Prostaglandin dehydrogenase is a target for successful induction of cervical ripening

Annavarapu Hari Kishore, Hanquan Liang, Mohammed Kanchwala, Chao Xing, Thota Ganesh, Yucel Akgul, Bruce Posner, Joseph M. Ready, Sanford D. Markowitz, Ruth Ann Word

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


The cervix represents a formidable structural barrier for successful induction of labor. Approximately 10% of pregnancies undergo induction of cervical ripening and labor with prostaglandin (PG) E2 or PGE analogs, often requiring many hours of hospitalization and monitoring. On the other hand, preterm cervical ripening in the second trimester predicts preterm birth. The regulatory mechanisms of this paradoxical function of the cervix are unknown. Here, we show that PGE2 uses cell-specific EP2 receptor-mediated increases in Ca2+ to dephosphorylate and translocate histone deacetylase 4 (HDAC4) to the nucleus for repression of 15-hydroxy prostaglandin dehydrogenase (15-PGDH). The crucial role of 15-PGDH in cervical ripening was confirmed in vivo. Although PGE2 or 15-PGDH inhibitor alone did not alter gestational length, treatment with 15-PGDH inhibitor + PGE2 or metabolism-resistant dimethyl-PGE2 resulted in preterm cervical ripening and delivery in mice. The ability of PGE2 to selectively autoamplify its own synthesis in stromal cells by signaling transcriptional repression of 15-PGDH elucidates long sought-After molecular mechanisms that govern PG action in the cervix. This report details unique mechanisms of action in the cervix and serves as a catalyst for (i) the use of 15-PGDH inhibitors to initiate or amplify low-dose PGE2-mediated cervical ripening or (ii) EP2 receptor antagonists, HDAC4 inhibitors, and 15-PGDH activators to prevent preterm cervical ripening and preterm birth.

Original languageEnglish (US)
Pages (from-to)E6427-E6436
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number31
StatePublished - Aug 1 2017

ASJC Scopus subject areas

  • General


Dive into the research topics of 'Prostaglandin dehydrogenase is a target for successful induction of cervical ripening'. Together they form a unique fingerprint.

Cite this