宫腔粘连组织中解离素-金属蛋白酶15、17的表达

Expression of Disintegrin and Metalloproteinase ADAM15,17 in Intrauterine Adhesion

目的研究宫腔创伤微环境中解离素-金属蛋白酶(a disintegrin and metalloproteinase,ADAM)家族成员ADAM-15、17的表达,探讨宫腔粘连(intrauterin adhesion,IUA)的分子生物学机制。方法选择就诊于宁夏医科大学总医院经宫腔镜诊断为IUA的68例(IUA组)及同期主因"不孕症"行宫腔镜检查为正常宫腔的18例患者(对照组)为研究对象,IUA组根据粘连轻、中、重程度分为IUA-I(n=28)、IUA-II(n=22)和IUA-III(n=18)级,Western blot和real-time PCR方法分别检测IUA组粘连组织以及对照组子宫内膜中的ADAM-15、ADAM-17的mRNA及蛋白表达水平。结果与对照组相比,ADAM-15和ADAM-17蛋白水平及RNA转录水平都显著升高(P<0.05),IUA组间比较,ADAM-15和ADAM-17蛋白水平及RNA转录水平在IUA-III级中升高最为明显,其表达水平与宫腔粘连的严重程度具有相关性。其表达水平与宫腔粘连的严重程度具有相关性。结论 ADAM-15和ADAM-17在宫腔粘连的病理形成过程中具有重要的调节作用,可能成为宫腔粘连治疗及预后判断的分子生物学指标。

Objective To explore the molecular biological mechanism of intrauterine adhesion with the study of expression of disintegrin and metalloproteinase ADAM- 15,ADAM- 17 in healing microenvironment after uterine trauma. Methods 68 patients were proved to have IUAs in the study performed at the department of gynecology,General Hospital of Ningxia Medical University. 18 healthy volunteer participants were recruited in the study. All patients and volunteers were submitted to diagnostic hysteroscopy using a continuous- flow hysteroscope. Patients from each pathology subgroup were assigned into three groups according to the classification of March et: IUA- I( n = 28),IUA- II( n = 22),IUA- III( n = 18). All the volunteers were assigned to control group( Con,n = 18). Protein level and mRNA level of ADAMs( a disintegrin and metalloproteinase) 15 and 17 in the adhesive band tissues in patients and the functional endometrium in volunteer were measured by western blot and real- time PCR. Results The ADAM- 15 and ADAM- 17 protein level and transcript level were significantly upregulated in IUA patients compared to that in controls( P < 0. 05). The protein levels of ADAM- 15 and AMAM- 17 in grade III IUA patients were significantly higher than those in grade II and grade I patients( P < 0. 05). Conclusion ADAM- 15 and ADAM- 17 play an important role in the remodeling of the human uterus under pathological challenge,which can be a potential marker to outline prognosis and results of treatment of intrauterine adhesions.