基质金属蛋白酶MMP-7及其抑制因子TIMP-1在子宫内膜异位症中的表达及意义

目的 观察基质金属蛋白酶-7(matrix metalloproteinase-7,MMP-7)和基质金属蛋白酶抑制因子-1(tissue inhibitors of matrix metalloproteinase-1,TIMP-1)在子宫内膜异位症(Endmetriosis,EMs)中的表达,探讨二者在EMs发病机制中的作用.方法 采用免疫组化链霉菌抗生物素蛋白-过氧化物酶连接(SP)法检测35例EMs患者的在位内膜,异位内膜及20例时照组为因肌壁间或浆膜下子宫肌瘤在我科行子宫切除术,且月经周期正常的子宫内膜中MMP-7和TIMP-1表达情况,检测结果采用SPSS软件进行统计学分析.结果 MMP-7在EMs在位内膜中的阳性表达率为57.1%,异位内膜中的阳性表达率45.7%,与对照组子宫内膜组织的表达(阳性率为40.0%)相比无显著性差异(P＞0.05).研究组异位内膜中的表达强度明显高于对照组,两者比较,差异有统计学意义(P＜0.05).TIMP-1在两组所有标本中均有阳性表达.TIMP-1在研究组异位内膜中的表达强度低于在位内膜,两者比较,差异有统计学意义(P＜0.05).研究组在位内膜中的表达强度稍低于对照组,两组比较,差异无统计学意义(P＞0.05).结论 MMP-7在EMs的发生过程中起了重要作用.MMP-7在位内膜中表达增强,异位内膜TIMP-1表达减弱,是EMs患者在位内膜、异位内膜细胞具有侵袭能力的原因之一.     

基质金属蛋白酶2及其抑制因子2在子宫腺肌病中的表达及意义

目的 探讨基质金属蛋白酶2(MMP-2)及其抑制因子2(TIMP-2)在子宫腺肌病(AM)在位内膜与异位内膜的表达及意义.方法 选取广州医学院附属广州市第一人民医院2006年2月至2007年9月因AM行全子宫切除术的42例病例(取其在位及异位内膜分为AM在位内膜组和AM异位内膜组)和同期因子宫肌瘤在该院行全子宫切除术的32例病例(取其内膜作为正常子宫内膜组),应用半定量反转录聚合酶链反应(RT-PCR)检测AM在位内膜、异位内膜及正常子宫内膜中MMP-2、TIMP-2mRNA的表达.结果 (1)MMP-2 mRNA在AM异位内膜组中相对表达量(1.43±0.32)高于AM在位内膜组和正常子宫内膜组(1.22±0.35,0.97±0.37,P＜0.05).TIMP-2 mRNA在AM异位内膜组和AM在位内膜组中均低表达,其相对表达量分别低于正常子宫内膜组(0.96±0.31,1.13±0.30,1.29±0.19,P＜0.05).(2)MMP-2 mRNA、TIMP-2 mRNA在子宫腺肌病在位内膜组、正常子宫内膜组的表达有周期性,分泌期均高于增生期(P＜0.05);而在AM异位内膜组中,两者分泌期与增生期则差异无统计学意义.(3)MMP-2/TIMP-2的比值在AM异位内膜组、AM在位内膜组、正常子宫内膜组中依次递减,其中AM异位内膜组与后两组差异有统计学意义(均P＜0.05).结论 AM异位和在位内膜组织中MMP-2高表达,TIMP-2低表达,使MMP-2/TIMP-2平衡失调,异位内膜组织侵袭降解细胞外基质的能力增强.     

MMP-2在子宫内膜异位症中的表达及临床意义

目的:研究基质金属蛋白酶2(MMP-2)在子宫内膜异位症(EMs)中的表达.方法:检测EMs患者异位内膜36例、在位内膜36例及正常内膜中的MMP-2的表达情况,以平均光度作为MMP-2的表达强度.结果:(1)异位内膜组、在位内膜组、正常内膜组MMP-2平均吸光值分别为0.1847±0.0109、0.1529±0.0112、0.1509±0.0112.异位内膜组的MMP-2平均吸光值显著高于其余两组(P<0.05);在异位内膜组中,MMP-2蛋白在增生期平均吸光值显著高于分泌期(P<0.05),在正常内膜组和在位内膜组中,MMP-2蛋白在增生期平均吸光值高于分泌期,但差异无统计学意义.结论:异位内膜、特别是异位内膜增生期存在MMP-2的高表达,可能导致了细胞外基质的降解、血管生成,利于种植及生长,更易发生远处部位的种植转移;检测MMP-2的表达可用于判断子宫内膜异位症的侵袭转移和评估预后.     

MMP-2和TIMP-2基因多态性与子宫内膜异位症和子宫腺肌病发病风险的关联研究

目的 探讨基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)和金属蛋白酶组织抑制剂-2(tissue inhibitor of metalloproteinase-2,TIMP-2)基因启动子区单核苷酸多态性与子宫内膜异位症和子宫腺肌病发病风险的关系.方法 采用PCR-限制性片段长度多态方法检测298例子宫内膜异位症患者(内异症组)、180例子宫腺肌病患者(腺肌病组)和324名对照妇女(对照组)MMP-2和TIMP-2基因型频率的分布.结果 MMP-2-1306C/T多态的基因型和等位基因频率分布在子宫内膜异位症组与对照组间差异无统计学意义(P＞0.05);但在腺肌病组和对照组间MMP-2-1306C/T多态的基因型和等位基因频率分布均有明显的差异(P＜0.05);与CT+TT基因型相比,CC基因型明显增加腺肌病的发病风险,OR值为1.83(95%CI:1.13～2.96).MMP-2-735C/T多态的基因型和等位基因频率分布在3组间均未发现明显差异(P＞0.05);统计学分析显示MMP-2基因的2个多态性位点间存在着连锁不平衡(D'=0.74),但4种单倍型频率在3组之间分布差异无统计学意义(P＞0.05).TIMP-2-418G/C多态的等位基因频率分布在3组间差异无统计学意义(P＞0.05),但CC基因型频率在子宫内膜异位症组患者中为0.7%,与对照组(3.7%)比较,差异有统计学意义(P＜0.05).结论 MMP-2-1306C/T多态C等位基因的存在可明显增加腺肌病的发病风险,但与子宫内膜异位症的发病风险无关;MMP-2-735C/T和77MP-2-418G/C多态与子宫内膜异位症和腺肌病的发病风险无明显关联.     

MMP-2、MMP-9及EMMPRIN在子宫内膜异位症中的表达及临床意义

目的研究基质金属蛋白酶2（MMP-2）、基质金属蛋白酶9（MMP-9）、细胞外基质金属蛋白酶诱导因子（EMMPRIN）在子宫内膜异位症（EMs）的表达和意义。方法应用免疫组化二步法检测EMs患者异位内膜42例、在位内膜42例及正常内膜20例中的MMP-2、MMP-9、EMMPRIN的表达情况,并对它们的EMMPRIN、MMP-2、MMP-9蛋白表达水平进行相关性分析。结果 MMP-2、MMP-9、EMMPRIN在异位内膜组中阳性表达率分别为95.24%、92.86%和90.48%,显著高于在位内膜组、正常内膜组（P〈0.05）;而在位内膜组和正常内膜组差异无统计学意义（P〉0.05）。异位内膜组中,EMMPRIN分别和MMP-2,MMP-9呈正相关性（P〈0.01）。结论 MMP-2、MMP-9、EMMPRIN共同参与了子宫内膜异位症的发生发展;EMMPRIN可能通过促进MMP-2和MMP-9的合成与分泌发挥其作用。     

启动子区DNA去甲基化增强子宫内膜异位症患者子宫内膜基质细胞MMP-9的表达

目的研究子宫内膜异位症中基质金属蛋白酶9(MMP-9)基因表达的DNA甲基化调控机制。方法采用甲基化特异性PCR检测在位与异位子宫内膜组织中MMP-9 mRNA的表达,采用免疫组织化学染色检测在位与异位子宫内膜组织中MMP-9蛋白的表达。原代培养子宫内膜异位基质细胞,细胞经5-杂氮-2'-脱氧胞苷(5-Aza-dC)处理后,分析MMP-9基因的表达及其启动子甲基化状态。结果异位子宫内膜组织中MMP-9 mRNA和蛋白的表达高于在位子宫内膜组织。异位子宫内膜组织中MMP-9基因启动子区DNA甲基化水平低于在位子宫内膜组织。5-Aza-dC处理异位子宫内膜细胞后,MMP-9的表达水平升高,MMP-9基因启动子区出现明显的去甲基化。结论 MMP-9基因启动子区DNA去甲基化增强子宫内膜异位症患者异位内膜基质细胞中MMP-9的表达。     

子宫腺肌症与肿瘤转移相关基因之间关系的研究

目的：探讨肿瘤转移相关基因在子宫腺肌症发生中的作用。 方法： 采用免疫组织化学方法，对43例子宫腺肌症患者、22例对照组（正常子宫内膜）的nm23-H1、基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶-9（MMP-9）、膜型1-基质金属蛋白酶（MT1-MMP）和基质金属蛋白酶组织抑制因子-1（TIMP-1）的表达进行研究。 结果： 子宫腺肌症中，MMP-2、MMP-9和MT1-MMP的表达水平明显高于对照组（P<0.01），nm23-H1和TIMP-1的表达水平无显著差异（P>0.05）。 结论： MMP-2、MMP-9和MT1-MMP在子宫腺肌症的发病过程中可能起重要的作用。     

红藤方对内异位症小鼠MMP-2表达的影响

目的 探讨红藤方对小鼠子宫内膜异位症(endometriosis,EMs)的治疗作用及其机制.方法 采用手术移植法造成小鼠子宫内膜异位模型,随机分为模型组和实验组,实验组口服绐药红藤方,21 d后,分别取出子宫异位内膜组织,通过异位内膜组织苏木精-伊红(HE)染色方法,观察组织形态学变化及采用免疫组织化学方法检测基质金属蛋白酶2(matrix metalloproteinases,MMPs)的表达.结果 光镜下观察发现用药后异位组织周围血管丰富,异位内膜减少,异位腺上皮变矮,腺细胞核固缩.用药组异位组织生长状况没有模型组好,基本无明显的腺体;MMP-2表达减少.结论 红藤方能抑制异位内膜增生,促进炎症包块消退,对子宫内膜异位症具有一定的治疗作用,其治疗机制可能与抑制MMP-2的表达有关系.     

子宫内膜异位症患者MMP-2、MMP-9及其组织抑制因子的表达

目的探讨血清和腹腔液中基质金属蛋白酶MMP-2、MMP-9及其组织抑制因子TIMP-1、TIMP-2水平与子宫内膜异位症(EMs)发病的关系。方法收集2014年1月~2015年12月确诊的83例EMs患者和35例对照组血清和腹腔液,用酶联免疫吸附法(ELISA)检测MMP-2、MMP-9、TIMP-1和TIMP-2的浓度。结果 EMs组血清和腹水中MMP-2和MMP-9浓度显著高于对照组,TIMP-1和TIMP-2显著低于对照组(P0.05);Ⅲ-Ⅳ期患者组MMP-2和MMP-9水平显著高于Ⅰ-Ⅱ期组,TIMP-1和TIMP-2水平显著低于Ⅰ-Ⅱ期组(P0.05)。结论 EMs患者MMP-2和MMP-9高表达,TIMP-1和TIMP-2低表达,MMP-2/TIMP-2和MMP-9/TIMP-1的比值增高,使异位内膜组织具有更强的侵袭力,可能在子宫内膜异位症的发生发展中起重要作用。     

组蛋白去乙酰化酶1在子宫内膜异位症中的表达及意义

目的 研究组蛋白去乙酰化酶1(HDAC1)在子宫内膜异位症患者在位及异位内膜中的表达,探讨其在子宫内膜异位症发生、发展中的作用. 方法 应用免疫组织化学和免疫印迹法检测20例子宫内膜异位症患者在位内膜和异位内膜组织(研究组)中及20例子宫肌瘤患者的子宫内膜组织(对照组)HDAC1的表达情况. 结果 HDAC1阳性着色主要分布于子宫内膜上皮细胞和间质细胞的细胞核,在位内膜中HDAC1的表达强度明显高于对照组子宫内膜(P<0.01).免疫印迹检测提示,子宫内膜异位症在位内膜和异位内膜组织中HDAC1蛋白的相对表达量分别为2.67±0.69和2.55±1.36,显著高于对照组子宫内膜1.63±0.93(P<0.01,P<0.05);而在位内膜组与异位内膜组之间无统计学差异(P＞0.05). 结论 HDAC1在子宫内膜异位症在位和异位内膜组织中的高表达,可能在子宫内膜异位症的发生、发展中起重要作用.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective: To explore the role of matrix metalloproteinase-1,2 (MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects (excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant (P ＜ 0.01). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

mRNA analysis of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis using a real-time quantitative RT-PCR assay

BACKGROUND: The plasminogen activator (PA) and matrix metalloproteinase (MMP) systems are implicated in the establishment of endometriosis. The mechanisms by which these systems are involved in the pathogenesis of this disease are not well defined and controversial results have been published. The aim of this study was to analyse mRNA and protein levels of several components of the PA and MMP systems in endometriotic tissue and endometrium from women with and without endometriosis. METHODS and RESULTS: Real-time quantitative RT-PCR assays were developed to quantify mRNA levels of these components in 57 women with endometriosis and 32 controls. Endometrium of women with endometriosis showed higher mRNA and antigenic levels of urokinase type-PA (uPA) and MMP-3 than endometrium from controls. In these patients, ovarian endometriotic tissue had higher mRNA and antigenic levels of PA inhibitor type 1 (PAI-1) and MMP inhibitor type 1 (TIMP-1) than endometrium. CONCLUSIONS: The increase in mRNA and protein levels of uPA and MMP-3 observed in endometrium of women with endometriosis may facilitate the attachment of endometrial tissue to the peritoneum and ovarian surface, as well as the invasion of the extracellular matrix. This process would lead to the formation of early endometriotic lesions. Once the ovarian endometriotic cyst is developed, PAI-1 and TIMP-1 would increase which could explain the frequent clinical finding of an endometrioma without invasion of the adjacent ovarian tissue.     

Increased expression of matrix metalloproteinase-9 in the eutopic endometrial tissue of women with endometriosis

BACKGROUND: Endometriosis is a disease where endometrial tissue implants in ectopic locations. Remodelling of the extracellular matrix (ECM) is a prerequisite for the implantation of this tissue to be possible. METHODS: In this study, we detected immunoreactive matrix metalloproteinase-9 (MMP-9) throughout endometrial tissue and identified von Willebrand factor (vWF)-positive endothelial cells, CD45-positive leukocytes, CD3-positive T lymphocytes and CD68-positive macrophages as cells expressing MMP-9 in the stroma. RESULTS: We found an increased expression of MMP-9 in the uterine endometrial tissue of women with endometriosis, as assessed by zymography and enzyme-linked immunosorbent assay (ELISA) (P < 0.05). However, RT-PCR did not show a statistically significant increase in MMP-9 mRNA expression in these tissues (P = 0.14). There was no significant difference between women with and without endometriosis in the expression of tissue inhibitor of MMPs (TIMP)-1, a known natural inhibitor of the pro- and active forms of MMP-9, whether tested by ELISA or by RT-PCR (P = 0.46 and 0.37, respectively). Interestingly, the ratio of MMP-9/TIMP-1 expression was significantly higher in women with endometriosis than in normal women both at the protein and the mRNA levels (P < 0.05). CONCLUSION: These findings make plausible the involvement of MMP-9/TIMP-1 imbalance in the invasiveness of the endometrial tissue of patients with endometriosis and the ectopic development of the disease.     

Eutopic endometrium and peritoneal,ovarian and bowel endometriotic tissues express a different profile of matrix metalloproteinases-2, -3 and -11, and of tissue inhibitor metalloproteinases-1 and -2

Endometriosis is subsequent to the ability of endometrial glands to invade normal tissues. Matrix metalloproteinases (MMPs)—enzymes that mediate normal tissue turnover, including endometrial breakdown during menstruation—appear to be involved in this invasive process. Here, we examined the immunohistochemical expression of MMP-2, MMP-3, MMP-11, tissue inhibitor metalloproteinase (TIMP)-1 and TIMP-2 in endometrium from women with (n=9) or without endometriosis (n=18) in comparison with peritoneal (n=20), ovarian (n=20) and colorectal endometriosis (n=20). Women with endometriosis showed decreased endometrial MMP-2 expression compared with women without endometriosis (mean±SD positive cells: 24.3±28.3% and 69.3±12.1%), together with loss of MMP-3 expression (0 versus 17.5%±20.2). MMP-11, TIMP-1 and TIMP-2 expression was similar in the two groups. Endometrial MMP-2, -3 and -11 expression and TIMP-1 and -2 expression were similar in women with endometriosis and in those with peritoneal endometriosis. MMP-2, -3 and -11 expression was higher in colorectal endometriosis than in ovarian and peritoneal endometriosis. TIMP-2 expression was lower in colorectal endometriosis (P=0.0002) and ovarian endometriotic cysts (P=0.003) than in peritoneal endometriosis. TIMP-1 expression did not vary according to the location of endometriotic lesions. These results suggest that MMP-2 and -3 and TIMP-2 may be involved in the pathogenesis of endometriosis. Interestingly, MMP-2 and -3 overexpression was related to the infiltrative nature of endometriotic lesions, with possible sequential expression from peritoneal to colorectal endometriosis.     

Expression of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis

BACKGROUND: Endometriosis is considered a benign disease that has the ability to invade normal tissue. As in neoplastic growth, local extracellular proteolysis may take place. The aim of this study is to analyse several components of the plasminogen activator (PA) pathway and the matrix metalloproteinase (MMP) system in endometriotic tissue, endometrium and peritoneal fluid from women with and without endometriosis (controls). METHODS AND RESULTS: Thirty-nine women with endometriosis and 35 controls were studied. In eutopic endometrium of women with endometriosis, the antigenic levels of urokinase-type PA (uPA) and MMP-3 were elevated when compared with endometrium from controls. Ovarian endometriotic tissues had higher antigenic levels of PA inhibitor type 1 (PAI-1) and tissue inhibitor of metalloproteinases type 1 (TIMP-1) than endometrium. The peritoneal fluid from women with endometriosis showed a significant increase in uPA levels compared with controls. CONCLUSIONS: The increase in antigenic levels of uPA and MMP-3 in endometrium of women with endometriosis might contribute to the invasive potential of endometrial cells. Once the ovarian endometriotic cyst is developed, an increase in PAI-1 and TIMP-1 is detected and significant proteolytic activity is no longer observed. This increase in inhibitors and decrease in proteolytic activity could explain the frequent clinical finding of isolated endometriotic cyst without invasion of the surrounding ovarian tissue.     

Survivin, MMP-2, MT1-MMP, and TIMP-2: their impact on survival, implantation, and proliferation of endometriotic tissues

In order to study survivin, matrix metalloproteinases (MMP-2), membranous type 1 matrix metalloproteinase (MT1-MMP), and tissue inhibitor metalloproteinase-2 (TIMP-2) expression immunohistochemically in endometriotic tissues and normal endometrium, our retrospective study considered 194 patients affected by endometriosis and 71 patients with normal endometrium. Tissue microarrays were created from paraffin-embedded blocks; immunohistochemistry was used to assess protein expression. In endometriotic tissues, survivin was expressed at a higher level than in normal endometrium; its glandular expression level was higher in non-ovarian than in ovarian endometriotic tissues and lower in stromal components. Endometrial tissues from women without endometriosis and endometriotic tissues had different matrix metalloproteinase expression profiles. MMP-2 and MT1-MMP correlated with TIMP-2 in endometriotic tissues. Furthermore, in endometriotic tissues, expression of survivin, aurora B kinase, and Ki-67 showed a significant positive correlation, which indicates a role in cellular proliferation that could be closely linked to its anti-apoptotic activity in endometriosis development. Our results imply a role for matrix metalloproteinases in endometriosis invasiveness; correlation of their expression with that of TIMP-2 underscores its possible key regulatory role.     

Evidence for an increased release of proteolytic activity by the eutopic endometrial tissue in women with endometriosis and for involvement of matrix metalloproteinase-9

BACKGROUND: For the implantation of endometrium in ectopic locations, remodelling of the extracellular matrix (ECM) is necessary. Many studies have shown an increased expression of various proteases in the ectopic endometrium of women with endometriosis. Few, however, have addressed possible changes in protease expression in the eutopic endometrium. METHODS AND RESULTS: Herein, we reveal an increased release of proteolytic activity by the eutopic endometrium of women with endometriosis compared with normal women (P < 0.01). Using zymography and western blotting, we identified matrix metalloproteinase (MMP)-2 and MMP-9 in the culture medium, and further found that MMP-9 secretion, as assessed by zymography and enzyme-linked immunosorbent assay (ELISA), was elevated in women with endometriosis compared with normal women (P < 0.05). No statistically significant difference in MMP-2 secretion between women with and without endometriosis was noted. However, a significant difference in the levels of the tissue inhibitor of metalloproteinases (TIMP)-1, a known MMP-9 inhibitor, was found (P < 0.05). CONCLUSION: The endometriosis-associated increase in proteolysis and imbalance between the secretion of MMP-9 and that of its natural inhibitor, TIMP-1, revealed in the culture medium of endometrial tissue may reflect in vivo the enhanced capacity of this tissue to break down the ECM in host tissues, thereby favouring its ectopic implantation and development.     

Interleukin 1alpha and tissue-lytic matrix metalloproteinase-1 are elevated in ectopic endometrium of patients with endometriosis

BACKGROUND: Matrix metalloproteinases (MMP) play an essential role in tissue remodelling and menstruation and appear to be regulated by cytokines such as interleukin-1alpha (IL-1alpha). In order to investigate their role in the pathogenesis of endometriosis, the aim of the present study was to compare the protein localization of matrix metalloproteinase-1 (MMP-1) and of its main stimulatory cytokine IL-1alpha in eutopic and dystopic endometrium of patients with endometriosis. METHODS: MMP-1 and IL-1alpha protein localization was analysed retrospectively in paired paraffin-embedded tissue biopsies obtained simultaneously from the endometrial cavity and from endometrial lesions of 37 patients with peritoneal or ovarian endometriosis and in cycling endometria from 37 women without endometriosis. Protein localization was demonstrated by immunohistochemistry; antibody specificity was confirmed by western blot analysis. RESULTS: MMP-1 and IL-1alpha protein staining in women suffering from endometriosis was significantly more pronounced in endometriotic lesions than in eutopic endometrium. This held true for both epithelial MMP-1 and IL-1alpha staining (P < 0.006 and P < 0.001), and for stromal MMP-1 and IL-1alpha staining (P < 0.001 and P < 0.001). Furthermore, stromal MMP-1 and IL-1alpha were significantly co-expressed in dystopic endometriotic tissue (P = 0.045). Endometrial MMP-1 and IL-1alpha protein expression pattern in eutopic endometrium from women suffering from endometriosis, however, did not differ significantly from the pattern seen in healthy women. CONCLUSIONS: The increased expression of both matrix-degrading MMP-1 and its major stimulatory cytokine IL-1alpha in endometriotic lesions and the selective co-expression in the stroma of endometriotic foci clearly suggests their involvement in the pathogenic mechanisms leading to local invasion and tissue destruction.