Departamento de Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR.
Departamento de Diagnostico por Imagem, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2021 Jan 22;76:e2145. doi: 10.6061/clinics/2021/e2145. eCollection 2021.
Arterial embolization of myomas (AEM) is controversial because of the changes that occur in the extracellular matrix (ECM) of the endometrium and its effect on gestational success in infertile patients desiring reproductive capability. Therefore, we performed this study on the expression of genes in the ECM of the endometrium, such as those coding metalloproteinases (MMP), before and 6 months after embolization of the uterine arteries.
Seven women with leiomyomas were evaluated, and MMP3 and MMP10 levels were measured. The women underwent pelvic nuclear magnetic resonance (NMR), examination, and endometrial biopsy between the 20th and 24th day of the menstrual cycle, and pre- and post-AEM (after 6 months). For data analysis, the Cq comparative method, also known as the 2-ΔΔCT method, was used to calculate the relative quantities of MMP gene expression among the samples collected.
There was a significant decrease by 9.52 times in the expression of MMP3 (p=0.007), and a non-significant change in the expression of MMP10 (p=0.22) in post-AEM-treated women than pre-AEM-treated women.
The results suggest that ECM continues to undergo tissue remodeling 6 months after AEM, at least with regard to MMP3 expression, suggesting that AEM affects the ECM for at least 6 months after the procedure.
子宫肌瘤的动脉栓塞术(AEM)存在争议,这是因为子宫内膜细胞外基质(ECM)的变化及其对有生殖能力需求的不孕患者妊娠成功的影响。因此,我们在 AEM 治疗前后 6 个月对子宫内膜 ECM 中的基因表达进行了研究,如编码金属蛋白酶(MMP)的基因。
评估了 7 名患有子宫肌瘤的女性,测量了 MMP3 和 MMP10 的水平。这些女性在月经周期第 20-24 天进行盆腔核磁共振(NMR)检查和子宫内膜活检,并在 AEM 治疗前(治疗前)和治疗后(治疗后 6 个月)进行检查。为了进行数据分析,采用 Cq 比较法(也称为 2-ΔΔCT 法)计算 MMP 基因表达的相对数量。
与治疗前相比,治疗后 MMP3 的表达显著降低了 9.52 倍(p=0.007),而 MMP10 的表达无显著变化(p=0.22)。
这些结果表明,至少在 MMP3 表达方面,AEM 治疗后 6 个月 ECM 仍在进行组织重塑,提示 AEM 至少在治疗后 6 个月内影响 ECM。