Falconer C, Ekman-Ordeberg G, Ulmsten U, Westergren-Thorsson G, Barchan K, Malmström A
Karolinska Institutet, Department of Obstetrics and Gynecology, Danderyd Hospital, Sweden.
Maturitas. 1996 Jul;24(3):197-204. doi: 10.1016/s0378-5122(96)82010-x.
To study whether the transition to menopause is accompanied by changes in the paraurethral connective tissue and if these changes are modified by estrogen replacement therapy.
Biopsies were obtained from the paraurethral tissue from 34 women; 12 menstruating, 14 postmenopausal without estrogen treatment, and 8 with estrogen treatment. Collagen concentration and collagen extractability by pepsin digestion were measured. Proteoglycan composition and concentration were analysed using Alcian blue. The mRNA levels for collagen I and III, the small proteoglycans (PGS) decorin and biglycan, and the large proteoglycan versican, were estimated.
The paraurethral biopsies consisted of fibrous connective tissue, with collagen fibers as dominating structure. Several proteoglycans were identified; versican, heparansulphate proteoglycans, biglycan and decorin. The small proteoglycan decorin represented 85% of all proteoglycans. The collagen concentration was almost doubled in postmenopausal biopsies compared to premenopausal. The collagen fibril organization was also changed with higher cross-linking after menopause whereas the amount and the composition of the proteoglycans were unchanged. The proteoglycan/collagen ratio was significantly decreased. Estrogen replacement therapy resulted in decreased collagen concentration, decreased cross-linking of the collagen and reversal of the PGS/collagen ratio to almost premenopausal level. The therapy resulted in increased levels of mRNA for collagen I and III which suggests that the changes are due to an increased turnover.
The decrease in estrogen levels at menopause results in a connective tissue with different qualities after menopause. Estrogen replacement therapy tends to restore the metabolism of the genitourinary connective tissue to premenopausal conditions.
研究绝经过渡阶段尿道旁结缔组织是否发生变化，以及这些变化是否会因雌激素替代疗法而改变。
对34名女性的尿道旁组织进行活检；其中12名处于月经周期，14名绝经后未接受雌激素治疗，8名绝经后接受雌激素治疗。测量胶原蛋白浓度以及通过胃蛋白酶消化后的胶原蛋白提取率。使用阿尔辛蓝分析蛋白聚糖的组成和浓度。估算I型和III型胶原蛋白、小分子蛋白聚糖（PGS）核心蛋白聚糖和双糖链蛋白聚糖以及大分子蛋白聚糖多功能蛋白聚糖的mRNA水平。
尿道旁活检组织由纤维结缔组织组成，以胶原纤维为主要结构。鉴定出几种蛋白聚糖；多功能蛋白聚糖、硫酸乙酰肝素蛋白聚糖、双糖链蛋白聚糖和核心蛋白聚糖。小分子蛋白聚糖核心蛋白聚糖占所有蛋白聚糖的85%。与绝经前相比，绝经后活检组织中的胶原蛋白浓度几乎翻倍。绝经后胶原纤维组织也发生变化，交联增加，而蛋白聚糖的数量和组成未变。蛋白聚糖/胶原蛋白比率显著降低。雌激素替代疗法导致胶原蛋白浓度降低、胶原蛋白交联减少以及PGS/胶原蛋白比率逆转至几乎绝经前水平。该疗法导致I型和III型胶原蛋白的mRNA水平升高，这表明这些变化是由于周转率增加所致。
绝经时雌激素水平下降导致绝经后结缔组织性质不同。雌激素替代疗法倾向于将泌尿生殖结缔组织的代谢恢复到绝经前状态。
