TRPV1及其致敏因子在子宫内膜异位症患者血清、在位内膜、异位内膜中的表达变化

目的 本研究旨在探讨TRPV1及其致敏因子在子宫内膜异位症患者的血清、在位内膜、异位内膜的表达变化规律,以期对子宫内膜异位症部分发病机制进行研究.方法 随机选择2013年10月至2015年10月行手术治疗的子宫内膜异位症患者70例作为研究对象,其中痛经组45例,无痛组25例.另外选择同时期手术的子宫肌瘤患者30例,作为对照组.依据视觉模拟评分法将痛经组45例患者分组,包括轻度、中度和重度痛经患者各15例.在手术前空腹取静脉血,测定下列指标血清神经生长因子(NGF)、缓激肽(BK)和前列腺素F2α(PGF2α),手术中采集在位内膜及异位内膜标本,分别采用免疫组化法和免疫印记检测法检测在位内膜组织和异位内膜组织中NGF、BKB1R、TRPV1表达水平.结果 子宫内膜异位症痛经组患者血清中NGF、BK和PGF2α的含量显著高于对照组和无痛组(P<0.05);血清中NGF表达与PGF2α以及BK表达与PGF2α表达均呈正相关(P<0.05).而痛经患者按照VAS分级从轻度、中度和重度上升,患者血清中NGF、BK和PGF2α的含量亦呈逐渐升高趋势(P<0.05),Pearson相关分析也表明血清中NGF、BK和PGF2α表达均与VAS呈正相关(P<0.05).通过免疫组化和免疫印记方法检测对在位内膜和异位内膜进行研究发现NGF、BKB1R、TRPV1主要定位于细胞浆,在位、异位内膜的腺体内均有表达.痛经组患者在位内膜NGF、BKB1R、TRPV1的表达显著高于无痛组和对照组(P<0.05);而痛经组患者异位内膜NGF、BKB1R、TRPV1的表达显著高于无痛组(P<0.05).相关性亦表明NGF与TRPVl,BKB1R与TRPV1表达呈正相关(P<0.05).结论 TRPV1及其致敏因子NGF、BKB1R、PGF2α可能在子宫内膜异位症患者痛经的发生机制中发挥重要作用.

Changes of expressions of TRPV1 and its sensitizing factor in serum,eutopic endometrium and ectopic endometrium of patients with endometriosis

Objective To investigate the change regulation of expressions of TRPV 1 and its sensitizing factor in serum, eutopic endometrium and ectopic endometrium of patients with endometriosis in order to explore the pathogenesis mechanism of endometriosis .Methods Seventy patients with endometriosis who were admitted and treated in our hospital from October 2013 to October 2015 were randomly divided into dysmenorrhea group ( n =45) and non-pain group ( n =25). Besides the other 30 patients with uterine fibroids who underwent synchronization surgery were served as control group . Moreover the 45 patients in dysmenorrhea group were redivided into 3 subgroups by means of Visual Analogue Scale ,including mild,medium,severe dysmenorrhea groups,with 15 patients in each group.The expression levels of of TRPV1 and sensitizing factors including NGF, BKB1R, PGF2αin serum, eutopic endometrium and ectopic endometrium of patients with endometriosis were detected by ELISA ,immunohistochemistry and Western Blot ,respectively .Results The expression levels of NGF,BK and PGF2αin dysmenorrhea group were significantly higher than those in control group and non -pain group ( P<0.05).The expression of NGF in serum was positively correlated to that of PGF 2α,and the expression of BK was positively correlated to that of PGF2α( P <0.05).The Pearson correlation analysis showed that expressions of NGF ,BK, PGF2αwere positively correlated with VAS ( P <0.05).The results by immunohistochemistry and Western Blot showed that the expression levels of NGF,BKB1R and TRPV1 in dysmenorrhea group were significantly higher than those in non -pain group and control group ( P <0.05).The correlation analysis showed that the expression of NGF was positively correlated to that of TRPVl , BKB1R,TRPV1( P <0.05).Conclusion TRPV1 and its sensitizing factor including NGF ,BKB1R,PGF2αmay play an important role in the pathogenesis mechanism of dysmenorrhea in patients with endometriosis .