瘦素及其受体在多囊卵巢综合征卵巢的表达及意义

STUDY OF LEPTIN AND LONG FORM LEPTIN RECEPTOR ON OVARIA WITH POLYCYSTIC OVARY SYNDROME

目的探讨瘦素(Leptin)及其受体(Ob gene receptor,Ob-R)系统与多囊卵巢综合征(polycystic ovary syn-drome,PCOS)发病机制间的关系。方法用免疫组织化学和原位杂交技术检测Leptin、具有信号传导功能的leptin长受体(Ob-Rb)在PCOS患者(15例)和月经周期规律的对照组(20例)卵巢的表达。结果Leptin及Ob-Rb的蛋白及mRNA在PCOS患者和对照组的卵巢均有表达。②Leptin主要分布在各级卵母细胞、窦状卵泡至排卵前卵泡的颗粒细胞(granulosa cell,GC)、不同生长阶段及闭锁卵泡的卵泡膜细胞(theca cell,TC),在PCOS患者卵母细胞的表达明显高于对照组,差异有统计学意义(P<0.01)。③Ob-Rb主要分布在各级卵母细胞、各级生长卵泡及闭锁卵泡的TC、次级及近成熟卵泡的GC、成熟黄体的颗粒黄体细胞。在PCOS患者的卵母细胞、窦状卵泡的TC及闭锁卵泡TC的表达显著高于对照组(P<0.01/P<0.05)。④Leptin及Ob-Rb在不同发育阶段卵巢的表达规律:卵母细胞强阳性表达,在初级卵泡的GC及TC表达较弱,随着卵泡发育表达逐渐增强,在排卵前卵泡或闭锁卵泡TC强阳性表达,Ob-Rb在发育期黄体的颗粒黄体细胞亦呈强阳性表达。⑤Leptin及Ob-Rb在PCOS患者小卵泡TC的表达高于GC,差异有统计学意义(P<0.05)。结论卵巢具有分泌Leptin的功能。②Leptin及受体系统在卵母细胞、卵泡和黄体发育、受精及受精卵着床过程中可能起重要作用。③Leptin及其受体系统在PCOS的卵巢异常表达。

Objective To explore the expression of leptin , leptin receptor in ovaries of the women with normal menstrual cycle or with polycystic ovary syndrome （PCOS）. Methods Paraffin sections from 20 normal human ovaries and 15 wedge resections with PCOS were investigated by means of immunochemistry and in situ hybridization. The expression of leptin, Ob- Rb polyclonal antibodies and oligoprobe were measured. Results Leptin was expressed in the oocyte, granulosa cells （GC） and the thecal layer （TC） of small and large follicles,except primary and secondary follicles in normal and PCOS ovaries. The expression was significantly higher in oocyte of PCOS （P〈0. 001）. The positive cells of Ob- Rb were located in the oocyte, GC and TC of all follicles, TC of atretic follicles, and in the luteinized GC. The expression was significantly higher in oocyte, TC of smalll and atretic follicles of patients with PCOS （P〈0. 001/〈0.05） comparing to that of the control group,which was found in a regular pattern, the expression of leptin and Ob- Rb protein was strongest in oocyte, GC and TC of large follicles, and the strongest expression was in TC of atretic follicles and luteinized granulosa layer in PCOS and control. The expression of leptin and Ob- Rb was significantly higher in GC than TC of small follicles of PCOS （P〈0. 001）. Conclusion Leptin is produced in the ovary and may act in autocrine and paracrine ways. The expression of Ob - Rb protein is at higher level in patients with PCOS,which suggests that leptin is involved in pathophysiologieal mechanism of polycystic ovary syndrome.