Gardella Barbara, Scatigno Annachiara Licia, Belli Giacomo, Gritti Andrea, Visoná Silvia Damiana, Dominoni Mattia
Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
Front Med (Lausanne). 2022 Apr 15;9:863945. doi: 10.3389/fmed.2022.863945. eCollection 2022.
Pelvic organ prolapse (POP) affects many women and contributes significantly to a decrease in their quality of life causing urinary and/or fecal incontinence, sexual dysfunction and dyspareunia. To better understand POP pathophysiology, prevention and treatment, many researchers resorted to evaluating animal models. Regarding this example and because POP affects principally older women, our aim was to provide an overview of literature on the possible biomechanical changes that occur in the vaginas of animal models and their supportive structures as a consequence of aging. Papers published online from 2000 until May 2021 were considered and particular attention was given to articles reporting the effects of aging on the microscopic structure of the vagina and pelvic ligaments in animal models. Most research has been conducted on rodents because their vagina structure is well characterized and similar to those of humans; furthermore, they are cost effective. The main findings concern protein structures of the connective tissue, known as elastin and collagen. We have noticed a significant discordance regarding the quantitative changes in elastin and collagen related to aging, especially because it is difficult to detect them in animal specimens. However, it seems to be clear that aging affects the qualitative properties of elastin and collagen leading to aberrant forms which may affect the elasticity and the resilience of tissues leading to pelvic floor disease. The analysis of histological changes of pelvic floor tissues related to aging underlines how these topics appear to be not fully understood so far and that more research is necessary.
盆腔器官脱垂（POP）影响着许多女性，严重降低了她们的生活质量，导致尿失禁和/或大便失禁、性功能障碍和性交困难。为了更好地理解POP的病理生理学、预防和治疗方法，许多研究人员借助动物模型进行评估。鉴于此例，且由于POP主要影响老年女性，我们的目的是综述文献中关于衰老导致动物模型阴道及其支持结构可能发生的生物力学变化。我们纳入了2000年至2021年5月在线发表的论文，并特别关注了报道衰老对动物模型阴道和盆腔韧带微观结构影响的文章。大多数研究是在啮齿动物身上进行的，因为它们的阴道结构特征明确且与人类相似；此外，成本效益高。主要研究结果涉及结缔组织的蛋白质结构，即弹性蛋白和胶原蛋白。我们注意到，关于弹性蛋白和胶原蛋白与衰老相关的定量变化存在显著差异，尤其是因为在动物标本中很难检测到它们。然而，衰老似乎明显影响弹性蛋白和胶原蛋白的定性特性，导致异常形式，这可能会影响组织的弹性和恢复力，进而导致盆底疾病。对盆底组织与衰老相关的组织学变化分析表明，到目前为止，这些问题似乎尚未得到充分理解，还需要更多的研究。
