Setiawan Alvin, Syam Hanom Husni, Permadi Wiryawan, Anwar Ruswana, Madjid Tita Husnitawati, Tjahyadi Dian, Mahayasa Putu Doster
Reproductive Endocrinology and Infertility Subdivision, Department of Obstetrics and Gynecology, Padjadjaran University Medical School, Hasan Sadikin Hospital, West Java, Indonesia.
Reproductive Endocrinology and Infertility Subdivision, Department of Obstetrics and Gynecology, Udayana University Medical School, Prof. Ngoerah Hospital, Bali, Indonesia.
Obstet Gynecol Sci. 2024 Jul;67(4):421-429. doi: 10.5468/ogs.24021. Epub 2024 Jun 11.
This study aimed to investigate the levels of chitinase-3-like protein-1 (CHI3L1), matrix metalloproteinase-9 (MMP-9), and monocyte chemoattractant protein-1 (MCP-1) in adenomyosis, as compared to normal myometrial tissue. These biomarkers may be useful for determining potential treatment targets.
This was a correlative, analytical, and observational study with a cross-sectional design. Participants with a diagnosis of moderate-to-severe adenomyosis, as determined through transvaginal ultrasonography and histological examination, and who underwent laparotomy or laparoscopic surgery for the treatment of adenomyosis, were enrolled in the study. Unlike other studies that recruited healthy women as controls, our study used adenomyotic and healthy nonadenomyotic myometria obtained from the same individual. The levels of CHI3L1, MMP-9, and MCP-1 in the biopsy samples were determined using enzyme-linked immunoassay kits, according to the manufacturer's protocol.
A highly significant increase in the levels of CHI3L1, MMP-9, and MCP-1 was found in adenomyotic tissues compared to non-adenomyotic tissues (P<0.001). A significant positive correlation was found between CHI3L1 and MMP-9 levels (r=0.463; P=0.008), CHI3L1 and MCP-1 levels (r=0.594; P<0.001), and MCP-1 and MMP-9 levels (r=0.680; P<0.001) in adenomyotic tissues.
CHI3L1 may play a role in the pathogenesis of adenomyosis via the regulation of the MCP-1 and MMP-9 pathways. Therefore, these molecules may serve as biomarkers and potential therapeutic targets for adenomyosis.
本研究旨在调查与正常子宫肌层组织相比，子宫腺肌病中几丁质酶-3样蛋白-1（CHI3L1）、基质金属蛋白酶-9（MMP-9）和单核细胞趋化蛋白-1（MCP-1）的水平。这些生物标志物可能有助于确定潜在的治疗靶点。
这是一项采用横断面设计的相关性、分析性和观察性研究。通过经阴道超声检查和组织学检查确诊为中重度子宫腺肌病且接受剖腹手术或腹腔镜手术治疗子宫腺肌病的参与者被纳入研究。与其他招募健康女性作为对照的研究不同，我们的研究使用了从同一个体获取的子宫腺肌病和健康非子宫腺肌病的子宫肌层组织。根据制造商的方案，使用酶联免疫分析试剂盒测定活检样本中CHI3L1、MMP-9和MCP-1的水平。
与非子宫腺肌病组织相比，子宫腺肌病组织中CHI3L1、MMP-9和MCP-1的水平显著升高（P<0.0０1）。在子宫腺肌病组织中，CHI3L1与MMP-9水平之间（r=0.463；P=0.008）、CHI3L1与MCP-1水平之间（r=0.594；P<0.001）以及MCP-1与MMP-9水平之间（r=0.680；P<0.001）存在显著正相关。
CHI3L1可能通过调节MCP-1和MMP-9途径在子宫腺肌病的发病机制中发挥作用。因此，这些分子可能作为子宫腺肌病的生物标志物和潜在治疗靶点。
