Kong Desheng, Zhang Lin, Xu Xin, Zhang Jingkun, Li Yanan, Huang Xianghua
Department of Gynecology and Obstetrics, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Gynecol Obstet Invest. 2018;83(5):499-507. doi: 10.1159/000479086. Epub 2017 Jul 20.
To study whether small intestine submucosa (SIS) could be a treatment option for preventing the formation of intrauterine adhesions (IUAs).
The IUAs model was established by mechanical curettage and infectious injury in a rat model. One uterine horn of the rat model was treated with the transplantation of SIS (SIS group) and the other one was left without any treatment (control group). The endometrium was evaluated with endometrial thickness, number of glands and fibrosis area. The endometrial receptive factors were detected by quantitative real-time polymerase chain reaction The number and location of embryos were documented to assess the function of endometrium.
In the SIS group, endometrial thickness was significantly thicker than that in the control group on the 14th and 21st day and the percentage of fibrosis area was significantly lower during the entire observation process (p < 0.05). The number of glands was similar between the 2 groups (p > 0.05). Receptive factors changed as follows: in the SIS group, the expression of uteroglobin was higher and peaked on the 21st day (3.42-fold, p < 0.05); the HOXA10 level was significantly higher on the 10th day (2.16-fold, p < 0.05), and it then decreased. More embryos were seen in SIS horns (5.13 vs. 1.25, p < 0.05).
SIS could be a potential physical barrier for the formation of IUAs. It contributes to the regeneration of and improvement of the receptivity of endometrium, and helps in the implantation and development of embryos in a rat model.
研究小肠黏膜下层(SIS)是否可作为预防宫腔粘连(IUA)形成的一种治疗选择。
通过机械刮宫和感染性损伤建立大鼠IUA模型。对该大鼠模型的一个子宫角进行SIS移植治疗(SIS组),另一个子宫角不做任何处理(对照组)。通过子宫内膜厚度、腺体数量和纤维化面积评估子宫内膜。采用定量实时聚合酶链反应检测子宫内膜容受性相关因子。记录胚胎数量和着床位置以评估子宫内膜功能。
在SIS组,第14天和第21天的子宫内膜厚度显著厚于对照组,且在整个观察过程中纤维化面积百分比显著更低(p<0.05)。两组间腺体数量相似(p>0.05)。容受性相关因子变化如下:在SIS组,子宫珠蛋白表达更高,并在第21天达到峰值(3.42倍,p<0.05);第10天HOXA10水平显著更高(2.16倍,p<0.05),随后下降。在接受SIS移植的子宫角中可见更多胚胎(5.13 vs. 1.25,p<0.05)。
SIS可能是IUA形成的潜在物理屏障。它有助于子宫内膜的再生和容受性改善,并在大鼠模型中促进胚胎着床和发育。