Ersahin Aynur Adeviye, Ersahin Suphan, Gungor Nur Dokuzeylul
Department of Obstetrics and Gynecology, Bahcesehir University School of Medicine, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Altınbaş University Medical Faculty, Istanbul, Turkey.
Reprod Sci. 2020 Mar;27(3):787-792. doi: 10.1007/s43032-019-00136-y. Epub 2020 Feb 18.
Although physiologic amount of inflammation is necessary for successful implantation, pathological inflammation inhibits the expression of receptivity molecules and genes. Because hydrosalpinges is an inflammatory disease, adverse effects of hydrosalpinges on implantation may be in part mediated by disturbed endometrial expression of nuclear factor-kappa B (NF-κB), a dimer implicated in inflammation. We examined the expression of NF-κB p65 (Rel A) during the window of implantation in the endometrium of infertile women (n = 14) with uni or bilateral hydrosalpinges prior to and following salpingectomy and of fertile controls (n = 14) by immunohistochemistry. We assessed the influence of salpingectomy on NF-κB p65 expression by comparing pre- and post-operative endometrial samples. To evaluate the intensity of endometrial NF-κB p65 (Rel A) immunoreactivity, H-score method was used. We showed a decrease in NF-κB p65 expression in 13 out of the 14 post-salpingectomy endometrial samples. The mean NF-κB p65 level was significantly higher in the endometrium of women with hydrosalpinges before salpingectomy compared with control cases without hydrosalpinges (3.94 ± 6.2 vs 2.18 ± 0.7, p < .02). Salpingectomy decreased the mean endometrial NF-κB p65 levels in both unilateral and bilateral hydrosalpinges (2.87 ± 1.1). When we compared the endometrial NF-κB p65 levels of the post-salpingectomy samples with their age-matched fertile controls, we did not observe any significant difference. After salpingectomy, the mean H-score of endometrial NF-κB p65 expression significantly decreased to a level similar to that of the fertile group (2.87 ± 1.1 vs 2.18 ± 0.7, p > .64). NF-κB p65 expression was detected in cytoplasmic and membranous parts of luminal and glandular epithelial cells of endometrium obtained before salpingectomy. Both epithelial and stromal components of the endometrium showed decreased staining for NF-κB p65 compared with the pre- and post-salpingectomy samples. The decreased NF-κB p65 (Rel A) immunoreactivity was predominantly localized to luminal and glandular epithelial cells. Uni or bilateral hydrosalpinges causes pathological endometrial inflammation. Improvement in pathological inflammation following salpingectomy in women with hydrosalpinges may be in part mediated by the downregulation of endometrial NF-κB p65 (Rel A) expression.
尽管生理性炎症对于成功着床是必要的，但病理性炎症会抑制接受性分子和基因的表达。由于输卵管积水是一种炎症性疾病，输卵管积水对着床的不利影响可能部分是由子宫内膜中参与炎症的二聚体核因子-κB（NF-κB）表达紊乱介导的。我们通过免疫组织化学检查了14例单侧或双侧输卵管积水不孕妇女在输卵管切除术前和术后以及14例生育对照妇女在着床窗口期子宫内膜中NF-κB p65（Rel A）的表达。我们通过比较手术前后的子宫内膜样本评估输卵管切除术对NF-κB p65表达的影响。为了评估子宫内膜NF-κB p65（Rel A）免疫反应性的强度，采用了H评分法。我们发现14例输卵管切除术后子宫内膜样本中有13例NF-κB p65表达下降。与无输卵管积水的对照病例相比，输卵管积水妇女在输卵管切除术前子宫内膜中NF-κB p65的平均水平显著更高（3.94±6.2对2.18±0.7，p<0.02）。输卵管切除术降低了单侧和双侧输卵管积水患者子宫内膜中NF-κB p65的平均水平（2.87±1.1）。当我们将输卵管切除术后样本的子宫内膜NF-κB p65水平与其年龄匹配的生育对照进行比较时，未观察到任何显著差异。输卵管切除术后，子宫内膜NF-κB p65表达的平均H评分显著降低至与生育组相似的水平（2.87±1.1对2.18±0.7，p>0.64）。在输卵管切除术前获得的子宫内膜腔上皮和腺上皮细胞的细胞质和膜部分检测到NF-κB p65表达。与输卵管切除术前和术后的样本相比，子宫内膜的上皮和基质成分中NF-κB p65的染色均减少。NF-κB p65（Rel A）免疫反应性降低主要定位于腔上皮和腺上皮细胞。单侧或双侧输卵管积水会导致病理性子宫内膜炎症。输卵管积水妇女输卵管切除术后病理性炎症的改善可能部分是由子宫内膜NF-κB p65（Rel A）表达的下调介导的。
