Division of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria.
J Anat. 2013 Apr;222(4):462-72. doi: 10.1111/joa.12029. Epub 2013 Feb 13.
Literature on the development of the human vagina is abundant; however, contributions concerning the prenatal development of the entire utero-vaginal anlagen (UVA) are rare or carried out in rodents. The primary epithelial characteristics in the adult vagina and uterus are determined during prenatal development and depend on epithelio-mesenchymal stroma interaction; thus an investigation summarizing the spatiotemporal distribution of relevant molecular markers in the entire human UVA will be of current interest. We phenotyped epithelial and mesenchymal characteristics in sagittal sections from 24 female fetuses of 14-34 weeks of gestation and two female newborns by immunostaining with cytokeratins 8, 13, 14 and 17, p63, bcl-2, bmp4, HOX A13, CD31, VEGF, SMA, Pax2 and vimentin. Epithelial differentiation followed a caudal-to-cranial direction in the UVA. Due to the cytokeratin profile of cytokeratins 8, 13 and 14, the characteristics of the different epithelial zones in the UVA could already be recognized in middle-age fetuses. Vaginal epithelium originated from the urogenital sinus in the lower portion and initiated the transformation of vimentin-positive Müllerian epithelium in the upper vaginal portion. During prenatal development the original squamo-columnar junction was clearly detectable from week 24 onwards and was always found in the cervical canal. Early blc-2 positivity within the surrounding mesenchyme of the entire vagina including the portio region pointed to an organ-specific mesenchymal influence. Prenatal findings in human specimens clearly show that fornix epithelium up to the squamo-columnar junction is of vaginal Müllerian origin, and the cervical epithelium cranial to the squamo-columnar junction is of uterine Müllerian origin and includes cells with enough plasticity to transform into squamous epithelium.
有关人类阴道发育的文献资料丰富，但有关整个子宫阴道原基（UVA）的产前发育的研究却很少，或者是在啮齿动物中进行的。成年阴道和子宫的主要上皮特征是在产前发育过程中确定的，取决于上皮-间充质基质的相互作用；因此，总结整个人类 UVA 中相关分子标记物的时空分布将是当前的研究热点。我们通过对 24 名 14-34 孕周的女性胎儿和 2 名女性新生儿的矢状切片进行免疫染色，用细胞角蛋白 8、13、14 和 17、p63、bcl-2、bmp4、HOX A13、CD31、VEGF、SMA、Pax2 和波形蛋白进行表型分析。UVA 中的上皮分化沿着从尾侧向头侧的方向进行。由于细胞角蛋白 8、13 和 14 的细胞角蛋白特征，UVA 中不同上皮区域的特征在中年胎儿中已经可以识别。阴道上皮起源于下部的尿生殖窦，并启动上部阴道段的间充质上皮的转化。在产前发育过程中，从第 24 周开始，原始的鳞柱状交界处清晰可见，并始终存在于宫颈管内。整个阴道包括阴道上段的周围间质中早期的 bcl-2 阳性，表明存在器官特异性的间质影响。人标本的产前研究结果清楚地表明，穹窿上皮直到鳞柱状交界处都来源于阴道 Müller 上皮，而颈管内头侧的鳞柱状交界处的宫颈上皮来源于子宫 Müller 上皮，包括具有足够可塑性以转化为鳞状上皮的细胞。
