促超排卵周期表皮生长因子对人卵泡发育的调节

Regulation of Ovarian Follicular Development by Epidermal Growth Factor in IVF Superovulation Cycles

目的：研究表皮生长因子（ＥＧＦ）、转化生长因子α（ＴＧＦα）及其共同受体（ＥＧＦＲ）在促超排卵过程中对卵泡发育的调节。方法：采用免疫组织化学及原位杂交技术，研究１０例正常卵巢组织、５例体外受精－胚胎移植（ＩＶＦ－ＥＴ）周期得到的颗粒细胞ＥＧＦ和ＥＧＦＲ的表达；分别采用放射免疫受体法、放射免疫法检测ＩＶＦ患者体液（１６例用药前血清、４２例卵泡液及同期血清）内ＥＧＦ样物质（ＥＧＦｓ）（主要包括ＥＧＦ和ＴＧＦα）、６种性激素水平。结果：卵巢局部不产生ＥＧＦ，但颗粒细胞具有ＥＧＦＲ并可产生ＴＧＦα。促超排卵过程中，血清ＥＧＦｓ水平显著升高，其在卵泡液内的水平明显高于同期血清水平；所有标本中未发现ＥＧＦｓ与性激素间存在相关关系。结论：卵巢局部产生ＥＧＦｓ是ＴＧＦα而非ＥＧＦ，ＴＧＦα通过自分泌作用于ＥＧＦＲ；促超排卵药物作用后，血清ＥＧＦｓ水平升高。

Objective: To study the role of epidermal growth factors (EGFs) in the regulation of ovarian follicular development in invitro fertilization (IVF) superovulation cycles. Methods: In situ hybridyzation and immunochemistry were used to locate EGF, transforming growth factor α (TGFα) and their receptor (EGFR) in 10 normal ovarian specimens and in 5 granulosa cell samples obtained from IVF egg retrieval procedure. Radioimmunoassay was used for 6 sex hormones and radioreceptor assay for EGFs (mainly including EGF and TGFα) determinations in the serum and follicular fluid. Results: (1) EGF was not detected in the ovary, while EGFR and TGFα were found to be present in human granulosa cells. (2) Serum EGFs levels increased with the development of follicles, and EGFs levels in the follicular fluid were higher than those of the matched plasma. No correlation was found between EGFs and sex hormones. Conclusions: TGFα but not EGF might be synthesized locally, acting on the granulosa cells in an autocrine fashion through EGFR in granulosa cells. Serum EGFs levels (including EGF and TGFα) might be stimulated by exogeneous gonadotropins.