Al-Azemi M, Refaat B, Aplin J, Ledger W
Academic Unit of Reproductive and Developmental Medicine, Level 4, The Jessop Wing, Royal Hallamshire Hospital, Sheffield S10 2SF, UK.
Hum Reprod. 2009 Oct;24(10):2582-7. doi: 10.1093/humrep/dep233. Epub 2009 Jun 27.
Ectopic pregnancy is a major cause of maternal morbidity and mortality with increasing incidence worldwide. We have investigated whether epithelia from Fallopian tubes (FTs) bearing an ectopic pregnancy differ from normal tubes in expression of MUC1.
Since it is not possible to collect FTs from women carrying a healthy pregnancy, we studied tissue collected at the time of hysterectomy for benign disease. Women were injected with hCG in the days leading up to hysterectomy, and pseudopregnancy confirmed by the presence of high serum progesterone levels and the decidualization of the endometrium. FTs from the different stages of the menstrual cycle (n = 24), tubes bearing an ectopic pregnancy (n = 15) and pseudo-pregnant tubes (n = 6) were collected and examined using immunohistochemistry and quantitative RT-PCR.
MUC1 was present at the apical surface of the tubal epithelial cells throughout the menstrual cycle, but intracellular localization was minimal in the follicular phase, increasing to a maximum in the luteal phase. MUC1, including the glycoform recognized by antibody 214D4, was found at the apical surface of tubal epithelium in both the ectopic and pseudo-pregnant groups and the intracellular expression was much stronger in the pseudo-pregnant group than in the ectopic group. The 214D4 epitope was absent from tubal tissue adjacent to ectopic implants.
The decrease in MUC1 expression and altered glycosylation in tubal epithelium from ectopic pregnancy may reflect an increase in receptivity.
异位妊娠是孕产妇发病和死亡的主要原因,在全球范围内发病率不断上升。我们研究了发生异位妊娠的输卵管上皮细胞中MUC1的表达是否与正常输卵管不同。
由于无法从正常妊娠的女性中收集输卵管,我们研究了因良性疾病行子宫切除术时收集的组织。在子宫切除术前几天给女性注射人绒毛膜促性腺激素,并通过高血清孕酮水平和子宫内膜蜕膜化来确认假孕。收集月经周期不同阶段的输卵管(n = 24)、发生异位妊娠的输卵管(n = 15)和假孕输卵管(n = 6),并使用免疫组织化学和定量逆转录聚合酶链反应进行检测。
在整个月经周期中,MUC1存在于输卵管上皮细胞的顶端表面,但在卵泡期细胞内定位最少,在黄体期增加到最大值。在异位妊娠组和假孕组的输卵管上皮顶端表面均发现了MUC1,包括被抗体214D4识别的糖型,并且假孕组的细胞内表达比异位妊娠组强得多。异位植入物附近的输卵管组织中不存在214D4表位。
异位妊娠输卵管上皮中MUC1表达的降低和糖基化的改变可能反映了接受性的增加。