Endometriosis Research Centre Charité, Department of Gynaecology, Charité, Campus Benjamin Franklin, Berlin, Germany.
Brain Behav Immun. 2012 Jan;26(1):132-41. doi: 10.1016/j.bbi.2011.08.004. Epub 2011 Aug 25.
To investigate possible mechanisms of pain pathophysiology in patients with peritoneal endometriosis, a clinical study on sensory and sympathetic nerve fibre sprouting in endometriosis was performed. Peritoneal lesions (n=40) and healthy peritoneum (n=12) were immunostained and analysed with anti-protein gene product 9.5 (PGP 9.5), anti-substance P (SP) and anti-tyrosine hydroxylase (TH), specific markers for intact nerve fibres, sensory nerve fibres and sympathetic nerve fibres, respectively, to identify the ratio of sympathetic and sensory nerve fibres. In addition, immune cell infiltrates in peritoneal endometriotic lesions were analysed and the nerve growth factor (NGF) and interleukin (IL)-1β expression was correlate with the nerve fibre density. Peritoneal fluids from patients with endometriosis (n=40) and without endometriosis (n=20) were used for the in vitro neuronal growth assay. Cultured chicken dorsal root ganglia (DRG) and sympathetic ganglia were stained with anti-growth associated protein 43 (anti-GAP 43), anti-SP and anti-TH. We could detect an increased sensory and decreased sympathetic nerve fibres density in peritoneal lesions compared to healthy peritoneum. Peritoneal fluids of patients with endometriosis compared to patients without endometriosis induced an increased sprouting of sensory neurites from DRG and decreased neurite outgrowth from sympathetic ganglia. In conclusion, this study demonstrates an imbalance between sympathetic and sensory nerve fibres in peritoneal endometriosis, as well as an altered modulation of peritoneal fluids from patients with endometriosis on sympathetic and sensory innervation which might directly be involved in the maintenance of inflammation and pain.
为了探究腹膜子宫内膜异位症患者疼痛病理生理学的可能机制，我们进行了一项关于子宫内膜异位症中感觉和交感神经纤维发芽的临床研究。对腹膜病变（n=40）和健康腹膜（n=12）进行免疫染色，并使用针对完整神经纤维、感觉神经纤维和交感神经纤维的特异性标志物，即蛋白基因产物 9.5（PGP 9.5）、P 物质（SP）和酪氨酸羟化酶（TH）进行分析，以确定交感神经纤维和感觉神经纤维的比例。此外，分析腹膜子宫内膜异位症病变中的免疫细胞浸润，并将神经生长因子（NGF）和白细胞介素（IL）-1β的表达与神经纤维密度相关联。我们使用来自子宫内膜异位症患者（n=40）和无子宫内膜异位症患者（n=20）的腹膜液进行体外神经元生长测定。培养的鸡背根神经节（DRG）和交感神经节用抗生长相关蛋白 43（anti-GAP 43）、抗 SP 和抗 TH 染色。与健康腹膜相比，我们在腹膜病变中检测到感觉神经纤维密度增加，而交感神经纤维密度降低。与无子宫内膜异位症患者相比，子宫内膜异位症患者的腹膜液诱导 DRG 感觉神经突的发芽增加，而交感神经节的神经突生长减少。总之，这项研究表明，腹膜子宫内膜异位症中存在交感神经纤维和感觉神经纤维的失衡，以及子宫内膜异位症患者腹膜液对交感和感觉神经支配的改变调节，这可能直接参与炎症和疼痛的维持。
