AAT、MMP-9在胎膜早破患者中的表达及意义

Expression and significance of AAT and MMP-9 in patients with premature rupture of membranes

目的探讨AAT、MMP-9在胎膜早破患者胎膜中的表达及意义。方法免疫组化、RT-PCR和western blot法检测40例TPROM、40例PPROM、42例TL及43例PTL产妇胎膜中AAT、MMP-9的表达。结果免疫组化结果:4组胎膜中均有AAT、MMP-9的阳性表达;MMP-9表达强度在PTL组最低,TPROM组最高,PPROM组高于TL组(P<0.05);而AAT表达强度趋势恰与之相反,PTL组最高,TL组高于PPROM组,TPROM组最低(P<0.05)。RT-PCR和western blot结果:MMP-9 mRNA和其蛋白在PTL组最低,PPROM组高于TL组,TPROM组最高(P<0.05)。反之,AAT mRNA和其蛋白在PTL组最高,TL组高于PPROM组,TPROM组最低(P<0.05);胎膜MMP-9表达水平与AAT表达呈负相关(P<0.05)。结论 PROM患者胎膜中AAT表达下调,MMP-9表达上升,当MMP-9/AAT比例失衡时,ECM降解加速,胎膜完整性受损,导致PROM。

Objective To investigate the expression and significance of AAT and MMP- 9 in patients with premature rupture of membranes. Methods Immunohistochemical method,RT- PCR and western blot were used to detect the expression of AAT and MMP- 9 in 40 cases of term premature rupture of membrane,40 preterm premature rupture of membranes,42 term labor and 43 premature labor. Results Immunohisto- chemistry： The positive expression of AAT and MMP- 9 were all existed in4 groups. The expression of MMP- 9 in PTL group was the lowest,the expression intensity of MMP- 9 was the highest in the TPROM group,the TL group was higher than that in PTL group,the PPROM group was higher than that in TL group（ P〈0. 05）. While the expression trend of AAT was the opposite： the expression intensity of AAT was the highest in PTL group,followed by TL group,and then PPROM group,the intensity of TPROM group was the lowest（ P〈0. 05）. RT- PCR and western blot： MMP- 9 mRNA and its protein was the lowest in PTL group,MMP- 9 mRNA and its protein was higher in TL group than that in PTL group,PPROM group was higher than TL group,TPROM group was the highest（ P〈0. 05）. Conversely,AAT mRNA and its protein was highest in the PTL group,followed by TL group and PPROM group,TPROM group was the lowest（ P〈0. 05）. The expression of MMP- 9 in fetal membranes was negatively correlated with the expression of AAT（ P〈0. 05）.Conclusion The expression of AAT was down- regulated in PROM in patients while the expression of MMP- 9 increased,which suggested that AAT might play a role in the maintenance of pregnancy and also a protective factor for fetal membranes by inhibiting the effect of MMP- 9. When the balance between MMP- 9 / AAT breaks,which could accelerate the degradation of extracellular matrix and the damage of cell integrity in fetal membranes,finally result in the occurrence of PROM.