【摘要】 目的:探讨盆底结缔组织中弹性纤维相关基因Fibulin-5和类赖氨酰氧化酶1(LOXL1)的表达与盆腔器官脱垂(POP)发生的关系。方法:用Real-time RT-PCR检测24例POP患者(POP组)和22例因妇科良性疾病行子宫全切术患者(对照组)的骶韧带和(或)阴道前壁组织Fibulin-5及LOXL1的mRNA表达水平;同时采用免疫组化ElivisionTM Plus两步法检测其蛋白的表达。结果:①POP组患者骶韧带和阴道前壁组织中Fibulin-5 mRNA的表达明显低于对照组,而LOXL1 mRNA的表达明显高于对照组(P<0.05);且POPⅡ、Ⅲ期患者骶韧带组织中Fibulin-5 mRNA的表达量均数随POP程度加重而降低,LOXL1 mRNA的表达量均数随POP程度加重而增加(P<0.05)。②Fibulin-5蛋白的表达主要定位于细胞外基质,LOXL1蛋白的表达主要定位于成纤维细胞和平滑肌细胞胞质中。POP组骶韧带及阴道前壁组织中Fibulin-5蛋白的阳性表达率低于对照组(P<0.05),而LOXL1蛋白的阳性表达率高于对照组(P<0.05)。结论:POP患者盆底结缔组织中Fibulin-5 mRNA和蛋白的表达降低,LOXL1 mRNA和蛋白的表达升高,且变化的程度均与脱垂程度有关。两者可能通过影响弹性纤维的聚合过程,促进POP的发病。更多还原

【Abstract】 Objective:To investigate the expressions of Fibulin5 and lysyl oxidaselike 1(LOXL1) in uterosacral ligaments and anterior vaginal wall in women with pelvic organ prolapse (POP) and their relationship with the occurrence of POP.Methods:Quantitative realtime polymerase chain reaction (realtime RTPCR) was performed to measure the level of Fibulin5 and LOXL1 mRNA in the uterosacral ligaments and anterior vaginal wall of 24 POP patients(POP group) and 22 patients who received hysterectomy for benign gynecological diseases(control group).Simultaneously,Fibulin5 and LOXL1 protein expressions were assessed by immunohistochemistry.Results:①Comparing to controls,significant decrease in Fibulin5 mRNA expression and increase of LOXL1 mRNA expression were found in the uterosacral ligaments and anterior vaginal wall of patients with POP (P<005).In patients with POP Ⅱ,Ⅲ stage,the level of Fibulin5 in the uterosacral ligaments was decreased with increasing degrees of prolapse,while the level of LOXL1 was increased with increasing degrees of prolapse(P<005).②Fibulin5 was almost expressed in the extracellular matrix and LOXL1 in the cytoplasm of fibroblasts and smooth muscle cells.Comparing with controls,the positive rate of Fibulin5 expression in the uterosacral ligaments and anterior vaginal wall was significantly lower in patients with POP while the positive rate of LOXL1 was significantly higher (P<005).Conclusions:There is a decreased expression of Fibulin5 and an increased expression of LOXL1 in the uterosacral ligaments and anterior vaginal wall of patients with POP.Alterations of Fibulin5 and LOXL1 expression might impact the synthesis of elastic fibers and hence induce POP.更多还原