[Inhibitory effect of Jiawei Sanleng pill medicated serum on estrogen production and its influence on apoptosis of human endometrial cells of endometriosis].

OBJECTIVE

To study the inhibitory effect on estradiol (E2) production of endometriosis by medicated serum of Jiawei Sanleng pill (SLW) and approach the mechanism of inducing apoptosis of human endometrial cells of endometriosis by medicated serum of SLW.

METHODS

The eutopic endometrial cells of hysteromyoma and endometriosis patients were cultured. Taking that of the endometrial cells of hysteromyoma as control, the secretion level of E2 of endometrial cells in the culture media supernatant at different time point with the treatment of high, middle and low dose of SLW serum was detected by electrochemiluminescence immunoassay and the apoptosis percentage of endometrium cells in early stage and late stage was detected by flow cytometry and TUNEL method. After the optimal time for SLW to induce apoptosis of eutopic endometrial cells of endometriosis in early stage and late stage was identified based on time-effect relationship, another endometrium cells were divided into six groups: hysteromyoma endometrium group, eutopic endometrium of endometriosis group, eutopic endometrium of endometriosis + middle dose of SLW serum group, eutopic endometrium of endometriosis + anastrozole serum group, eutopic endometria of endometriosis + middle dose of SLW serum + E2 group and eutopic endometrium of endometriosis + E2 group. The apoptosis percentage of endometrial cells in early stage and late stage of each group was detected according to the optimal time point respectively.

RESULTS

The secretion level of E2 of eutopic endometrium of endometriosis was decreased by SLW, which showed the dependence of concentration and time. The apoptosis percentage of endometrial cells in hysteromyoma endometrium group in early stage and late stage was increased along with the time and they was significantly higher than that of eutopic endometrium of endometriosis group at the same time point (P < 0.05 or P < 0.01). After 72 hours and 96 hours, with the treatment of middle dose of SLW serum, the apoptosis percentage of eutopic endometrial cells of endometriosis in early stage and late stage was 35.67 +/- 1.73 and 57.56 +/- 1.09 respectively, and the effect of inducing apoptosis was significantly stronger than that of the other time point. After 72 hours, with the combined treatment of middle dose of SLW serum and 5.30 ng/L E2, or after 96 hours, with the combined treatment of middle dose of SLW serum and 6. 36 ng/L E2, the apoptosis percentage of eutopic endometrial cells in early stage and late stage was decreased to 11.25 +/- 2.00 and 7.72 +/- 0.71 respectively, which had significant difference with that of middle dose of SLW serum group (P < 0.01). The apoptosis of the eutopic endometrial cells of endometriosis was induced by medicated serum of SLW could not be completely counteracted by E2 add-back treatment. Just with the treatment of 5.30 ng/L or 6.36 ng/L E2, the apoptosis percentage of eutopic endometrial cells of endometriosis in early stage and late stage tended to decrease, but there was no statistical significance (P > 0.05). Anastrozole, a specific aromatase inhibitor, had the contrary action to E2.

CONCLUSION

SLW could decrease the secretion of E2 so as to induce apoptosis of the eutopic endometrial cells of endometriosis.