that calcitonin mRNA expression during pseudopregnancy, like that in normal pregnancy, is under progesterone regulation. We further examined the steroid hormone regulation of uterine calcitonin expression in a delayed implantation model. In pregnant rats in which implantation is blocked upon removal of both ovaries on day 4 of gestation, continued administration of progesterone sustains calcitonin expression in the uterus for several days in the absence of estrogen. Administration of estrogen, which allows delayed implantation, also rapidly reduces calcitonin expression, indicating a role for this steroid hormone in turning off calcitonin gene expression. In gene transfection studies, expression of the progesterone receptor B isoform in cultured endometrial cells induces RNA synthesis from a reporter gene containing a 1.3-kb calcitonin promoter fragment in a hormone-dependent manner. As expected, mifepristone-complexed progesterone receptor B isoform fails to activate the calcitonin promoter. Progesterone acting through its nuclear receptor therefore regulates the expression of the calcitonin gene at the level of transcription. Finally, using RIA we investigated whether calcitonin is secreted from its glandular site of synthesis at the time of implantation by analyzing uterine flushings obtained from pregnant rats. We report the detection of a significant amount of calcitonin in the luminal secretions collected on day 4 and a lower amount on day 5 of gestation, whereas similar samples collected from animals on either day 3 or 6 of gestation did not contain detectable amounts of this peptide hormone. A transient burst of calcitonin secretion into the uterine lumen therefore occurs immediately preceding implantation. Based on these results, we propose that calcitonin is a measurable marker that forecasts the receptive state of rat endometrium during blastocyst implantation.