Tanyel F C, Okur H D
The Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey.
Hernia. 2004 May;8(2):149-54. doi: 10.1007/s10029-003-0196-z. Epub 2004 Jan 17.
Failed obliteration of processus vaginalis (PV) has recently been proposed to be due to persistence of the smooth muscle (SM), which is transiently present to generate the physical force to descend the testis. Sacs from hernia, hydrocele, or undescended testis reveal alterations in Ca(2+) contents. Since Ca(2+) signaling and some regulatory proteins are involved in programmed cell death (PCD), a flow cytometric evaluation was planned to evaluate the expression of inducers or inhibitors of PCD in sacs from different diagnostic sources.
Sacs associated with male hernia ( n=16), female hernia ( n=11), undescended testis ( n=9), and hydrocele ( n=11) were evaluated for binding of annexin and expressions of Bcl-2, Bax, Fas, Fas-ligand (Fas-L), and Fas+Fas-L. The binding and expressions in cells that express alpha-smooth muscle actin (alpha-SMA) were also determined. Expressions according to the groups were compared through unpaired t-test, and P values less than 0.05 were considered to be significant.
Sacs associated with undescended testis that contain the least SM revealed the most annexin binding, and sacs associated with hernia that contain the most SM binded the least annexin. However, expressions of Bcl-2, Bax, Fas, Fas-L and Fas+Fas-L have not revealed a significant difference. On the other hand, Bax and Fas expressions of cells that express alpha-SMA have been significantly higher in sacs associated with undescended testis.
Since increase of Bax and Fas in cells that express alpha-SMA are encountered in sacs with the least SM content, Bax and Fas appear to play roles in the amount of persisting SM. The necessities of initial depletion of Ca(2+) stores through inositol 1,4,5-trisphosphate receptors and subsequent increase of Bax and Fas levels in the mitochondrial pathway of PCD, together with the role of the sympathetic system in maintenance of SM, suggest a determinative role of the autonomic nervous system for obliteration of PV.
最近有人提出，鞘突（PV）闭塞失败是由于平滑肌（SM）持续存在，平滑肌短暂出现以产生使睾丸下降的物理力。来自疝气、鞘膜积液或隐睾的囊显示钙（Ca2+）含量发生改变。由于Ca2+信号传导和一些调节蛋白参与程序性细胞死亡（PCD），因此计划进行流式细胞术评估，以评估来自不同诊断来源的囊中PCD诱导剂或抑制剂的表达。
评估与男性疝气（n = 16）、女性疝气（n = 11）、隐睾（n = 9）和鞘膜积液（n = 11）相关的囊，检测膜联蛋白结合情况以及Bcl-2、Bax、Fas、Fas配体（Fas-L）和Fas+Fas-L的表达。还测定了表达α-平滑肌肌动蛋白（α-SMA）的细胞中的结合情况和表达情况。通过不成对t检验比较各组的表达情况，P值小于0.05被认为具有显著性。
与隐睾相关且SM含量最少的囊显示膜联蛋白结合最多，而与疝气相关且SM含量最多的囊膜联蛋白结合最少。然而，Bcl-2、Bax、Fas、Fas-L和Fas+Fas-L的表达未显示出显著差异。另一方面，在与隐睾相关的囊中，表达α-SMA的细胞的Bax和Fas表达明显更高。
由于在SM含量最少的囊中，表达α-SMA的细胞中Bax和Fas增加，可以看出Bax和Fas在持续存在的SM量中发挥作用。通过肌醇1,4,5-三磷酸受体最初耗尽Ca2+储存的必要性，以及随后在PCD线粒体途径中Bax和Fas水平的增加，再加上交感神经系统在维持SM中的作用，表明自主神经系统对PV闭塞起决定性作用。
