绝经前盆腔器官膨出患者子宫主韧带中Elastin、LOX基因表达的研究

Expressions of Elastin and Lysyl oxidase in the cardinal ligament of premenopausal pelvic organ prolapse

目的检测女性盆底器官膨出(pelvic organ prolapse,POP)患者子宫主韧带中弹性蛋白(Elastin)和赖氨酰氧化酶(1ysyl oxidase,LOX)表达水平,探讨Elastin、LOX基因与POP发生机制间的关系。方法选择因POP而行全子宫切除术的绝经前患者42例,同期选择因妇科良性疾病、无压力性尿失禁(stress urinary incontinence,SUI)或POP行全子宫切除术绝经前患者27例作为对照。术中取子宫主韧带,采用逆转录-聚合酶链式反应(RT-PCR)法测定Elas-tin和LOX的mRNA表达,免疫蛋白印迹法(Western blotting)检测两种蛋白的表达。结果POP组子宫主韧带中Elastin、LOX mRNA及其蛋白表达水平明显低于对照组(P<0.05),POP组患者子宫主韧带中Elastin与LOX mRNA及蛋白表达水平呈明显的正相关(P<0.05)。结论POP患者子宫主韧带Elastin表达减弱影响弹性纤维形成,同时LOX表达减弱可通过影响胶原与弹性纤维的交联亦使盆腔支持结构稳定性降低,进而参与POP的发生。

Objective To investigate the Elastin and lysyl oxidase（LOX）expressions in the cardinal ligament of premenopausal women with pelvic organ prolapse（POP）so as to determine the alteration that contributes to POP. Methods Cardinal ligament samples were obtained from 42 pre-menopausal POP subjects and 27 non- POP control women that underwent a hysterectomy. Reverse transcription polymerase chain reaction（RT-PCR）was used to verify the mRNA level of Elastin and LOX, The concentration of Elastin and LOX was determined by the Western blotting technique, electrophoretic separation and quantification, Results The POP group demonstrated a significant decrease of expressions of Elastin and LOX in the cardinal ligament than in the control group （P 〈 0.05）. There was an identical tendency in protein level of these two groups （P 〈 0.05）. Also, there was a positive correlation between the two groups（ P 〈 0.05）. Conclusion The significant decrease in Elastin production in the cardinal ligaments may lead to a loss of functional tissue elasticity, a condition that may progress to the development of POP, and collagen and elastin metabolism in POP is altered by LOX. This alteration results in less flexible connective tissue, which is probably more likely to break. LOX might be involved in the pathogenesis of POP.