Caspase-3、Caspase-8、Caspase-9在胎膜早破中的作用

Role of Caspase-3,Caspase-8 and Caspase-9 in Premature Rupture of Fetal Membranes

目的:通过检测自发性胎膜早破患者、正常分娩产妇和择期剖宫产产妇胎膜中凋亡因子Caspase-3,-8,-9蛋白的表达及定位,探讨凋亡因子Caspase-3-、8-、9在自发性胎膜早破中的作用。方法:取自发性胎膜早破未发动分娩行剖宫产的患者的胎膜(即胎膜早破组)8例,正常经阴道分娩产妇的胎膜(即阴道分娩组)8例以及无产科并发症择期剖宫产的产妇的胎膜(即剖宫产组)8例,其中,阴道分娩组和剖宫产组均作为对照组。应用免疫组化方法(SP法)对三组胎膜中Caspase-3,-8,-9蛋白的表达及定位进行检测,同时在光学显微镜下观察胎膜组织形态学的改变,在透射电镜下观察胎膜细胞超微结构的变化。结果:Caspase-3,-9蛋白在3组胎膜中均表达,Caspase-3,-9蛋白主要表达在羊膜上皮细胞、绒毛膜滋养层细胞,少数表达于网状细胞和间叶细胞,均为胞浆表达,胎膜早破组Caspase-3蛋白表达量(OD)为[(62.86±3.83)×10-2],高于阴道分娩组[(42.33±2.99)×10-2]和剖宫产组[(20.97±2.94)×10-2],在阴道分娩组的表达高于剖宫产组,两两比较,差异有统计学意义(P<0.05);胎膜早破组Caspase-9蛋白表达量为[(52.20±3.28)×10-2],高于阴道分娩组[(25.87±5.52)×10-2]和剖宫产组[(17.65±1.78)×10-2],在阴道分娩组的表达高于剖宫产组,两两比较,差异有统计学意义(P<0.05)。Caspase-8在3组几乎不表达。胎膜早破组胎膜在光镜下观察发现组织形态学发生明显改变,电镜下可观察到大量凋亡细胞。结论:Caspase-9和Caspase-3分别作为凋亡的线粒体途径的启动因子和效应因子,在胎膜早破中表达明显增高,超微结构也观察到大量凋亡细胞。因此推测线粒体途径的凋亡在胎膜早破发病机制中可能起到一定的作用。

Objective： To study the expression and localization of caspase-3, caspase-8 and caspase-9 in human amniochorionic membrane and the role in human premature rupture of fetal membranes （PROM）. Methods： Amniochorionic membranes were collected from women with spontaneous PROM n= 8）, from women with normal labor in term after vaginal delivery （n = 8） as control group, and from women undergoings elective repeat cesarean section（C-section） before the onset of labor and who had no complications of pregnancy （n = 8） （C-section group）. Caspase-3, caspase-8 and caspase-9 peptides were studied with SP method. The morphologic features of fatal membranes was studied with optical microscope, and the ultrastructure of fetal membrane cell was studied with electron microscope. Results： The expression of Caspase-3 and Caspase-9 peptides were detected in all the three groups. The caspase-3 and caspase-9 were mainly found in the amniotic epithelial cells and chorionic cytotrophoblast cells, while expressed weakly in amnion mesenchymal cells and cells of the reticular of the matrix. The expression of caspase-3 peptides （OD value） was （62.86±3.83）×10^-2, （42.33±2.99）×10^-2 and （20. 97±2.94）×10^-2 respectively in PROM group, vaginal delivery group and C-section group with statistical difference （P〈 0.05）. The expression of caspase-9 peptides was （52.20±3.28）×10^-2, （25.87±5.52）×10^-2 and （17.65±1.78）×10^-2 respectively and also with statistical difference （P〈0.05）. The expression of caspase-8 was negative in the three groups. In PROM, the morphologic features of fatal membranes changed significantly in optical microscope. There were large numbers of apoptosis cells in electron microscope. Conclusion. Caspase-3 and caspase-9, respectively as start-up apoptosis factors and apoptosis effective factors, express more in PROM than in vaginal delivery and C-section group, along with the appearance of large numbers of apoptosis cells. So caspase-3 and caspase-9 may play a role in the pathogenesis of PROM.