Expression and localization of apelin and its receptor APJ in the bovine corpus luteum during the estrous cycle and prostaglandin F2α-induced luteolysis

in Reproduction
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Koumei Shirasuna Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Takashi Shimizu Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Kohei Sayama Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Takayuki Asahi Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Motoki Sasaki Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Bajram Berisha Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Dieter Schams Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Akio Miyamoto Graduate School of Animal and Food Hygiene, Department of Basic Veterinary Sciences, Institute of Physiology, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan

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Angiogenesis, changes in blood flow, and extracellular matrix remodeling are the processes associated with the development and demise of the bovine corpus luteum (CL) during the estrous cycle. APJ (putative receptor protein related to angiotensin type 1 receptor) is a G-protein-coupled receptor, and its ligand, apelin, has been identified as a novel regulator of blood pressure and as an angiogenic factor. We hypothesized that the apelin–APJ system is involved in luteal function. This study investigated whether apelin–APJ exists in bovine CL and determined their expression profiles and localization during luteal phase and prostaglandin F2α (PGF2α)-induced luteolysis. During the luteal phase, apelin mRNA expression increased from early to late CL and decreased in regressed CL. APJ mRNA expression increased from early to mid-CL and remained elevated in late and regressed CL. Apelin and APJ proteins were immunohistochemically detected only in the smooth muscle cells of intraluteal arterioles during the luteal phase. PGF2α stimulated apelin and APJ mRNA expression at 0.5–2 and 2 h respectively, and then the mRNA expression of apelin–APJ was inhibited from 4 h during PGF2α-induced luteolysis. Additionally, apelin mRNA and protein were stimulated at 1 h after PGF2α injection only in the periphery of mid- but not early CL. The present study indicated that the apelin–APJ was localized in the smooth muscle cells of intraluteal arterioles, and responded to PGF2α at the periphery of mid-CL in the cow. Thus, the apelin–APJ system may be involved in the maturation of CL and the luteolytic cascade as a regulator of intraluteal arterioles in cow.

Abstract

Angiogenesis, changes in blood flow, and extracellular matrix remodeling are the processes associated with the development and demise of the bovine corpus luteum (CL) during the estrous cycle. APJ (putative receptor protein related to angiotensin type 1 receptor) is a G-protein-coupled receptor, and its ligand, apelin, has been identified as a novel regulator of blood pressure and as an angiogenic factor. We hypothesized that the apelin–APJ system is involved in luteal function. This study investigated whether apelin–APJ exists in bovine CL and determined their expression profiles and localization during luteal phase and prostaglandin F2α (PGF2α)-induced luteolysis. During the luteal phase, apelin mRNA expression increased from early to late CL and decreased in regressed CL. APJ mRNA expression increased from early to mid-CL and remained elevated in late and regressed CL. Apelin and APJ proteins were immunohistochemically detected only in the smooth muscle cells of intraluteal arterioles during the luteal phase. PGF2α stimulated apelin and APJ mRNA expression at 0.5–2 and 2 h respectively, and then the mRNA expression of apelin–APJ was inhibited from 4 h during PGF2α-induced luteolysis. Additionally, apelin mRNA and protein were stimulated at 1 h after PGF2α injection only in the periphery of mid- but not early CL. The present study indicated that the apelin–APJ was localized in the smooth muscle cells of intraluteal arterioles, and responded to PGF2α at the periphery of mid-CL in the cow. Thus, the apelin–APJ system may be involved in the maturation of CL and the luteolytic cascade as a regulator of intraluteal arterioles in cow.

Introduction

APJ (putative receptor protein related to angiotensin type 1 receptor), previously designated as an orphan G-protein-coupled receptor, was cloned from a human gene (O'Dowd et al. 1993). APJ most closely resembles the angiotensin type 1 receptor; however, the APJ receptor does not bind to angiotensin II (O'Dowd et al. 1993). APJ mRNA and immunoreactive APJ are abundantly expressed in various human and rat tissues including the ovary, lung, heart, artery, vein, kidney, liver, and brain (O'Carroll et al. 2000, Medhurst et al. 2003, Kleinz et al. 2005). In 1998, Tatemoto et al. (1998) isolated a novel endogenous apelin peptide from the bovine stomach, which was found to be a ligand of the receptor APJ. This peptide is produced through processing from the C-terminal portion of the pre-proprotein consisting of 77 amino acid residues and exists in multiple molecular forms. Apelin mRNA and immunoreactive apelin are detected in various tissues and organs such as stomach, brain, heart, blood vessels, lung, uterus, and ovary (Habata et al. 1999, Kawamata et al. 2001, De Falco et al. 2002). Apelin causes endothelium-dependent vasorelaxation by triggering the release of nitric oxide (NO), and this effect can be almost completely abolished in the presence of endothelial NO synthase (eNOS) inhibitor, suggesting that the apelin–APJ system may exert a vasorelaxation effect via activation of the eNOS pathway (Tatemoto et al. 2001, Ishida et al. 2004, Zhong et al. 2007). Moreover, it is reported that apelin peptide is a potent angiogenic factor inducing endothelial cell (EC) proliferation, EC migration, and the development of blood vessels in vivo (Kasai et al. 2004, Cox et al. 2006).

The bovine corpus luteum (CL) is a transient organ that secretes progesterone (P), a prerequisite for the establishment and maintenance of pregnancy. The CL undergoes drastic changes in its function and structure during the estrous cycle. Active angiogenesis and P synthesis occur during the development, while a drastic decrease in P secretion (functional luteolysis) and disruption of vascular vessels and luteal cells (structural luteolysis) are induced by the luteolytic action of prostaglandin F2α (PGF2α; Nett et al. 1976, McCracken et al. 1981). Luteal vascular ECs represent more than 50% of the total number of cells in the CL and secrete vasoactive substances directly regulating P secretion (O'Shea et al. 1989), suggesting that the blood vessels and the ECs within the CL have an essential role in luteal function in cow. Most recently, we demonstrated that the acute increase in luteal blood flow is the earliest physiological signals to initiate luteolysis in cow, and this phenomena may be induced by vasodilatation due to the action of luteal NO stimulated by PGF2α (Acosta et al. 2002, Miyamoto et al. 2005).

Given their role in angiogenesis and blood vessel dilation, apelin and its receptor APJ are hypothesized to be involved in the luteolytic cascade including acute increase in the luteal blood flow, but the expression of apelin–APJ in the bovine CL has not been described so far. Therefore, in the present study, to determine local production and the possible role of the apelin–APJ system in the bovine CL, we investigated the mRNA expression and the localization of apelin and APJ during formation, maturation, and regression of the CL in cow.

Results

The mRNA expression of apelin and APJ in the bovine CL throughout the luteal phase

The expression of mRNAs in the CL tissue during the luteal phase is shown in Fig. 1. Apelin mRNA expression increased (P<0.05) throughout the luteal stages, reaching the highest level in the late-stage CL before decreasing in the regressed CL (Fig. 1A). APJ mRNA expression increased from the early to mid-luteal stages and maintained high levels toward the regressed luteal stages (Fig. 1B).

Figure 1
Figure 1

Relative mRNA levels of apelin (A) and APJ (B) in bovine CL throughout the estrous cycle (n=6 for each stage of the CL). All values are shown as mean±s.e.m. (relative to GAPDH mRNA levels). Different superscript letters indicate significant differences (P<0.05) as determined by ANOVA followed by Bonferroni's multiple comparison test.

Citation: REPRODUCTION 135, 4; 10.1530/REP-07-0409

Immunohistochemical localization of apelin and APJ in the bovine CL

The protein expression of both apelin (Fig. 2A and B) and APJ (Fig. 2D and E) in the mid- and late CL is shown in Fig. 2. Immunostaining of both apelin and APJ was detected in blood vessels (indicated by arrows) but not in luteal parenchyma, and staining intensity and pattern was similar during the luteal phase (data not shown). Protein from both apelin and APJ was immunohistochemically observed in all CL stages during the luteal phase. To determine the cell-specific localization of apelin and APJ, we observed continuous sections stained with the smooth muscle (using smooth muscle actin (SMA) antibody) and ECs (using antibody of von Willebrand Factor (vWF)). In Fig. 2G and H, we showed that apelin and APJ were positively stained in the smooth muscle cells (Fig. 2G–I) of luteal blood vessels but not in the endothelial (Fig. 2J) and luteal cells.

Figure 2
Figure 2

Immunohistochemical localization of apelin and APJ in bovine CL of (A and D) mid- and late (B and E) luteal stages. Apelin (A and B) and APJ (D and E) proteins are selectively expressed in the area of intraluteal arterioles (arrows). The specificity of the staining was monitored in negative control sections (C and F) by replacing the antibody with goat anti-rabbit IgG. Scale bars represent 100 μm (A, B, D and E). Immunohistochemical detailed localization of apelin and APJ in the bovine CL of mid-luteal stages were shown in G–J. Apelin (G) and APJ (H) proteins are selectively expressed in smooth muscle cells of intraluteal arterioles (I). Serial sections (I and J) were stained for anti-a smooth muscle actin antibody (I) and von Willebrand factor (J) respectively. These sections indicate the same blood vessels within the CL (G–J). Scale bars represent 10 μm (G–J).

Citation: REPRODUCTION 135, 4; 10.1530/REP-07-0409

Changes in mRNA expression of apelin and APJ during PGF2α-induced luteolysis in cow

The changes in mRNA expression for apelin and APJ are shown in Fig. 3. Apelin mRNA expression significantly increased at 0.5–2 h after PGF2α injection. Thereafter, the mRNA expression of apelin showed a significant decrease at 4 h after PGF2α and maintained low levels compared with control (Fig. 3A). APJ mRNA expression increased at 2 h after PGF2α injection and significantly decreased at 4 h after PGF2α and maintained low levels compared with control (Fig. 3B).

Figure 3
Figure 3

Relative mRNA levels of apelin (A) and APJ (B) in bovine CL during PGF2α-induced luteolysis (n=5 for each time point). The expression of mRNA was expressed as the percentage of the baseline (0 h). All values are shown as mean±s.e.m. (relative to GAPDH mRNA levels). Different superscript letters indicate significant differences (P<0.05) as determined by ANOVA followed by Bonferroni's multiple comparison test.

Citation: REPRODUCTION 135, 4; 10.1530/REP-07-0409

Luteal phase-dependent (early CL versus mid-CL) and site-dependent (periphery versus center of the CL) effects of PGF2α

We investigated the effect of PGF2α, which depended on the luteal phase and local area of the CL. PGF2α as treatment and saline as control were injected during the early (day 4) and the mid-CL (days 10–12). The mRNA expression and the index of positive immunostaining area of both apelin and APJ are shown in Fig. 4. In the early CL, PGF2α did not affect apelin mRNA expression (Fig. 4A) and the immunostaining area (Fig. 4C) both at the periphery and in the center of the CL. On the other hand, PGF2α administration drastically increased the apelin-positive area and apelin mRNA expression at the periphery but not in the center of the mid-CL (Fig. 4A and C). The APJ-positive area and mRNA expression in the early CL were not changed after PGF2α treatment (Fig. 4B and D). Although PGF2α administration stimulated APJ mRNA expression (Fig. 4B) in the center but not in the periphery of the mid-CL, APJ-positive staining (Fig. 4D) was increased by PGF2α both in the periphery and in the center of the mid-CL.

Figure 4
Figure 4

Effect of PGF2α injection on apelin (A) and APJ (B) mRNA expression and on apelin (C) and APJ (D) immunostaining-positive area in the early and the mid-CL in cow. The experiments were conducted on day 4 as early CL, days 10–12 as mid-CL, and PGF2α or saline as control was injected respectively (early CL control, n=5; early CL PGF2α treat, n=5; mid-CL control, n=4; mid-CL PGF2α treat; n=4). At 30 min after injection of PGF2α or saline, luteal blood flow was observed using color Doppler ultrasound. After observing, the cows were ovariectomized at 1 h after treatment, and the portions of the CL were fixed for immunohistochemistry and processed for mRNA analysis. Sampling areas within the CL were designated as periphery and center of the CL. All values are shown as mean±s.e.m. Asterisk indicates statistically different values (P<0.05).

Citation: REPRODUCTION 135, 4; 10.1530/REP-07-0409

Discussion

In the present study, we evaluated for the first time the expression of apelin–APJ in the bovine CL tissue during the estrous cycle and PGF2α-induced luteolysis. Immunohistochemistry showed that apelin and APJ were localized in the smooth muscle cells of intraluteal arterioles. Luteolytic PGF2α stimulated the expression of apelin–APJ at an early stage of luteolysis. Most recently, we demonstrated that the acute increase in the luteal blood flow is the earliest physiological signal to initiate luteolysis in cow (Acosta et al. 2002, Miyamoto et al. 2005). Thus, the bovine CL has an apelin–APJ system that may be involved in the acute increase of the luteal blood flow as the earliest physiological event in cow.

Apelin–APJ has been already investigated in many organs including the brain, heart, lung, kidney, uterus, and ovary using PCR and immunohistochemistry (Habata et al. 1999, O'Carroll et al. 2000, Kawamata et al. 2001, De Falco et al. 2002, Medhurst et al. 2003, Kleinz et al. 2005). Recent studies have reported that although apelin mRNA and protein are mainly expressed in the ECs of the artery and vein, other cell types including cardiac muscle cells, adipocytes, chondrocytes, and smooth muscle cells also have been observed to show apelin immunoreactivity in rats (Tatemoto et al. 2001, Cheng et al. 2003, Medhurst et al. 2003), mice (Zhong et al. 2007), humans (O'Carroll et al. 2000, Kleinz et al. 2005), and lizards (De Falco et al. 2004). APJ mRNA and protein are also widely expressed such as in the endothelial and smooth muscle cells in most of the peripheral tissues (O'Carroll et al. 2000, Medhurst et al. 2003, De Falco et al. 2004, Kleinz et al. 2005). In the present study, the expression of both apelin–APJ mRNA and protein was strictly detected on the smooth muscle cells of luteal arterioles only, but not on the endothelial and luteal cells in the bovine CL. This result suggests that the apelin–APJ system may not be likely regulate the synthesis of P directly, and that this system may be associated with the vascular function in the CL.

During the luteal phase, the expression of apelin mRNA gradually increased from the early to late CL followed by a decrease in the regressed CL in the cow. Also, APJ mRNA expression was significantly higher in the mid to regressed CL than in the early CL. The co-expression of mRNA for apelin–APJ strongly suggests that apelin may have some function as a local regulator in the bovine CL. Indeed, the presence of a localized source of apelin induced vascular development and angiogenic branching whose effects were abolished in APJ-deficient frog embryos in vivo (Cox et al. 2006). Moreover, apelin can stimulate the proliferation, migration, and angiogenesis of the ECs in mouse (Kasai et al. 2004). Therefore, our findings suggest that the apelin–APJ system localized in smooth muscle cells may be an autocrine and/or paracrine factor, and may have physiological roles in the vascular establishment, maturation, and maintenance in the CL. However, it is still not possible to isolate smooth muscle cells from the bovine CL in our laboratory; thus further investigations on isolated smooth muscle cells in culture is needed to examine the function of apelin–APJ system.

A luteolytic dose of PGF2α induced a very clear and acute increase in the luteal blood flow only in peripheral area within the CL, and this phenomenon was detected within 0.5–2 h after PGF2α only in the mid-CL but not in the early CL (Acosta et al. 2002). Thus, we hypothesized that luteolytic PGF2α stimulates the expression of eNOS followed by vasodilation in the periphery of the CL and induces an acute increase in the luteal blood flow at a very early stage of luteolysis in cow (Miyamoto et al. 2005). In the present study, PGF2α-increased apelin mRNA expression at 0.5–2 h completely coincides with the timing of the luteal blood flow increase. Moreover, both apelin mRNA and protein expression were stimulated by PGF2α injection at 1 h only in the periphery area of the mid-CL. It has been reported that apelin modulates phosphorylation and activation of the eNOS signaling pathway causing NO release, which is completely abolished by the NOS inhibitor treatment (Tatemoto et al. 2001, Ishida et al. 2004, Zhong et al. 2007). In addition, apelin signaling via APJ induces vasodilation due to the stimulation of NO production followed by a decrease in the blood pressure, suggesting that the apelin–APJ system may have a regulatory role for vascular toning by modulating the eNOS–NO signaling pathway (Ishida et al. 2004, Zhong et al. 2007). Although the administration of apelin decreases the blood pressure in wild-type mice, this hypotensive response to apelin is abolished in APJ-deficient mice (Zhong et al. 2007). On the other hand, the expression of APJ mRNA and APJ immunoreactivity were also stimulated by the administration of PGF2α in the bovine mid-CL. These results suggest that the apelin–APJ system may be involved in the acute increase of the luteal blood flow due to the regulation of NO-vasodilation as the earliest physiological event for the luteolytic cascade in the cow. Furthermore, a severe decrease in the luteal blood flow by vasoconstriction occurs from 4 h after PGF2α injection (Acosta et al. 2002), when mRNA expression of apelin and APJ were drastically reduced in the present study. The findings support the hypothesis that the apelin–APJ system regulates vasodilation in the bovine CL.

We considered the possibility that apelin–APJ regulates the eNOS–NO system in the bovine CL because the apelin–APJ system localized in smooth muscle cells in the present study. In general, the interaction between endothelial and smooth muscle cells in the vessel wall is considered to be an important factor in the control of blood vessel growth and function. The gap junction is formed with a tunnel-like structure and enables regulatory molecules, nutrients, and ions of less than about 1 kDa (i.e., Ca2+, cAMP, inositol 1,4,5-triphosphate) to be exchanged between adjacent cells (Yamasaki & Naus 1996). It was reported that apelin immediately increased Ca2+ in smooth muscle cells (Dai et al. 2006). Moreover, eNOS binds to calmodulin in a reversible and Ca2+-dependent manner and releases NO for short periods (Moncada et al. 1991). We therefore speculate that apelin–APJ system stimulated by PGF2α increased Ca2+ in the smooth muscle cells of luteal arterioles, and Ca2+ may be transferred to the neighboring ECs. These findings suggest that the apelin–APJ system might be involved in the regulation of the luteal blood flow and NO-vasodilation in the bovine CL.

In addition to the roles of apelin–APJ as an angiogenic factor and vasorelaxant, apelin–APJ has a role as an anti-apoptotic factor in humans (Xie et al. 2007) and mice (Tang et al. 2007). In fact, apelin induces the expression of Bcl-2 protein, down-regulates the production of Bax protein, and also blocks the release of cytochrome c and activation of caspase-3, resulting in the suppression of apoptosis in osteoblastic cells (Tang et al. 2007, Xie et al. 2007). Moreover, knock-down of APJ with siRNA abolishes the anti-apoptotic effect of apelin in human osteoblastic cells (Xie et al. 2007). During PGF2α-induced luteolysis in this study, the mRNA expression of apelin–APJ was inhibited at low levels from 4 h after PGF2α injection. Indeed, the Bax expression levels and Bax/Bcl-2 ratio increased at 4 h after PGF2α injection in the bovine CL (Yadav et al. 2005). These findings suggest that down-regulation of the apelin–APJ system may be related to structural luteolysis induced by cell apoptosis in the bovine CL. However, further studies are needed to clarify the local roles of apelin–APJ in apoptosis occurring in the regressing CL.

In summary, the present study defines the expression of both apelin–APJ mRNA and immunoreactivity in the bovine CL during the luteal phase and PGF2α-induced luteolysis. The apelin–APJ system was localized in the smooth muscle cells of intraluteal arterioles, and responded to PGF2α at the periphery of the mid-CL. Thus, the apelin–APJ system may be involved in the CL maturation and the luteolytic cascade as a regulator of intraluteal arterioles in cow.

Materials and Methods

All animal experiments were conducted at the Field Center of Animal Science and Agriculture, Obihiro University, and the experimental procedures complied with the Guidelines for the Care and Use of Agricultural Animals of Obihiro University.

Collection of bovine CL during estrous cycle

Ovaries bearing the CL from Holstein cows were collected at a local slaughterhouse. The luteal stages were classified as early, mid, late, or regressed (n=6 for each stage of the CL) by macroscopic observation of the ovary as described previously (Miyamoto et al. 2000). After the stages were determined, the CL were immediately separated from the ovaries. Thereafter, they were minced and ∼0.1 g luteal tissues were placed in a 1.5 ml microcentrifuge tube with 400 μl TRIzol reagent (Gibco BRL), homogenized immediately, and stored at −80 °C until analysis.

RNA extraction and real-time PCR

Total RNA was extracted from the luteal tissues following the protocol of Chomczynski & Sacchi (1987) using TRIzol reagent and treated with DNase using a commercial kit (SV total RNA Isolation System; Promega Co.), and they were frozen at −20 °C in THE RNA Storage Solution (Ambion Inc., Austin, TX, USA). The mRNA expression for apelin, APJ, and GAPDH were quantified by real-time PCR with a LightCycler (Roche Diagnostics Co.) as reported previously (Watanabe et al. 2006). The primers used for real-time PCR were as follows: apelin (106 bp) – forward, 5′-AAGGCACCATCCGATACCTG-3′ and reverse, 5′-ATGGGACCCTTGTGGGAGA-3′; APJ (100 bp) – forward, 5′-TCTGGGCCACCTACACCTAT-3′ and reverse, 5′-ACGCTGGCGTACATGTTG-3′; and GAPDH (160 bp) – forward, 5′-CTCTCAAGGGCATTCTAGGC-3′ and reverse, 5′-TGACAAAGTGGTCGTTGAGG-3′. The PCR products were subjected to electrophoresis, the target band cut out, and purified using a DNA purification kit (SUPRECTM-01; TaKaRa Bio. Inc., Otsu, Japan). Three to five stepwise-diluted DNA standards were included in every PCR run. Primer sets were tested in the luteal tissue samples to confirm amplification of single bands, amplified products were cloned, and sequenced to confirm their identity, prior to the use of primers in the analysis of samples. The values were normalized using GAPDH as the internal standard.

Immunohistochemistry

Ovaries bearing the CL from Holstein cows were collected at a local slaughterhouse. The luteal stages were classified as early, mid, late, or regressed (n=4 for each stage of the CL) by macroscopic observation of the ovary as described previously (Miyamoto et al. 2000). After the stages were determined, the CL were immediately separated from the ovaries. The tissue samples were fixed in Bouin's fixative for 24 h at room temperature and then embedded in paraffin wax. Serial sections of 5 μm were mounted on a glass microscope slide coated with aminopropyltriethoxysilane (APS). The sections were stained with hematoxylin–eosin for general histological observations.

Light microscopic immunohistochemical staining using the avidin–biotin peroxidase complex (ABC) method (Hsu et al. 1981) was used in the present study. The sections were deparaffinized in xylene, rehydrated in a graded series of ethanol, and then washed with distilled water (DW). Subsequently, endogenous peroxidase was inactivated with 0.3% H2O2 in methanol for 10 min at room temperature and washed with 0.01 M PBS (pH 7.4). After treatment with normal goat serum for 30 min at room temperature, the sections were incubated with polyclonal antibodies for vWF (dilution 1:200; Dako, Glostrup, Denmark), which is the marker of the ECs, SMA (M0851, dilution 1:200; Dako), rabbit apelin-12 (dilution 1:100, has cross-reactivity with bovine; Phoenix Pharmaceuticals Inc., Belmont, CA, USA), and rabbit APJ receptor (dilution 1:100, has cross-reactivity with bovine; Phoenix Pharmaceuticals Inc.) overnight at 4 °C. As a negative control, the sections were incubated with goat anti-rabbit IgG overnight at 4 °C. After incubation, the sections were washed with PBS, incubated with biotinylated goat anti-rabbit IgG (1:200, BA-1000; Vector Laboratories Inc., Burlingame, CA, USA) for vWF, apelin, and APJ, and with biotinylated goat anti-mouse IgG (dilution 1:200, BA-9200; Vector Laboratories Inc.) for SMC for 30 min at room temperature, and then washed with PBS. Horseradish peroxidase-conjugated ABC (1:2, PK-6100, Vectastain Elite ABC kit; Vector Laboratories Inc.) was combined with secondary antibody at room temperature for 30 min. The binding sites were visualized with 0.02% 3,3′-diaminobenzidine tetrahydrochloride in 50 mM Tris–HCl (pH 7.4) containing 0.02% H2O2. After immunohistochemical staining, the sections were lightly counterstained with Mayer's hematoxylin. The sections were washed with DW, dehydrated in a graded series of ethanol, cleared in xylene, and a coverslip was added.

Percentage area of apelin and APJ immunostaining

The positive staining area was extracted using PopImaging (Ver. 3.01; Digital Being Kids, Japan) to calculate the percentage area of immunostaining (area of immunostaining divided by the total area measured×100) as consulted previously (Al-zi'abi et al. 2003). The areas were analyzed at a magnification of 200× using one section from each animal and five fields per section. The results were expressed as percentage of means±s.e.m. per unit area.

PGF2α-induced luteolysis in cow

Experimental design 1: effect of luteolytic PGF2α for apelin–APJ mRNA expression in the mid-CL

Forty multiparous, non-lactating Holstein cows were used for this study. The day of estrus was designated as day 0. Cows (n=5 for each time point) at the mid-luteal phase (days 8–12) were given an i.m. injection of 25 mg PGF2α (0 h; cloprostenol, Estrumate; Takeda Pharmaceutical. Co. Ltd, Osaka, Japan) and the ovaries collected by ovariectomy at 0, 0.5, 2, 4, 12, 24, 48, and 64 h. The CL tissue sample was collected and immediately placed in a 1.5 ml microcentrifuge tube containing 0.4 ml TRIzol reagent, homogenized immediately, and stored at −80 °C until analysis.

Experimental design 2: luteal phase-dependent (early CL versus mid-CL) and site-dependent (periphery versus center of the CL) effects of PGF2α

Eighteen multiparous, non-lactating Holstein cows were used for this study. The estrus synchronization protocol followed was an i.m. injection of 500 μg PGF2α analog followed by an i.m. injection of 100 μg GnRH at 48 h after the PGF2α injection. The day of estrus was designated as day 0. The experiments were conducted on day 4 as the early CL and days 10–12 as the mid-CL, and PGF2α or saline as control was injected respectively (early CL control, n=5; early CL PGF2α treatment, n=5; mid-CL control, n=4; mid-CL PGF2α treatment, n=4). At 30 min after injection of PGF2α or saline, the luteal blood flow was observed using color Doppler ultrasound. After observing, the cows were immediately ovariectomized at 1 h after treatment. To examine the spatial localization and the local effect of PGF2α for apelin and APJ in the CL, the sampling area within the CL was designated as the periphery (in the range of 1 mm from the boundary between the luteal tissue and ovarian parenchyma) and the center (in the range of 1.5 mm from center section (crossover point at major and minor axes after halving of the CL) of the CL). A CL tissue sample of both the periphery and the center was collected; thereafter, they were minced and ∼0.1 g luteal tissues placed in a 1.5 ml microcentrifuge tube containing 0.4 ml TRIzol reagent, homogenized immediately, and stored at −80 °C until analysis. For immunohistochemistry, the CL was enucleated from the ovary and dissected free of connective tissue. The tissue samples were fixed in Bouin's fixative.

Statistical analysis

All data were expressed as mean±s.e.m. The time of PGF2α analog injection was defined as 0 h. The expression of mRNA of apelin and APJ in Experimental Design 1 after PGF2α administration was expressed as the percentage of the baseline (0 h). The statistical significance of differences in (1) the amount of apelin and APJ mRNA in the CL during the luteal phase, (2) the change in apelin and APJ mRNA expression during PGF2α-induced luteolysis, and (3) the effect of PGF2α injection on apelin and APJ expression between the early and mid-luteal phases were assessed by ANOVA followed by Bonferroni's multiple comparison test. Probabilities <5% (P<0.05) were considered significant.

Acknowledgements

The authors thank Schering-Plough Animal Health K K, Japan, for Estrumate and Conceral. This study was supported by the Grant-in-Aid for Scientific Research of the Japan Society for the Promotion of Science (JSPS) and the 21st Century COE Program (A-1), Ministry of Education, Culture, Science and Technology, Japan. K S is supported by JSPS Research Fellowships for Young Scientists. The authors declare that there is no conflict of interest that would prejudice the impartiality of this scientific work.

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  • Chomczynski P & Sacchi N 1987 Single-step method of RNA isolation by acid guanidinium thiocyanate–phenol–chloroform extraction. Analytical Biochemistry 162 156159.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cox CM, D'Agostino SL, Miller MK, Heimark RL & Krieg PA 2006 Apelin, the ligand for the endothelial G-protein-coupled receptor, APJ, is a potent angiogenic factor required for normal vascular development of the frog embryo. Developmental Biology 296 177189.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Dai T, Ramirez-Correa G & Gao WD 2006 Apelin increases contractility in failing cardiac muscle. European Journal of Pharmacology 553 222228.

  • De Falco M, De Luca L, Onori N, Cavallotti I, Artigiano F, Esposito V, De Luca B, Laforgia V, Groeger AM & De Luca A 2002 Apelin expression in normal human tissues. In Vivo 16 333336.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • De Falco M, Fedele V, Russo T, Virgilio F, Sciarrillo R, Leone S, Laforgia V & De Luca A 2004 Distribution of apelin, the endogenous ligand of the APJ receptor, in the lizard Podarcis sicula. Journal of Molecular Histology 35 521527.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Habata Y, Fujii R, Hosoya M, Fukusumi S, Kawamata Y, Hinuma S, Kitada C, Nishizawa N, Murosaki S & Kurokawa T et al. 1999 Apelin, the natural ligand of the orphan receptor APJ, is abundantly secreted in the colostrum. Biochimica et Biophysica Acta 1452 2535.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hsu SM, Raine L & Fanger H 1981 Use of avidin–biotin–peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. Journal of Histochemistry and Cytochemistry 29 577580.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Ishida J, Hashimoto T, Hashimoto Y, Nishiwaki S, Iguchi T, Harada S, Sugaya T, Matsuzaki H, Yamamoto R & Shiota N et al. 2004 Regulatory roles for APJ, a seven-transmembrane receptor related to angiotensin-type 1 receptor in blood pressure in vivo. Journal of Biological Chemistry 279 2627426279.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kasai A, Shintani N, Oda M, Kakuda M, Hashimoto H, Matsuda T, Hinuma S & Baba A 2004 Apelin is a novel angiogenic factor in retinal endothelial cells. Biochemical and Biophysical Research Communications 325 395400.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kawamata Y, Habata Y, Fukusumi S, Hosoya M, Fujii R, Hinuma S, Nishizawa N, Kitada C, Onda H & Nishimura O et al. 2001 Molecular properties of apelin: tissue distribution and receptor binding. Biochimica et Biophysica Acta 1538 162171.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kleinz MJ, Skepper JN & Davenport AP 2005 Immunocytochemical localisation of the apelin receptor, APJ, to human cardiomyocytes, vascular smooth muscle and endothelial cells. Regulatory Peptides 126 233240.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • McCracken JA, Schramm W, Barcikowski B & Wilson L Jr 1981 The identification of prostaglandin F as a uterine luteolytic hormone and the hormonal control of its synthesis. Acta Veterinaria Scandinavica 77 7188.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Medhurst AD, Jennings CA, Robbins MJ, Davis RP, Ellis C, Winborn KY, Lawrie KW, Hervieu G, Riley G & Bolaky JE et al. 2003 Pharmacological and immunohistochemical characterization of the APJ receptor and its endogenous ligand apelin. Journal of Neurochemistry 84 11621172.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Miyamoto Y, Skarzynski DJ & Okuda K 2000 Is tumor necrosis factor alpha a trigger for the initiation of endometrial prostaglandin F release at luteolysis in cattle? Biology of Reproduction 62 11091115.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Miyamoto A, Shirasuna K, Wijayagunawardane MP, Watanabe S, Hayashi M, Yamamoto D, Matsui M & Acosta TJ 2005 Blood flow: a key regulatory component of corpus luteum function in the cow. Domestic Animal Endocrinology 29 329339.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Moncada S, Palmer RM & Higgs EA 1991 Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacological Reviews 43 109142.

  • Nett TM, Staigmiller RB, Akbar AM, Diekman MA, Ellinwood WE & Niswender GD 1976 Secretion of prostaglandin F in cycling and pregnant ewes. Journal of Animal Science 42 876880.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Carroll AM, Selby TL, Palkovits M & Lolait SJ 2000 Distribution of mRNA encoding B78/apj, the rat homologue of the human APJ receptor, and its endogenous ligand apelin in brain and peripheral tissues. Biochimica et Biophysica Acta 1492 7280.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Dowd BF, Heiber M, Chan A, Heng HH, Tsui LC, Kennedy JL, Shi X, Petronis A, George SR & Nguyen T 1993 A human gene that shows identity with the gene encoding the angiotensin receptor is located on chromosome 11. Gene 136 355360.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Shea JD, Rodgers RJ & D'Occhio MJ 1989 Cellular composition of the cyclic corpus luteum of the cow. Journal of Reproduction and Fertility 85 483487.

  • Tang SY, Xie H, Yuan LQ, Luo XH, Huang J, Cui RR, Zhou HD, Wu XP & Liao EY 2007 Apelin stimulates proliferation and suppresses apoptosis of mouse osteoblastic cell line MC3T3-E1 via JNK and PI3-K/Akt signaling pathways. Peptides 28 708718.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tatemoto K, Hosoya M, Habata Y, Fujii R, Kakegawa T, Zou MX, Kawamata Y, Fukusumi S, Hinuma S & Kitada C et al. 1998 Isolation and characterization of a novel endogenous peptide ligand for the human APJ receptor. Biochemical and Biophysical Research Communications 251 471476.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tatemoto K, Takayama K, Zou MX, Kumaki I, Zhang W, Kumano K & Fujimiya M 2001 The novel peptide apelin lowers blood pressure via a nitric oxide-dependent mechanism. Regulatory Peptides 99 8792.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Watanabe S, Shirasuna K, Matsui M, Yamamoto D, Berisha B, Schams D & Miyamoto A 2006 Effect of intraluteal injection of endothelin type A receptor antagonist on PGF-induced luteolysis in the cow. Journal of Reproduction and Development 52 551559.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Xie H, Yuan LQ, Luo XH, Huang J, Cui RR, Guo LJ, Zhou HD, Wu XP & Liao EY 2007 Apelin suppresses apoptosis of human osteoblasts. Apoptosis 12 247254.

  • Yadav VK, Lakshmi G & Medhamurthy R 2005 Prostaglandin F-mediated activation of apoptotic signaling cascades in the corpus luteum during apoptosis: involvement of caspase-activated DNase. Journal of Biological Chemistry 280 1035710367.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Yamasaki H & Naus CC 1996 Role of connexin genes in growth control. Carcinogenesis 17 11991213.

  • Zhong JC, Yu XY, Huang Y, Yung LM, Lau CW & Lin SG 2007 Apelin modulates aortic vascular tone via endothelial nitric oxide synthase phosphorylation pathway in diabetic mice. Cardiovascular Research 74 388395.

    • PubMed
    • Search Google Scholar
    • Export Citation

 

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  • Relative mRNA levels of apelin (A) and APJ (B) in bovine CL throughout the estrous cycle (n=6 for each stage of the CL). All values are shown as mean±s.e.m. (relative to GAPDH mRNA levels). Different superscript letters indicate significant differences (P<0.05) as determined by ANOVA followed by Bonferroni's multiple comparison test.

  • Immunohistochemical localization of apelin and APJ in bovine CL of (A and D) mid- and late (B and E) luteal stages. Apelin (A and B) and APJ (D and E) proteins are selectively expressed in the area of intraluteal arterioles (arrows). The specificity of the staining was monitored in negative control sections (C and F) by replacing the antibody with goat anti-rabbit IgG. Scale bars represent 100 μm (A, B, D and E). Immunohistochemical detailed localization of apelin and APJ in the bovine CL of mid-luteal stages were shown in G–J. Apelin (G) and APJ (H) proteins are selectively expressed in smooth muscle cells of intraluteal arterioles (I). Serial sections (I and J) were stained for anti-a smooth muscle actin antibody (I) and von Willebrand factor (J) respectively. These sections indicate the same blood vessels within the CL (G–J). Scale bars represent 10 μm (G–J).

  • Relative mRNA levels of apelin (A) and APJ (B) in bovine CL during PGF2α-induced luteolysis (n=5 for each time point). The expression of mRNA was expressed as the percentage of the baseline (0 h). All values are shown as mean±s.e.m. (relative to GAPDH mRNA levels). Different superscript letters indicate significant differences (P<0.05) as determined by ANOVA followed by Bonferroni's multiple comparison test.

  • Effect of PGF2α injection on apelin (A) and APJ (B) mRNA expression and on apelin (C) and APJ (D) immunostaining-positive area in the early and the mid-CL in cow. The experiments were conducted on day 4 as early CL, days 10–12 as mid-CL, and PGF2α or saline as control was injected respectively (early CL control, n=5; early CL PGF2α treat, n=5; mid-CL control, n=4; mid-CL PGF2α treat; n=4). At 30 min after injection of PGF2α or saline, luteal blood flow was observed using color Doppler ultrasound. After observing, the cows were ovariectomized at 1 h after treatment, and the portions of the CL were fixed for immunohistochemistry and processed for mRNA analysis. Sampling areas within the CL were designated as periphery and center of the CL. All values are shown as mean±s.e.m. Asterisk indicates statistically different values (P<0.05).

  • Acosta TJ, Yoshizawa N, Ohtani M & Miyamoto A 2002 Local changes in blood flow within the early and midcycle corpus luteum after prostaglandin F injection in the cow. Biology of Reproduction 66 651658.

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    • Export Citation
  • Al-zi'abi MO, Watson ED & Fraser HM 2003 Angiogenesis and vascular endothelial growth factor expression in the equine corpus luteum. Reproduction 125 259270.

  • Cheng X, Cheng XS & Pang CC 2003 Venous dilator effect of apelin, an endogenous peptide ligand for the orphan APJ receptor, in conscious rats. European Journal of Pharmacology 470 171175.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Chomczynski P & Sacchi N 1987 Single-step method of RNA isolation by acid guanidinium thiocyanate–phenol–chloroform extraction. Analytical Biochemistry 162 156159.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cox CM, D'Agostino SL, Miller MK, Heimark RL & Krieg PA 2006 Apelin, the ligand for the endothelial G-protein-coupled receptor, APJ, is a potent angiogenic factor required for normal vascular development of the frog embryo. Developmental Biology 296 177189.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Dai T, Ramirez-Correa G & Gao WD 2006 Apelin increases contractility in failing cardiac muscle. European Journal of Pharmacology 553 222228.

  • De Falco M, De Luca L, Onori N, Cavallotti I, Artigiano F, Esposito V, De Luca B, Laforgia V, Groeger AM & De Luca A 2002 Apelin expression in normal human tissues. In Vivo 16 333336.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • De Falco M, Fedele V, Russo T, Virgilio F, Sciarrillo R, Leone S, Laforgia V & De Luca A 2004 Distribution of apelin, the endogenous ligand of the APJ receptor, in the lizard Podarcis sicula. Journal of Molecular Histology 35 521527.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Habata Y, Fujii R, Hosoya M, Fukusumi S, Kawamata Y, Hinuma S, Kitada C, Nishizawa N, Murosaki S & Kurokawa T et al. 1999 Apelin, the natural ligand of the orphan receptor APJ, is abundantly secreted in the colostrum. Biochimica et Biophysica Acta 1452 2535.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hsu SM, Raine L & Fanger H 1981 Use of avidin–biotin–peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. Journal of Histochemistry and Cytochemistry 29 577580.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Ishida J, Hashimoto T, Hashimoto Y, Nishiwaki S, Iguchi T, Harada S, Sugaya T, Matsuzaki H, Yamamoto R & Shiota N et al. 2004 Regulatory roles for APJ, a seven-transmembrane receptor related to angiotensin-type 1 receptor in blood pressure in vivo. Journal of Biological Chemistry 279 2627426279.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kasai A, Shintani N, Oda M, Kakuda M, Hashimoto H, Matsuda T, Hinuma S & Baba A 2004 Apelin is a novel angiogenic factor in retinal endothelial cells. Biochemical and Biophysical Research Communications 325 395400.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kawamata Y, Habata Y, Fukusumi S, Hosoya M, Fujii R, Hinuma S, Nishizawa N, Kitada C, Onda H & Nishimura O et al. 2001 Molecular properties of apelin: tissue distribution and receptor binding. Biochimica et Biophysica Acta 1538 162171.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kleinz MJ, Skepper JN & Davenport AP 2005 Immunocytochemical localisation of the apelin receptor, APJ, to human cardiomyocytes, vascular smooth muscle and endothelial cells. Regulatory Peptides 126 233240.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • McCracken JA, Schramm W, Barcikowski B & Wilson L Jr 1981 The identification of prostaglandin F as a uterine luteolytic hormone and the hormonal control of its synthesis. Acta Veterinaria Scandinavica 77 7188.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Medhurst AD, Jennings CA, Robbins MJ, Davis RP, Ellis C, Winborn KY, Lawrie KW, Hervieu G, Riley G & Bolaky JE et al. 2003 Pharmacological and immunohistochemical characterization of the APJ receptor and its endogenous ligand apelin. Journal of Neurochemistry 84 11621172.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Miyamoto Y, Skarzynski DJ & Okuda K 2000 Is tumor necrosis factor alpha a trigger for the initiation of endometrial prostaglandin F release at luteolysis in cattle? Biology of Reproduction 62 11091115.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Miyamoto A, Shirasuna K, Wijayagunawardane MP, Watanabe S, Hayashi M, Yamamoto D, Matsui M & Acosta TJ 2005 Blood flow: a key regulatory component of corpus luteum function in the cow. Domestic Animal Endocrinology 29 329339.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Moncada S, Palmer RM & Higgs EA 1991 Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacological Reviews 43 109142.

  • Nett TM, Staigmiller RB, Akbar AM, Diekman MA, Ellinwood WE & Niswender GD 1976 Secretion of prostaglandin F in cycling and pregnant ewes. Journal of Animal Science 42 876880.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Carroll AM, Selby TL, Palkovits M & Lolait SJ 2000 Distribution of mRNA encoding B78/apj, the rat homologue of the human APJ receptor, and its endogenous ligand apelin in brain and peripheral tissues. Biochimica et Biophysica Acta 1492 7280.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Dowd BF, Heiber M, Chan A, Heng HH, Tsui LC, Kennedy JL, Shi X, Petronis A, George SR & Nguyen T 1993 A human gene that shows identity with the gene encoding the angiotensin receptor is located on chromosome 11. Gene 136 355360.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • O'Shea JD, Rodgers RJ & D'Occhio MJ 1989 Cellular composition of the cyclic corpus luteum of the cow. Journal of Reproduction and Fertility 85 483487.

  • Tang SY, Xie H, Yuan LQ, Luo XH, Huang J, Cui RR, Zhou HD, Wu XP & Liao EY 2007 Apelin stimulates proliferation and suppresses apoptosis of mouse osteoblastic cell line MC3T3-E1 via JNK and PI3-K/Akt signaling pathways. Peptides 28 708718.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tatemoto K, Hosoya M, Habata Y, Fujii R, Kakegawa T, Zou MX, Kawamata Y, Fukusumi S, Hinuma S & Kitada C et al. 1998 Isolation and characterization of a novel endogenous peptide ligand for the human APJ receptor. Biochemical and Biophysical Research Communications 251 471476.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tatemoto K, Takayama K, Zou MX, Kumaki I, Zhang W, Kumano K & Fujimiya M 2001 The novel peptide apelin lowers blood pressure via a nitric oxide-dependent mechanism. Regulatory Peptides 99 8792.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Watanabe S, Shirasuna K, Matsui M, Yamamoto D, Berisha B, Schams D & Miyamoto A 2006 Effect of intraluteal injection of endothelin type A receptor antagonist on PGF-induced luteolysis in the cow. Journal of Reproduction and Development 52 551559.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Xie H, Yuan LQ, Luo XH, Huang J, Cui RR, Guo LJ, Zhou HD, Wu XP & Liao EY 2007 Apelin suppresses apoptosis of human osteoblasts. Apoptosis 12 247254.

  • Yadav VK, Lakshmi G & Medhamurthy R 2005 Prostaglandin F-mediated activation of apoptotic signaling cascades in the corpus luteum during apoptosis: involvement of caspase-activated DNase. Journal of Biological Chemistry 280 1035710367.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Yamasaki H & Naus CC 1996 Role of connexin genes in growth control. Carcinogenesis 17 11991213.

  • Zhong JC, Yu XY, Huang Y, Yung LM, Lau CW & Lin SG 2007 Apelin modulates aortic vascular tone via endothelial nitric oxide synthase phosphorylation pathway in diabetic mice. Cardiovascular Research 74 388395.

    • PubMed
    • Search Google Scholar
    • Export Citation