Odagiri Kohei, Konno Ryo, Fujiwara Hiroyuki, Netsu Sachiho, Yang Chenghui, Suzuki Mitsuaki
Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Fertil Steril. 2009 Nov;92(5):1525-31. doi: 10.1016/j.fertnstert.2008.08.101. Epub 2008 Oct 18.
To investigate the pathogenesis of endometriotic pain.
Retrospective nonrandomized immunohistochemical study.
A university hospital, Department of Gynecology.
PATIENT(S): Twenty human endometriotic specimens were selected from different lesions including ovarian endometrioma, peritoneal lesion, and deep infiltrating lesion. Premenopausal women with histologically diagnosed endometriosis were selected (mean age 39 years; range, 25-53 years). The chief complaint was dysmenorrhea, dyschezia, and dyspareunia. A rat endometriosis model was induced in 10 SLC-Sprague-Dawley rats (8 weeks old) by surgical autotransplantation of the uterus.
INTERVENTION(S): Immunohistochemical staining of endometriotic specimens for alpha-smooth muscle actin (ASMA), neural cell adhesion molecule (NCAM), and nerve growth factor (NGF) expression.
MAIN OUTCOME MEASURE(S): Comparison of the immunoreactive staining of ASMA, NCAM, and NGF expression in human endometriosis and a rat endometriosis model.
RESULT(S): Morphological analysis revealed thick interstitium in both human and rat endometriotic lesions. The major components of fibrotic interstitium are smooth muscle cells, stained by anti-ASMA antibody, and nerve cells, stained by anti-NCAM antibody. Inflammatory cells are also present (e.g., macrophages and lymphocytes) as revealed by anti-NGF antibody staining.
CONCLUSION(S): These results suggest that the contraction of smooth muscle cells and the hyperalgia derived from innervation in the interstitial area is related to pain in endometriosis.
研究子宫内膜异位症疼痛的发病机制。
回顾性非随机免疫组织化学研究。
一所大学医院的妇科。
从不同病变（包括卵巢子宫内膜异位囊肿、腹膜病变和深部浸润性病变）中选取20例人类子宫内膜异位标本。选取组织学诊断为子宫内膜异位症的绝经前女性（平均年龄39岁；范围25 - 53岁）。主要症状为痛经、排便困难和性交困难。通过子宫自体移植手术在10只SLC - 斯普拉格 - 道利大鼠（8周龄）中诱导建立大鼠子宫内膜异位症模型。
对子宫内膜异位标本进行α - 平滑肌肌动蛋白（ASMA）、神经细胞黏附分子（NCAM）和神经生长因子（NGF）表达的免疫组织化学染色。
比较人类子宫内膜异位症和大鼠子宫内膜异位症模型中ASMA、NCAM和NGF表达的免疫反应性染色。
形态学分析显示人类和大鼠子宫内膜异位病变中均存在间质增厚。纤维化间质的主要成分是经抗ASMA抗体染色的平滑肌细胞和经抗NCAM抗体染色的神经细胞。抗NGF抗体染色显示也存在炎症细胞（如巨噬细胞和淋巴细胞）。
这些结果表明平滑肌细胞的收缩以及间质区域神经支配引起的痛觉过敏与子宫内膜异位症疼痛有关。
