Li Cheng-long, Leng Jin-hua, Li Meng-hui, Shi Jing-hua, Jia Shuang-zheng, Lang Jing-he
Department of Obstetrics and Gynecology, Chinese Academy of Medical Science, Beijing, China.
Zhonghua Fu Chan Ke Za Zhi. 2011 Nov;46(11):826-30.
To investigate the expression of transforming growth factor (TGF)-β and Smad pathway expressed in adhesion peritoneums in patients with endometriosis (EM).
From Dec. 2009 to Mar. 2010, 11 patients with EM [including 3 patients treated by gonadotropin releasing hormone agonist (GnRH-a) treatment] underwent laparoscopy surgery in Peking Union Medical College Hospital. In the mean time, 9 patients with benign ovarian tumor without EM and peritoneum adhesion were chosen as control. Peritoneum from lateral peritoneal cavity, adjacent from lesion and grossly normal was obtained during surgery. Microstructure of peritoneums was observed by HE staining and Masson staining. The expression of TGF-β1, TGF-β3, Smad 3 and Smad 7 in peritoneums were measured by immunohistochemistry staining and real-time PCR. The effect of GnRH-a on expressions of these markers were also analyzed.
(1) Microstructures of peritoneum: enlargement of nucleus of peritoneal mesothelial cells, thickening of connective tissue, distributive disorder of fiber, increasing numbers of fibroblast and inflammatory cells in EM were significantly different from those in control group. (2) The expression of TGF-β1 and 3 in peritoneum were 0.170 ± 0.020 and 0.110 ± 0.010 in EM group, which were significantly higher than 0.070 ± 0.010 and 0.050 ± 0.020 in control group. TGF-β1 was downregulated to 0.130 ± 0.030 and TGF-β3 was upregulated to 0.490 ± 0.090 by GnRH-a. (3) The expression of Smad 3 and 7 were 0.140 ± 0.020 and 0.110 ± 0.020 in peritoneum in EM group, which were significantly higher than 0.024 ± 0.004 and 0.014 ± 0.007 in control group. GnRH-a could upregualted the expression of smad 7 (0.040 ± 0.020), however, but no significant effect was observed on regulating Smad3 expression.
The changes of microstructure and the alteration of TGF-β/Smad expression in peritoneum of endometriosis were observed. GnRH-a could regulate the expression of TGF-β and Smad.
探讨转化生长因子（TGF）-β及Smad信号通路在子宫内膜异位症（EM）患者粘连腹膜中的表达情况。
2009年12月至2010年3月，11例EM患者[包括3例接受促性腺激素释放激素激动剂（GnRH-a）治疗的患者]在北京协和医院接受腹腔镜手术。同时，选取9例无EM及腹膜粘连的良性卵巢肿瘤患者作为对照。手术中获取侧腹膜腔、病变相邻及大体正常的腹膜。通过苏木精-伊红（HE）染色和Masson染色观察腹膜的微观结构。采用免疫组织化学染色和实时荧光定量聚合酶链反应（PCR）检测腹膜中TGF-β1、TGF-β3、Smad 3和Smad 7的表达。并分析GnRH-a对这些标志物表达的影响。
（1）腹膜微观结构：EM患者腹膜间皮细胞核增大、结缔组织增厚、纤维分布紊乱、成纤维细胞和炎性细胞数量增加，与对照组相比差异有统计学意义。（2）EM组腹膜中TGF-β1和TGF-β3的表达分别为0.170±0.020和0.110±0.010，显著高于对照组的0.070±0.010和0.050±0.020。GnRH-a使TGF-β1下调至0.130±0.030，TGF-β3上调至0.490±0.090。（3）EM组腹膜中Smad 3和Smad 7的表达分别为0.140±0.020和0.110±0.020，显著高于对照组的0.024±0.004和0.014±0.007。GnRH-a可上调Smad 7的表达（0.040±0.020），但对Smad3表达的调节无显著影响。
观察到子宫内膜异位症患者腹膜微观结构的改变以及TGF-β/Smad表达的变化。GnRH-a可调节TGF-β和Smad的表达。
