内异方对子宫内膜异位症黏附侵袭的作用及机制

作者	单位
周巧玲	第二军医大学长海医院中医科
张丹英	第二军医大学长海医院中医科
翟东霞	第二军医大学长海医院中医科
俞超芹	第二军医大学长海医院实验中心
韩洁	第二军医大学长海医院中医科
蔡在龙	第二军医大学长海医院实验中心

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中文摘要:

目的比较子宫内膜异位症(简称内异症)在位、异位子宫内膜组织与对照子宫内膜组织间的黏附侵袭能力,评价中药内异方的干预作用。方法采用Boyden侵袭小室实验、鸡胚尿囊膜(chick chorioallantoic membrane,CAM)异位种植及免疫组织化学EnVision方法,比较对照组子宫内膜基质细胞与内异症在位、异位子宫内膜基质细胞的侵袭能力,观察各组种植组织中黏附侵袭相关细胞因子的表达及中药内异方对其影响。结果内异症在位和异位内膜组基质细胞的穿膜数明显高于对照子宫内膜组(P<0.05);内异方、丹那唑血清处理后,内异方组的穿膜细胞数较丹那唑组显著减少(P<0.05)。与对照内膜组比较,内异症异位内膜组织种植灶中细胞间黏附因子-1(ICAM-1)及内异症在位、异位内膜组种植灶中基质金属蛋白酶-9(MMP-9)的表达显著升高(P<0.05),TIMP-1的表达明显降低(P<0.01);内异症在位内膜中,内异方、丹那唑血清均能显著降低MMP-9表达,并上调TIMP-1、ICAM-1的表达(P<0.01);内异症异位内膜中,内异方可显著降低MMP-9(P<0.01)、ICAM-1(P<0.05)的表达,丹那唑可显著降低ICAM-1表达(P<0.05)。与丹那唑比较,内异方下调MMP-9表达作用更明显(P<0.05)。结论内异症在位和异位子宫内膜存在MMP-9高表达,TIMP-1低表达,促使子宫内膜细胞易在异位侵袭种植。中药内异方可抑制异位子宫内膜基质细胞的侵袭能力及MMP-9的表达。

英文摘要:

Objective To assess the inhibitory effects of Neiyi Recipe by comparing adhesive and invasive effects of eutopic and ectopic endometrial tissues from endometriosis women and the endometrium from endometriosis-free women.Methods The invasive capacity of endometrial stromal cells from endometriosis-free women,eutopic and ectopic endometrial stromal cells from women with endometriosis were compared using Boyden chamber,the chick chorioallantoic membrane (CAM) ectope transplant,and immunohistochemical EnVision method.The expressions of adhension and invasion correlated cytokines in the transplanted tissue and effect of Neiyi Recipe on them were observed.Results The numbers of invasion stromal cells of eutopic and ectopic endometrial tissues were obviously more than those in the endometriosis-free women (P<0.05).After treatment with Neiyi Recipe and danazol respectively,the number of invasion stromal cells was significantly less in the Neiyi Recipe group than in the danazol group (P<0.05).Compared with endometriosis-free women,the expression of ICAM-1 in the ectopic endometrium tissue,and MMP-9 expressions in the eutopic and ectopic endometrium were significantly higher (all P<0.05) and TIMP-1 expressions obviously lower (P<0.01).In the eutopic endometrium,Neiyi Recipe and dananzol serum could significantly lower the expression of MMP-9,and up-regulate expressions of TIMP-1 and ICAM-1 (P<0.01).In the ectopic endometrium,Neiyi Recipe could significantly lower the expression of MMP-9 (P<0.01) and ICAM-1 (P<0.05),and dananzol serum could lower the expression of ICAM-1 (P<0.05).Compared with dananzol,Neiyi Recipe showed more obvious effect in down-regulating MMP-9 (P<0.05).Conclusions High expression of MMP-9 and low expression of TIMP-1 existed in eutopic and ectopic endometrial tissues of endometriosis,which could enhance the ectopic invasion and transplant of endometrial cells.Neiyi Recipe could inhibit the invasion of endometrial stromal cells and the expression of MMP-9.

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