title: The uterine myocyte as a target for prevention of preterm birth.
abstract: Preterm birth (PTB) remains the most common cause of neonatal morbidity and mortality as well as long-term disability. Current strategies to prevent or arrest spontaneous preterm labor (SPTL) have limited success. For almost three decades, there have been no novel pharmacological agents used clinically to address this important obstetrical complication. In this review, we focus on the uterine myocyte as a target for prevention of spontaneous PTB. After presenting an overview of intracellular signaling pathways that are important in regulation of smooth muscle contractility, we discuss previous and current pharmacological approaches to manage SPTL. We also present recent evidence from our own laboratories suggesting a potentially novel and uterine-specific approach to maintain or impose uterine relaxation. Finally, we briefly discuss extrinsic systems that might affect uterine activity and reinforce the concept that SPTL represents a syndrome that is the end result of a variety of pathophysiologic etiologies leading to PTB. We conclude by emphasizing the need for much more research to provide sufficient understanding of the mechanisms of SPTL and to make inroads towards reducing the incidence and adverse consequences of this common and serious syndrome.
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB, Canada ; University of Alberta Department of Physiology, Edmonton AB, Canada.
authors.forename: B F
authors.initials: BF
authors.lastname: Mitchell
authors.affiliation: University of Alberta Department of Physiology, Edmonton AB, Canada.
authors.forename: H N
authors.initials: HN
authors.lastname: Aguilar
authors.affiliation: University of Calgary, Department of Physiology and Pharmacology, Calgary AB Canada.
authors.forename: A
authors.initials: A
authors.lastname: Mosher
authors.affiliation: University of Calgary, Department of Obstetrics and Gynecology, Calgary AB Canada.
authors.forename: S
authors.initials: S
authors.lastname: Wood
authors.affiliation: University of Calgary, Department of Physiology and Pharmacology, Calgary AB Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: Slater
keywords: Prematurity; myosin regulatory light chain; preterm labour; rhoA-associated kinase; tocolysis; tocolysis contractility
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