Goepel Christian
Department of Gynecology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strabe 40, D-O6097 Halle (Saale), Germany.
Acta Histochem. 2008;110(3):204-9. doi: 10.1016/j.acthis.2007.10.014. Epub 2007 Dec 21.
Connective tissue, consisting mainly of collagen and structural glycoproteins, is an important part of the supportive structures of the genitourinary region. Relatively few data have been published with respect to the role of elastin and glycoproteins in pelvic organ prolapse (POP). Connective tissue of the uterosacral ligament in postmenopausal women with and without genital prolapse was compared. Fifty-nine consecutive women referred for hysterectomy were included in the study. The patients had POP or benign gynecological disease (e.g. myoma of the uterus). Tissue samples from the uterosacral ligament were investigated for localization and distribution of tenascin and elastin using immunofluorescence microscopy. Tissue samples of women with prolapse showed a significantly (p<0.001) weaker immunofluorescent labeling of tenascin compared to samples taken from women without prolapse. Tenascin was detectable in tissues of all women with POP, whereas its immunolabeling was decreased in the uterosacral ligament in women without POP. Intact elastin fibers were observed in tissues of all women without POP, whereas elastin was undetectable or sometimes fragmented in the uterosacral ligament in women with POP. Greater amounts of tenascin and lesser amounts of elastin were therefore found in patients with POP. These results suggest that an altered turnover of connective tissue in the uterosacral ligament might be responsible for the presence of pelvic floor relaxation in postmenopausal women. These data indicate a complex architecture of the extracellular matrix in the uterosacral ligaments, with marked differences in tenascin and elastin expression between postmenopausal women with or without POP.
结缔组织主要由胶原蛋白和结构糖蛋白组成，是泌尿生殖区域支持结构的重要组成部分。关于弹性蛋白和糖蛋白在盆腔器官脱垂（POP）中的作用，发表的数据相对较少。对有和没有生殖器脱垂的绝经后妇女的子宫骶韧带结缔组织进行了比较。59名连续接受子宫切除术的妇女被纳入研究。这些患者患有盆腔器官脱垂或良性妇科疾病（如子宫肌瘤）。使用免疫荧光显微镜对子宫骶韧带的组织样本进行了腱生蛋白和弹性蛋白的定位和分布研究。与未脱垂妇女的样本相比，脱垂妇女的组织样本显示腱生蛋白的免疫荧光标记明显较弱（p<0.001）。在所有盆腔器官脱垂妇女的组织中都可检测到腱生蛋白，而在没有盆腔器官脱垂的妇女中，其在子宫骶韧带中的免疫标记减少。在所有没有盆腔器官脱垂的妇女的组织中都观察到完整的弹性纤维，而在有盆腔器官脱垂的妇女中，弹性蛋白在子宫骶韧带中无法检测到或有时呈碎片状。因此，在盆腔器官脱垂患者中发现腱生蛋白含量较高而弹性蛋白含量较低。这些结果表明，子宫骶韧带结缔组织更新的改变可能是绝经后妇女盆底松弛的原因。这些数据表明子宫骶韧带细胞外基质的结构复杂，在有或没有盆腔器官脱垂的绝经后妇女之间，腱生蛋白和弹性蛋白的表达存在明显差异。
