Biochemistry and pharmacology of the myometrium and labor: regulation at the cellular and molecular levels

Abstract

This review presents the essentials of cell biology, biochemistry, and pharmacology of the myometrium and labor, especially as they relate to premature labor. The aim is to explore the neuroendocrine and pharmacologic regulation of myometrial muscle cells in the context of cell membrane function and contractile processes. In the first section, smooth muscle protein structure and interactions are described, the central roles of myosin light-chain kinase, calcium, and cyclic adenosine monophosphate (cAMP) are reviewed. Subsequently, events relating to hormone/drug receptor function and implications for pharmacologic applications are discussed. Finally, the processes of information transfer via hormones and drugs are incorporated into a model which explains how the hormones and drugs used in clinical practice may mediate myometrial contractility. The reader is introduced to current concepts of the cellular, molecular, and pharmacologic aspects of labor in order to facilitate the understanding of medical augmentation of labor and tocolytic therapy.