Malik Shazia, Day Kate, Perrault Isabelle, Charnock-Jones D Stephen, Smith Stephen K
Department of Obstetrics and Gynaecology, The Rosie Hospital, Robinson Way, Cambridge, UK.
Hum Reprod. 2006 Aug;21(8):2158-66. doi: 10.1093/humrep/del089. Epub 2006 Apr 3.
Heavy regular menstrual periods (menorrhagia) are an important cause of ill health in women and remain the leading indication for hysterectomy. Abnormalities of the endometrial blood vessels are among the possible causes of this condition. Many different factors affect endothelial cell growth, function and vessel remodelling. We sought to determine whether the levels of vascular endothelial growth factor-A (VEGF-A), tumour necrosis factor-alpha (TNF-alpha), matrix metalloproteinase (MMP)-2 and MMP-9 and soluble VEGF receptor-1 (VEGF-R1) were altered in the menstrual effluent of women with objective menorrhagia. We have also quantitated the VEGF-A mRNA in the menstruated endometrium.
We recruited 37 women and determined their menstrual blood loss (MBL) over two cycles and collected menstrual effluent during the 2nd day of bleeding for 4 h. There was no difference in the total level of VEGF-A, and neither latent MMP. However, the concentration of VEGF-A was significantly reduced in the women with menorrhagia, as was the VEGF-A mRNA level. In addition, the active forms of both MMPs were markedly reduced and the total sVEGF-R1 as well as the TNF-alpha content were increased.
This is the first study to show abnormalities of factors important for endothelial cell behaviour in the endometrium of women with menorrhagia. This may underlie the disordered vessel structure and/or function in this condition.
重度规律月经过多（月经过多）是女性健康不良的重要原因，仍是子宫切除术的主要指征。子宫内膜血管异常是该病症的可能病因之一。许多不同因素会影响内皮细胞生长、功能及血管重塑。我们试图确定血管内皮生长因子 -A（VEGF-A）、肿瘤坏死因子 -α（TNF-α）、基质金属蛋白酶（MMP）-2和MMP-9以及可溶性VEGF受体 -1（VEGF-R1）的水平在有客观月经过多的女性月经流出物中是否发生改变。我们还对月经后的子宫内膜中的VEGF-A mRNA进行了定量分析。
我们招募了37名女性，在两个月经周期内测定她们的月经失血量（MBL），并在出血第2天收集4小时的月经流出物。VEGF-A的总水平以及潜伏型MMP均无差异。然而，月经过多女性的VEGF-A浓度显著降低，VEGF-A mRNA水平也是如此。此外，两种MMP的活性形式均明显降低，sVEGF-R1总量以及TNF-α含量增加。
这是第一项显示月经过多女性子宫内膜中对内皮细胞行为重要的因子存在异常的研究。这可能是该病症中血管结构和/或功能紊乱的基础。
