Metabolic Flexibility and Energy Substrate Utilization Regulate Contractility in the Human Myometrium

The uterus requires energy for sustained contractility during labor, to deliver the fetus and diminish the risk of postpartum hemorrhage. Our objective was to define energy requirements and assess metabolic flexibility in quiescent and contractile myometrial cells. Cells were treated with oxytocin to stimulate myometrial contractility. We found that myometrial cells rely on oxidative phosphorylation during quiescence and, when treated with oxytocin, can adapt to higher energy demands by shifting their energy production to glycolysis. Treatment with mitochondrial oxidation inhibitors revealed that in quiescent myometrial cells basal oxygen consumption rate decreased when treated with glucose oxidation inhibitor UK5099, but not the long chain fatty acid oxidation inhibitor etomoxir or the glutamine oxidation inhibitor BPTES. In oxytocin treated myometrial cells, this decrease was also observed upon BPTES treatment in addition to UK5099, suggesting that contractile myometrial cells can shift energy production from glucose to glutamine. Functionally, myometrial contractility was significantly reduced by UK5099 but not by etomoxir, further indicating dependence on glucose utilization.