Department of Obstetrics & Gynecology and Women's Health, Division of Female Pelvic Medicine & Reconstructive Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Urology, Albert Einstein College of Medicine, Bronx, NY, USA.
J Sex Med. 2020 May;17(5):870-880. doi: 10.1016/j.jsxm.2020.02.010. Epub 2020 Mar 31.
Distension of hollow organs is known to release adenosine triphosphate (ATP) from the lining epithelium, which triggers local responses and activates sensory nerves to convey information to the central nervous system. However, little is known regarding participation of ATP and mediators of ATP release, such as Pannexin 1 (Panx1) channels, in mechanisms of vaginal mechanosensory transduction and of changes imposed by diabetes and menopause, conditions associated with vaginal dysfunction and risk for impaired genital arousal.
To investigate if intravaginal mechanical stimulation triggers vaginal ATP release and if (a) this response involves Panx1 channels and (b) this response is altered in animal models of diabetes and menopause.
Diabetic Akita female mice were used as a type 1 diabetes (T1D) model and surgical castration (ovariectomy [OVX]) as a menopause model. Panx1-null mice were used to evaluate Panx1 participation in mechanosensitive vaginal ATP release. Vaginal washes were collected from anesthetized mice at baseline (non-stimulated) and at 5 minutes after intravaginal stimulation. For the OVX and Sham groups, samples were collected before surgery and at 4, 12, 22, 24, and 28 weeks after surgery. ATP levels in vaginal washes were measured using the luciferin-luciferase assay. Panx1 mRNA levels in vaginal epithelium were quantified by quantitative polymerase chain reaction.
The main outcome measures are quantification of mechanosensitive vaginal ATP release and evaluation of impact of Panx1 deletion, OVX, and T1D on this response.
Intravaginal mechanical stimulation-induced vaginal ATP release was 84% lower in Panx1-null (P < .001) and 76% lower in diabetic (P < .0001) mice compared with controls and was reduced in a progressive and significant manner in OVX mice when compared with Sham. Panx1 mRNA expression in vaginal epithelium was 44% lower in diabetics than that in controls (P < .05) and 40% lower in OVX than that in the Sham (P < .05) group.
Panx1 downregulation and consequent attenuation of mechanosensitive vaginal responses may be implicated in mechanisms of female genital arousal disorder, thereby providing potential targets for novel therapies to manage this condition.
STRENGTHS & LIMITATIONS: Using animal models, we demonstrated Panx1 involvement in mechanosensitive vaginal ATP release and effects of T1D and menopause on this response and on Panx1 expression. A limitation is that sex steroid hormone levels were not measured, precluding correlations and insights into mechanisms that may regulate Panx1 expression in the vaginal epithelium.
Panx1 channel is a component of the vaginal epithelial mechanosensory transduction system that is essential for proper vaginal response to mechanical stimulation and is targeted in T1D and menopause. Harroche J, Urban-Maldonado M, Thi MM, et al. Mechanosensitive Vaginal Epithelial Adenosine Triphosphate Release and Pannexin 1 Channels in Healthy, in Type 1 Diabetic, and in Surgically Castrated Female Mice. J Sex Med 2020;17:870-880.
中空器官的膨胀已知会从衬里上皮释放三磷酸腺苷 (ATP),这会触发局部反应并激活感觉神经将信息传递到中枢神经系统。然而,关于 ATP 及其释放的介质(如 Pannexin 1 [Panx1] 通道)在阴道机械感觉转导机制中的作用以及糖尿病和绝经引起的变化知之甚少,这些变化与阴道功能障碍和生殖器唤起受损的风险有关。
研究阴道内机械刺激是否会引发阴道 ATP 释放,以及 (a) 这种反应是否涉及 Panx1 通道,以及 (b) 这种反应在糖尿病和绝经的动物模型中是否发生改变。
使用 Akita 雌性糖尿病小鼠作为 1 型糖尿病 (T1D) 模型,手术去卵巢(卵巢切除术 [OVX])作为绝经模型。使用 Panx1 缺失小鼠来评估 Panx1 参与机械敏感阴道 ATP 释放的情况。从麻醉小鼠的阴道冲洗液中收集基线(非刺激)和阴道内刺激后 5 分钟的样本。对于 OVX 和 Sham 组,在手术前和手术后 4、12、22、24 和 28 周收集样本。使用荧光素-荧光素酶测定法测量阴道冲洗液中的 ATP 水平。通过定量聚合酶链反应定量阴道上皮中的 Panx1 mRNA 水平。
与对照组相比,阴道内机械刺激诱导的阴道 ATP 释放在 Panx1 缺失(P <.001)和糖尿病(P <.0001)小鼠中分别降低了 84%和 76%,并且在 OVX 小鼠中呈进行性和显著降低。与 Sham 组相比,与对照组相比,阴道上皮中的 Panx1 mRNA 表达在糖尿病小鼠中降低了 44%(P <.05),在 OVX 小鼠中降低了 40%(P <.05)。
Panx1 下调和随之而来的机械敏感阴道反应减弱可能与女性生殖器唤醒障碍的机制有关,从而为管理这种疾病提供了新的治疗靶点。
使用动物模型,我们证明了 Panx1 参与了机械敏感的阴道 ATP 释放,以及 T1D 和绝经对这种反应和 Panx1 表达的影响。一个限制是没有测量性激素水平,因此无法进行相关性分析,也无法深入了解可能调节阴道上皮中 Panx1 表达的机制。
Panx1 通道是阴道上皮机械感觉转导系统的组成部分,对于阴道对机械刺激的适当反应至关重要,并且在 T1D 和绝经中受到靶向影响。Harroche J、Urban-Maldonado M、Thi MM 等人。健康、1 型糖尿病和手术去势雌性小鼠的机械敏感阴道上皮三磷酸腺苷释放和 Pannexin 1 通道。性医学杂志 2020;17:870-880。