不明原因不孕妇女子宫内膜种植窗期MMP-9和TIMP-1的表达

The effect of the expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 protein on the window phase of endometrial implantation in unexplained infertilie women

目的 :探讨不明原因不孕妇女子宫内膜种植窗期基质金属蛋白酶 - 9(MMP- 9)及金属蛋白酶组织抑制物- 1(TIMP- 1)的表达对胚胎着床的影响。方法 :实验组 2 9例 ,正常对照组 14例 ,采用链菌生物素蛋白 -过氧化酶连接法 ,免疫组化测定两组子宫内膜种植窗期 MMP- 9及 TIMP- 1。结果 :在全部子宫内膜标本中 ,MMP- 9均呈阳性表达 ,腺上皮细胞、腔上皮细胞和基质细胞胞浆内均可见棕黄色颗粒沉着 ,上皮细胞染色强度大于基质 ;TIMP- 1表达特点和 MMP- 9相似 ,但 MMP- 9和 TIMP- 1实验组的表达均较对照组弱 (MMP- 9:2 30 .79± 4 3.92 vs 30 7.78±4 4.2 5 ;TIMP- 1:2 33.0 5± 4 8.5 1vs 2 97.86± 35 .5 6 ,P<0 .0 5 )。血雌激素、孕激素和 MMP- 9、TIMP- 1实验组与对照组均无相关性 ,但对照组 MMP- 9、TIMP- 1与孕激素呈现负相关趋势 (r=- 0 .330 ,r=- 0 .4 0 1,但 P>0 .0 5 )。结论 :不明原因不孕妇女子宫内膜种植窗期 MMP- 9及 TIMP- 1的低表达 ,可能是影响胚胎着床导致不孕的重要因素之一。

Objective: To explore the role of matrix metalloproteinase 9 (MMP 9) and tissue inhibitor of metalloproteinase 1 (TIMP 1) protein on embryo implantation in unexplained infertile women.Methods: Forty three women were divided into two groups:29 unexplained infertile (study group) and 14 women with normal fertile function (control group). Immunohistochemical analysis was applied to measure the cell expression of MMP 9 and TIMP 1 in the endometrial implantation window phase of the two groups. Results: The cells positive for these solu ble proteinases were found in the epithelial and stromal cells in all endometrial samples. Semi quantitative analysis showed that,MMP 9 and TIMP 1 were weaker in the endometrial glandular cells of infertile women then in those of the control group (MMP 9:230.79±43.92 vs 307.78±44.25;TIMP 1:233.05±48.51 vs 297.86± 35.56 , P <0.05). There was no statistical correlation between MMP 9 and TIMP 1 with blood estradiol (E 2) and progesterone (P) in the two groups ( P >0.05). But in control group,there was a negative correlation tendency in MMP 9/P and TIMP 1/P (MMP 9/P: r =-0.330,TIMP 1/P: r =-0.401). Conclusion: In unexplained inferrile women, the low expression of MMP 9 and TIMP 1 protein in the implantation window phase may be one of the important factors that affect the embryo impantation.