赖氨酰氧化酶(LOX)在盆腔器官脱垂中的异常表达及临床意义

Expression and clinical significance of lysyl oxidase on pelvic organ prolapse

目的:通过对阴道前壁组织中赖氨酰氧化酶(LOX)蛋白表达水平的检测及其相关性的研究,分析赖氨酰氧化酶(LOX)与盆底器官脱垂(POP)发生的关系及与年龄、产次、体重指数、绝经时间的相关性分析。方法:取绝经前后POP组和对照组共4组46例患者,应用Western blotting方法检测LOX蛋白表达水平,并应用相关理论作统计学分析。结果:绝经前POP患者阴道前壁组织中赖氨酰氧化酶(LOX)蛋白表达水平明显低于绝经前对照组(p<0. 01),减少44%;绝经后POP患者阴道前壁组织中LOX蛋白的含量明显减少,平均减少幅度为82%;而且其LOX蛋白的表达在POP组与年龄、体重指数、绝经时间、POP的程度呈负相关,而与产次无相关性;在对照组则与产次呈负相关,而与年龄、体重指数无相关性。结论:①POP患者阴道前壁组织中胶原含量减少可能是由于局部LOX蛋白表达减弱所致,提示LOX蛋白表达减弱可能通过影响结缔组织的胶原含量和结构,进而参与POP发生;②POP的发生与年龄、体重指数和绝经状态密切相关。

Objective:To determine the expression of lysyl oxidase(LOX) in subjects with pelvic organ prolapse as compared to asymptomatic controls,to explore whether the alteration in LOX expression could contributed to pelvic organ prolapse (POP) and analysis the relationship between LOX and etiology of POP.Method:Transvaginal biopsies were obtained from the anterior vaginal in POP and in comparable control.Forty- six women participated in the study and they were divided into 3 groups. Western blotting study was performed to verify the protein level of LOX in anterior vaginal wall,GAPDH was used as the reference for the semiquatitative analysis.Results:The expression of LOX was significantly reduced(p<0.05) in both premenopausal (44%) and postmenopausal(82%) patients with POP,compared to the control group.The mean concentration of LOX was 44%lower in the premenopausal women with POP,In POP and control group,the expression of LOX was positively correlated with parity;In POP group,the expression of LOX was positively correlated with age、menopause status and BMI.Conclusion:①Patients with severe pelvic organ prolapse have a significant decreased level of LOX in the anterior vaginal wall,which maybe significantly reduce the content of collagen and alter the structure of collagen.These alterations could result in a less flexible connective tissue and these tissues probably were more likely to break,which suggested that LOX might be involved in the pathogenesis of POP.②The negative correlation with age、menopausal status and BMI in POP group indicated decrease in cross-link of collagen in genital tract relaxed the pelvic floor and disposed POP to progress.