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GnRH-a 诱导的围绝经期大鼠模型及黑升麻制剂对大鼠生殖内分泌的影响。

GnRH-a-Induced Perimenopausal Rat Modeling and Black Cohosh Preparations' Effect on Rat's Reproductive Endocrine.

机构信息

Department of Obstetrics and Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.

出版信息

Front Endocrinol (Lausanne). 2021 Dec 24;12:683552. doi: 10.3389/fendo.2021.683552. eCollection 2021.

Abstract

BACKGROUND

Endometriosis (EMS) is an estrogen-dependent disease, which easily recurs after operation. Gonadotropin-releasing hormone agonist (GnRH-a), an estrogen-inhibiting drug, can effectively inhibit the secretion of gonadotropin by pituitary gland, so as to significantly decrease the ovarian hormone level and facilitate the atrophy of ectopic endometrium, playing a positive role in preventing postoperative recurrence. The application of GnRH-a can lead to the secondary low estrogen symptoms, namely the perimenopausal symptoms, and is a main reason for patients to give up further treatment. The add-back therapy based on sex hormones can well address the perimenopausal symptoms, but long-term use of hormones may cause the recurrence of EMS, as well as liver function damage, venous embolism, breast cancer and other risks, which has long been a heated topic in the industry. Therefore, it is necessary to find effective and safe anti-additive drugs soon. Studies at home and abroad show that, as a plant extract, isopropanolic extract of cimicifuga racemosa (ICR) can well relieve the perimenopausal symptoms caused by natural menopause. Some studies have preliminarily confirmed that black cohosh preparations can antagonize perimenopausal symptoms of EMS patients treated with GnRH-a after operation.

OBJECTIVE

To establish a rat model of perimenopausal symptoms induced by GnRH-a injection, for the purposes of laying a foundation for further research and preliminarily exploring the effect of black cohosh preparations on reproductive endocrine of the rat model.

METHOD

The rat model of perimenopausal symptoms was established by GnRH-a injection, and normal saline (NS injection) was used as the control. The rats were randomly divided into four groups according to different modeling methods and drug intervention schemes. GnRH-a injection + normal saline intervention group (GnRH-a + NS), normal saline injection control + normal saline intervention group (NS + NS), GnRH-a injection + estradiol intervention group (GnRH-a + E2), and GnRH-a injection + black cohosh preparations intervention group (GnRH-a + ICR). After modelling was assessed to be successful with the vaginal smear method, the corresponding drugs were given for intervention for 28d. In the process of rat modeling and drug intervention, the skin temperature and anus temperature of the rat tails were measured every other day, the body weights of the rats were measured every other day, and the dosage was adjusted according to the body weight. After the intervention was over, the serum sex hormone level, the uterine weight, the uterine index, and the endometrial histomorphology changes, as well as the ovarian weight, the ovarian index, and the morphological changes of ovarian tissues of each group were measured.

RESULTS

(1) The vaginal cell smears of the control group (NS + NS) showed estrous cycle changes, while other model rats had no estrous cycle of vaginal cells. (2) The body weight gains of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups were significantly higher than that of the NS + NS control group. The intervention with E2 and ICR could delay the weight gain trend of rats induced by GnRH-A. (3) After GnRH-a injection, the temperature of the tail and anus of rats showed an overall upward trend, and the intervention with E2 and ICR could effectively improve such temperature change. (4) The E2, FSH, and LH levels in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups were significantly lower than those in the NS + NS group (P < 0.01). The E2 level was significantly higher and the LH level was significantly lower in the GnRH-a + E2 group than those in the GnRH-a + NS and GnRH-a + ICR groups (P < 0.05). Compared with those of the GnRH-a + NS and GnRH-a + ICR groups, the FSH level of the GnRH-a + E2 group showed a slight downward trend, but the difference was not statistically significant (P > 0.05). There was no significant difference in the levels of sex hormones between the GnRH-a + NS group and GnRH-a + ICR group (P > 0.05). (5) Compared with those of the NS + NS group, the uterine weight and uterine index of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups significantly decreased (P < 0.01). In a comparison between the groups, the uterine weight and uterine index in the GnRH-a + NS and GnRH-a + ICR groups were significantly lower than those in the GnRH-a + E2 group (P < 0.01). There was a statistical difference in the uterine weight and uterine index between the GnRH-a + NS group and GnRH-a + ICR group (P > 0.05). (6) Compared with those of the NS + NS group, the ovarian weight and ovarian index of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups significantly decreased (P < 0.01). There was no statistical difference in the ovarian weight and ovarian index among the GnRH-a + E2, GnRH-a + NS and GnRH-a + ICR groups (P > 0.05). (7) Compared with those in the NS + NS group, the number of primordial follicles increased significantly, while the number of growing follicles and mature follicles decreased significantly in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups (P < 0.01), but there was a statistical difference in the total number of follicles among the four groups (P > 0.05).

CONCLUSIONS

The GnRH-a injection could achieve the desired effect. The animal model successfully achieved a significant decrease in the E2, FSH, and LH levels in rats, and could cause the rats to have rising body surface temperature similar to hot flashes in the perimenopausal period. The intervention with E2 and ICR could effectively relieve such "perimenopausal symptoms", and ICR had no obvious effect on the serum sex hormone level in rats.

摘要

背景

子宫内膜异位症(EMS)是一种雌激素依赖性疾病,术后易复发。促性腺激素释放激素激动剂(GnRH-a)是一种抑制雌激素的药物,能有效抑制垂体分泌促性腺激素,从而显著降低卵巢激素水平,促进异位子宫内膜萎缩,对预防术后复发有积极作用。 GnRH-a 的应用会导致继发低雌激素症状,即围绝经期症状,这也是患者放弃进一步治疗的主要原因。基于性激素的添加治疗可以很好地解决围绝经期症状,但长期使用激素可能会导致 EMS 复发以及肝功能损害、静脉栓塞、乳腺癌等风险,这在业内一直是一个热门话题。因此,尽快找到有效且安全的抗添加剂药物是很有必要的。国内外研究表明,作为一种植物提取物,升麻属植物异丙醇提取物(ICR)可以很好地缓解自然绝经引起的围绝经期症状。一些研究初步证实,黑升麻制剂可以拮抗 GnRH-a 术后 EMS 患者的围绝经期症状。

目的

建立 GnRH-a 注射诱导的围绝经期大鼠模型,为进一步研究和初步探索黑升麻制剂对大鼠生殖内分泌的影响奠定基础。

方法

采用 GnRH-a 注射法建立围绝经期大鼠模型,以生理盐水(NS 注射)作为对照。根据不同的建模方法和药物干预方案,将大鼠随机分为 GnRH-a+NS 干预组(GnRH-a+NS)、NS 注射对照+NS 干预组(NS+NS)、GnRH-a+E2 干预组(GnRH-a+E2)和 GnRH-a+黑升麻制剂干预组(GnRH-a+ICR)。阴道涂片法评估建模成功后,给予相应药物干预 28d。在大鼠建模和药物干预过程中,每天测量大鼠尾部皮肤温度和肛门温度,每隔一天测量大鼠体重,根据体重调整剂量。干预结束后,测量各组大鼠血清性激素水平、子宫重量、子宫指数、子宫内膜组织形态学变化以及卵巢重量、卵巢指数和卵巢组织形态学变化。

结果

(1)对照组(NS+NS)阴道细胞涂片显示动情周期变化,而其他模型大鼠阴道细胞无动情周期。(2) GnRH-a+NS、GnRH-a+E2 和 GnRH-a+ICR 组大鼠体重增加明显高于 NS+NS 对照组。E2 和 ICR 的干预可以延缓 GnRH-A 诱导的大鼠体重增加趋势。(3) GnRH-a 注射后,大鼠尾部和肛门温度呈整体上升趋势,E2 和 ICR 的干预可有效改善这种温度变化。(4) GnRH-a+NS、GnRH-a+E2 和 GnRH-a+ICR 组大鼠的 E2、FSH 和 LH 水平明显低于 NS+NS 组(P<0.01)。GnRH-a+E2 组 E2 水平明显升高,LH 水平明显降低,与 GnRH-a+NS 和 GnRH-a+ICR 组比较差异有统计学意义(P<0.05)。与 GnRH-a+NS 和 GnRH-a+ICR 组相比,GnRH-a+E2 组 FSH 水平略有下降,但差异无统计学意义(P>0.05)。GnRH-a+NS 组和 GnRH-a+ICR 组之间的性激素水平无显著差异(P>0.05)。(5)与 NS+NS 组相比, GnRH-a+NS、GnRH-a+E2 和 GnRH-a+ICR 组大鼠子宫重量和子宫指数明显降低(P<0.01)。组间比较,GnRH-a+NS 和 GnRH-a+ICR 组大鼠子宫重量和子宫指数明显低于 GnRH-a+E2 组(P<0.01)。GnRH-a+NS 组与 GnRH-a+ICR 组大鼠子宫重量和子宫指数有统计学差异(P>0.05)。(6)与 NS+NS 组相比, GnRH-a+NS、GnRH-a+E2 和 GnRH-a+ICR 组大鼠卵巢重量和卵巢指数明显降低(P<0.01)。GnRH-a+E2、GnRH-a+NS 和 GnRH-a+ICR 组大鼠卵巢重量和卵巢指数无统计学差异(P>0.05)。(7)与 NS+NS 组相比, GnRH-a+NS、GnRH-a+E2 和 GnRH-a+ICR 组大鼠原始卵泡数量明显增加,生长卵泡和成熟卵泡数量明显减少(P<0.01),但四组总卵泡数量无统计学差异(P>0.05)。

结论

GnRH-a 注射可达到预期效果。动物模型成功地使大鼠的 E2、FSH 和 LH 水平显著降低,并能使大鼠出现类似围绝经期的体表温度升高。E2 和 ICR 的干预可有效缓解这种“围绝经期症状”,而 ICR 对大鼠血清性激素水平无明显影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f9a/8739485/b0226db52a76/fendo-12-683552-g001.jpg

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