Schmitz Carla Regina, Oehninger Sergio, Genro Vanessa Krebs, Chandra Neelima, Lattanzio Frank, Yu Liang, Cunha-Filho João Sabino
Graduate Program in Internal Medicine of the Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, Norfolk VA, USA.
JBRA Assist Reprod. 2017 Dec 1;21(4):313-320. doi: 10.5935/1518-0557.20170056.
The aim of this study was to compare the endometrial expression of milk fat globule-EGF factor 8 (MFG-E8), its receptor integrin αvβ3, and leukemia inhibitory factor (LIF) in patients with endometriosis and infertility and in healthy fertile patients during the window of implantation.
Five patients with peritoneal endometriosis and infertility (case group) and four healthy fertile patients (control group) were recruited. All patients were either diagnosed with or ruled out for endometriosis by laparoscopic surgery; the case group underwent surgery for infertility investigation and the control group for tubal ligation. Endometrial biopsies were performed in all patients during the window of implantation (LH+8 to LH+10), and then the samples were analyzed by immunochemistry for MFG-E8, integrin αvβ3, and LIF.
In patients with endometriosis and infertility, expression of MFG-E8 was significantly increased in the glandular epithelium when compared to healthy fertile patients (p<0.001). Moreover, LIF expression was lower in patients with endometriosis and infertility (p<0.05). Nevertheless, we found no difference in integrin αvβ3 expression between the groups (p=0.084).
This study showed for the first time that MFG-E8 expression is impaired in the endometrium of patients with endometriosis and infertility during the window of implantation. Moreover, LIF is also diminished in the endometrium of these patients as shown before.
本研究旨在比较子宫内膜异位症合并不孕症患者与健康可育患者在植入窗期子宫内膜中乳脂肪球表皮生长因子8(MFG-E8)、其受体整合素αvβ3和白血病抑制因子(LIF)的表达情况。
招募5例腹膜型子宫内膜异位症合并不孕症患者(病例组)和4例健康可育患者(对照组)。所有患者均通过腹腔镜手术确诊或排除子宫内膜异位症;病例组因不孕症行手术检查,对照组行输卵管结扎术。所有患者均在植入窗期(LH+8至LH+10)进行子宫内膜活检,然后通过免疫化学分析样本中MFG-E8、整合素αvβ3和LIF的表达情况。
与健康可育患者相比,子宫内膜异位症合并不孕症患者的腺上皮中MFG-E8的表达显著增加(p<0.001)。此外,子宫内膜异位症合并不孕症患者的LIF表达较低(p<0.05)。然而,我们发现两组之间整合素αvβ3的表达没有差异(p=0.084)。
本研究首次表明,在植入窗期,子宫内膜异位症合并不孕症患者的子宫内膜中MFG-E8表达受损。此外,如之前所示,这些患者的子宫内膜中LIF也减少。