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[孕酮和孕激素对子宫内膜异位症患者在位内膜中活化调节正常T细胞表达和分泌因子表达的影响]

[Effects of progesterone and progestin on expression of regulated on activation, normal T cell expressed and secreted in eutopic endometrium from patients with endometriosis].

作者信息

Deng Shan, Dai Yi, Lang Jing-He, Leng Jin-Hua, Liu Zhu-Feng, Sun Da-Wei, Zhu Lan, Tan Xian-Jie

机构信息

Department of Obstetrics and Gynecology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Apr;29(2):257-61.

Abstract

OBJECTIVE

To investigate the effects of progesterone and progestin on the expressions of regulated on activation, normal T cell expressed and secreted (RANTES) in eutopic endometrium from patients with endometriosis.

METHODS

We collected the samples of endometrium from patients with endometriosis before operation or after insertion of levenorgestrel releasing intrauterine system (LNG-IUS), administration of oral medroxyprogesterone (MPA), or injection of gonadotrophic hormone releasing hormone agonist (GnRHa). Reverse transcription-polymerase chain raction was used to assay the expression of RANTES mRNA. On the other hand, progesterone (Po) and tumor necrosis factor-alpha (TNFalpha) of different concentrations and different manners were used to treat cultured cells in vitro. RANTES secretion was evaluated in the culture medium using ELISA. In order to evaluate the effect of Po on the secretion of RANTES under stimulation of TNFalpha, the cells were cultured in medium containing 100 U/ml TNFalpha and Po of different concentrations for 24 hours. After the pretreatment of Po for 48 hours at different concentrations, TNFalpha (100 U/ml, 16 h) was added to observe whether Po inhibits RANTES or not.

RESULTS

The expression of RANTES mRNA in eutopic endometrium of patients with endometriosis was significantly higher than in control group (28.0 +/- 9.0 vs. 22.0 +/- 5.6, P < 0.05). Following the exposures to LNG-IUS (24.0 +/- 4.2 vs. 25.9 +/- 4.2, P > 0.05) or GnRHa (23.0 +/- 12.9 vs. 26.9 +/- 5.2, P > 0.05), the expression of RANTES mRNA had no change. MPA significantly increased the expression of RANTES mRNA (42.6 +/- 3.1 vs. 24.3 +/- 5.7, P < 0.05). Po itself had no significant effect on the secretion of RANTES. Stimulated by Po and TNFalpha at the same time, the secretion of RANTES significantly increased. After pretreatment with Po for 48 hours, the reaction of RANTES to the stimulating effect of TNFalpha was down-regulated.

CONCLUSION

The eutopic endometrium of patients with endometriosis has high chemotactic activity. It may be feasible to prevent and treat endometriosis with progestins.

摘要

目的

探讨孕酮和孕激素对子宫内膜异位症患者在位内膜中调节激活正常T细胞表达和分泌因子(RANTES)表达的影响。

方法

收集子宫内膜异位症患者术前或放置左炔诺孕酮宫内节育系统(LNG-IUS)、口服甲羟孕酮(MPA)或注射促性腺激素释放激素激动剂(GnRHa)后的子宫内膜样本。采用逆转录-聚合酶链反应检测RANTES mRNA的表达。另一方面,用不同浓度和不同方式的孕酮(Po)和肿瘤坏死因子-α(TNFα)体外处理培养细胞。采用酶联免疫吸附测定法评估培养基中RANTES的分泌。为了评估Po在TNFα刺激下对RANTES分泌的影响,将细胞在含有100 U/ml TNFα和不同浓度Po的培养基中培养24小时。用不同浓度的Po预处理48小时后,加入TNFα(100 U/ml,16小时),观察Po是否抑制RANTES。

结果

子宫内膜异位症患者在位内膜中RANTES mRNA的表达显著高于对照组(28.0±9.0对22.0±5.6,P<0.05)。接触LNG-IUS(24.0±4.2对25.9±4.2,P>0.05)或GnRHa(23.0±12.9对26.9±5.2,P>0.05)后,RANTES mRNA的表达无变化。MPA显著增加RANTES mRNA的表达(42.6±3.1对24.3±5.7,P<0.05)。Po本身对RANTES的分泌无显著影响。同时受到Po和TNFα刺激时,RANTES的分泌显著增加。用Po预处理48小时后,RANTES对TNFα刺激作用的反应下调。

结论

子宫内膜异位症患者的在位内膜具有高趋化活性。用孕激素防治子宫内膜异位症可能是可行的。

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