正常与药物流产绒毛蜕膜组织细胞凋亡及相关基因的表达

目的：探讨米非司酮对早孕绒毛蜕膜细胞调亡、增殖及相关基因表达的影响。方法：对正常早孕绒毛与蜕膜、药物流产完全与不完全的绒毛、药物流产不完全蜕膜标本各10份（共50份标本）,应用原位末端标记法进行细胞凋亡的组织学检测,免疫组织化学方法测定bcl-2、bax、fas、增殖细胞核捩的（PCNA）5种蛋白在组织中的分布与含量,同时应用原位杂交法测定fas与fasL mRNA的分布与含量。结果：正常早孕绒毛中存在少量凋 细胞,主要分布于合体滋养细胞,蜕膜中凋亡细胞偶见;绒毛蜕膜中均可检测到上述5种蛋白。米非司酮药物流产的绒毛合体滋养细胞凋亡显著增,蜕膜凋亡细胞也增多,同时伴有促凋亡baz、fas、fasL蛋白及fas、fasL、mRNA含量的增加,而PCNA蛋白含量无减少。结论：米非司酮能促进早孕绒毛合体滋养细胞,蜕膜间质及腺上皮细胞的凋亡,且主要通过fas与fasL转录及翻译途径介导,bax表达增加也有一定相关性,此可能为其抗早孕机理之一。

Apoptosis and expression of relative genes in early pregnant chorionic villi and decidua

Objective To investigate the effects of mifepristone on apoptosis and expression of relative genes in early pregnant chorionic villi and decidua Methods The specimen of early pergnant chorionic villi and decidua obtained from 10 cases of requesting temination of pregnancy by curettage, 20 cases of mifepriston contragestation The paraffin sections were used to determine apoptotic cells by TdT mediated dUTP biotin nick end labeling method, to identify bcl 2, bax, fas, fasL and proliferating cell nuclear antigen (PCNA) by immunohistochemistry, to demonstrate fas and fasL mRNA by in situ hybridization Results In normal early pregnant specimens, apoptotic cells were mainly observed in syncytiotrophoblast, but not in cytotrophoblast cells, occationally seen in decidua cells The antigen of bax, fas, fasL were present in syncytiotrophoblast cells and decidua with lower amount While bcl 2 antigen staining was strong in cytotrophoblastic cells and in decidua PCNA protein was present in cytotrophoblastic and decidual cells only In the specimens treated with mifepristone, apoptotic cells were increased in syncytiotrophoblastic cells of villi and visualized in decidua cells The expression of fas, fasL and bax was also higher than that of nomal Conclusions Mifepristone increased apoptosis in syncytiotrophoblastic and decidua cells, but had no effect on the expression of bcl 2 and PCNA