小剂量米非司酮对分泌中期人子宫内膜HOXA11基因表达的影响

通过口服米非司酮 ( RU486)改变子宫内膜的发育进程 ,观察内膜 H OXA11基因表达量的变化 ,以及与孕酮受体 ( PR)和白血病抑制因子 ( L IF)表达的相互关系。 13例月经周期正常志愿者观察两个周期。于对照周期的分泌中期取内膜。实验周期排卵前或后一次性口服 RU48610 mg,分泌中期取内膜 ,用原位杂交和免疫组织化学方法检测H OXA11、PR及 LIF的表达。结果 :对照周期内膜腺上皮 H OXA11和 PR呈阴性或弱阳性表达。服药后 ,腺上皮 H OXA11和 PR表达强度大多增加 ,而 LIF的表达强度大多下降 ;基质细胞的表达量变化无明显规律。提示 H OXA11基因的表达与孕激素及其受体密切相关 ;分泌中期腺上皮 H OX A11和 PR表达下降或消失是内膜分化成熟的重要标志 ;也是 L IF分泌达高峰的前提。

The effect of a single low dose mifepristone on HOXA11 gene expression of the human endometrium in the mid-secretory phase

Objective: The objective of this study was to investigate the expression of HOXA11 gene, progesterone receptor (PR) and leukemia inhibitory factor (LIF) proteins in the mid secretory endometrium after the treatment of mifepristone. Methods: Thirteen healthy female volunteers with normal menstrual cycles took a single dose of 10 mg of mifepristone in pre or post ovulation phase. Endometrial biopsies in the control and treatment cycles were collected on the 7 th day after the plasma luteinizing hormone (LH) surge. In situ hybridization was used to analyze HOXA11 gene expression and the immunohistochemical staining to examine the expression of PR and LIF. Results: In the control group the expression of HOXA11 gene and PR protein in the glandular epithelial cells was negative or mildly positive. After treatment with mifepristone, the expression of HOXA11 and PR was up regulated and LIF was down regulated in the glandular epithelial cells, while no differences were observed in stromal cells. Conclusion: The results suggest that the normal down regulation of HOXA11 expression in the glandular epithelial cells of mid secretory endometrium, as with the same pattern of PR, is a sign of differentiation and development maturation of endometrium, and also prerequisite for LIF peak expression in secretory phase.