BMPR2 is required for postimplantation uterine function and pregnancy maintenance

J Clin Invest. 2013 Jun;123(6):2539-50. doi: 10.1172/JCI65710. Epub 2013 May 8.

Abstract

Abnormalities in cell-cell communication and growth factor signaling pathways can lead to defects in maternal-fetal interactions during pregnancy, including immunologic rejection of the fetal/placental unit. In this study, we discovered that bone morphogenetic protein receptor type 2 (BMPR2) is essential for postimplantation physiology and fertility. Despite normal implantation and early placental/fetal development, deletion of Bmpr2 in the uterine deciduae of mice triggered midgestation abnormalities in decidualization that resulted in abnormal vascular development, trophoblast defects, and a deficiency of uterine natural killer cells. Absence of BMPR2 signaling in the uterine decidua consequently suppressed IL-15, VEGF, angiopoietin, and corin signaling. Disruption of these pathways collectively lead to placental abruption, fetal demise, and female sterility, thereby placing BMPR2 at a central point in the regulation of several physiologic signaling pathways and events at the maternal-fetal interface. Since trophoblast invasion and uterine vascular modification are implicated in normal placentation and fetal growth in humans, our findings suggest that abnormalities in uterine BMPR2-mediated signaling pathways can have catastrophic consequences in women for the maintenance of pregnancy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiopoietins / metabolism
  • Animals
  • Bone Morphogenetic Protein Receptors, Type II / genetics*
  • Bone Morphogenetic Protein Receptors, Type II / metabolism
  • Bone Morphogenetic Protein Receptors, Type II / physiology
  • Cell Differentiation
  • Cell Proliferation
  • Decidua / immunology
  • Decidua / metabolism*
  • Decidua / pathology
  • Embryo Implantation*
  • Estradiol / blood
  • Female
  • Fetal Growth Retardation / genetics
  • Gene Expression
  • Giant Cells / pathology
  • Infertility, Female / genetics
  • Interleukin-15 / metabolism
  • Killer Cells, Natural / physiology
  • Male
  • Mice
  • Mice, 129 Strain
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Placenta / blood supply
  • Placenta / pathology
  • Pregnancy
  • Pregnancy Maintenance*
  • Progesterone / blood
  • Serine Endopeptidases / metabolism
  • Signal Transduction
  • Trophoblasts / pathology
  • Uterus / immunology
  • Uterus / metabolism
  • Uterus / physiopathology
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Angiopoietins
  • Interleukin-15
  • Vascular Endothelial Growth Factor A
  • vascular endothelial growth factor A, mouse
  • Progesterone
  • Estradiol
  • Bmpr2 protein, mouse
  • Bone Morphogenetic Protein Receptors, Type II
  • Corin protein, mouse
  • Serine Endopeptidases