IVF-ET反复种植失败患者子宫内膜HOXA-10基因的表达

Expression of HOXA-10 in the Endometria of Patients with Recurrent Implantation Failure in IVF-ET

目的研究同源框基因-10(HOXA-10)在人子宫内膜组织中的表达,并探讨其与体外受精-胚胎移植(IVF-ET)反复种植失败的相关性。方法以40例IVF-ET治疗反复种植失败的患者为研究对象,以40例正常妇女及5例早孕人流患者作为对照,获取患者各时期子宫内膜及蜕膜组织,采用免疫组织化学法检测HOXA-10蛋白在各时期子宫内膜及蜕膜上的定位和表达,采用反转录-聚合酶链反应(RT-PCR)方法和蛋白印迹法(Western blotting)测定HOXA-10 mRNA在各时期子宫内膜及蜕膜上的表达及其蛋白水平。结果 HOXA-10蛋白定位于子宫内膜腺上皮细胞和间质细胞,其mRNA和蛋白在各期子宫内膜及蜕膜组织中均有表达。在对照组中以分泌中期、晚期及蜕膜中的表达最强,明显高于月经期和增殖期(P<0.05);而在反复种植失败患者子宫内膜中的表达水平基本一致,无明显分泌中、晚期峰,并且分泌中、晚期的表达要显著低于对照组,差异有统计学意义(P<0.05)。结论 HOXA-10基因在分泌中、晚期子宫内膜及早孕蜕膜组织中的高表达与胚胎种植及妊娠维持密切相关;其表达下降可能是导致IVF-ET反复种植失败的重要原因之一。

Objective To investigate the expression of HOXA - 10 in the endometria of patients with recurrent implantation failure in in vitro fertilization and embryo transfer （IVF - ET） and explore its correlation with recurrent implantation failure. Methods 40 pa- tients with recurrent implantation failure in IVF - ET treatment were analyzed as study group, and other 40 normal women and 5 normal pregnant patients as control group. The samples of endometrium throughout the menstrual cycle and deciduas were obtained in patients. Expression of HOXA - 10 mRNA and protein was evaluated by using RT - PCR and Western blotting, and the location of HOXA - 10 pro- tein was evaluated by immunohistochemistry in all samples. Results HOXA - 10 protein was located in both glandular epithelial cells and stromal ceils of endometrium, and mRNA and protein was expressed in endometrium throughout the menstrual cycle. The levels of expres- sion were obviously increased in mid, later secretory phase and was highest in deciduas in control group （ P 〈 0.05）. But in study group, the levels of expression remained roughly constant and the expression in mid - and late - secretory phase was lower than that of control group （ P 〈 0.05 ）. Conclusion The higher expression of HOXA - 10 protein in mid - , late - secretory endometria and deciduas is asso- ciated with implantation,decidualization and pregnancy. It＇ s defective expression may be one of the reason that cause implantation failure.