米非司酮对人甲孕绒毛细胞增殖和凋亡的影响

探讨米非司酮对人早孕绒毛滋养细胞增殖和凋亡的影响。方法 对１５例正常早吸宫流产和１５例米非司酮流病例的绒毛组织，应用免疫组织化学，ＡＢＣ法检测增殖细胞核抗原在细胞中的染色情况，ＤＮＡ缺口原位末端标记法检测细胞凋亡。结果正常早孕绒毛细胞滋养细胞增殖指数为５３．７４％±１．３４％，且见细胞浆阳性染色，合体滋细胞未见ＰＣＮＡ阳性染色；     

米非司酮对早孕绒毛及蜕膜细胞周期动力学的影响

目的 探讨米非司酮对早孕绒毛及蜕膜细胞周期动力学的影响,方法 应用流式细胞技术对２３例正常早孕和２４例口服米非司酮后吸宫流产物的绒毛及蜕膜组织,进行细胞周期动力学分析。结果 服用米非司酮后,绒毛滋养细胞Ｇ０,Ｇ１期细胞明显增加（Ｐ〈０．０１）,Ｇ２,Ｍ期明显降低（Ｐ〈０．０１）,细胞增殖指数明显降低（Ｐ〈０．０１）,蜕膜细胞除Ｇ２,Ｍ期细胞上升（Ｐ〈０．０５）外,其余各期无变化,结论米非司酮可阻断     

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。     

米非司酮药物流产后绒毛蜕膜细胞凋亡的相关研究

目的:探讨米非司酮对早孕绒毛蜕膜细胞凋亡、增殖的作用机制。方法:以20例药物流产患者为研究组,以20例非意愿妊娠要求行人工流产负压吸引刮宫术的患者为对照组,分别收集绒毛和蜕膜标本,应用原位末端标记法(TUNEL)检测细胞凋亡,并采用免疫组织化学方法检测bcl-2、bax、fas、fasL、增殖细胞核抗原(PCNA)5种蛋白在绒毛和蜕膜中的分布与表达强度,同时应用原位杂交法测定fas与fasLmRNA的分布与表达强度。结果:凋亡细胞在正常早孕绒毛合体滋养细胞中少量存在,蜕膜中偶见;绒毛、蜕膜中bcl-2、bax、fas、fasL、PCNA均有表达。采用米非司酮药物流产的绒毛合体滋养细胞及蜕膜间质及腺上皮细胞的凋亡显著增多,同时伴有促凋亡bax、fas、fasL蛋白及fasLmRNA含量的增加,而PCNA蛋白含量与C组比没有变化。结论:米非司酮不仅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,而且主要通过Fas与FasL转录及翻译途径介导,bax表达增加也其也有一定的相关性,此可能为其抗早孕机制之一。     

三苯氧胺联合米非司酮药物流产对早孕绒毛细胞凋亡及调控基因的影响

目的:探讨三苯氧胺联合米非司酮对早孕绒毛细胞凋亡及凋亡调控基因bcl-2和bax表达的影响。方法:将妊娠49d内的早孕妇女50例随机分成两组,试验组和对照组分别给予三苯氧胺120mg或安慰剂联合米非司酮150mg配伍米索前列醇600μg的药物流产方案,收集两组服用米索前列醇后6h内自然排出的绒毛组织,应用脱氧核糖核酸转移酶介导的缺口末端标记法(TUNEL)检测绒毛组织的细胞凋亡指数,免疫组化方法检测绒毛组织中bcl-2、bax的表达,并用Imageproplus4.10版本的专业图像分析软件测定bcl-2、bax蛋白表达积分光密度值。结果:①绒毛细胞凋亡主要发生于细胞滋养细胞和合体滋养细胞,且试验组指数明显高于对照组(14.40%±7.05%vs9.06%±5.04%,P<0.01;9.89%±3.95%vs5.85%±2.15%,P<0.01)。②Bcl-2蛋白表达于合体滋养细胞浆中,试验组其表达积分光密度值低于对照组(328.24±194.20vs682.41±237.41,P<0.01);Bax蛋白主要表达于细胞滋养细胞和合体滋养细胞胞浆中,且试验组的表达积分光密度值均高于对照组(1036.18±369.47vs658.78±200.76,P<0.01;1554.28±554.20vs988.18±301.14,P<0.01)。结论:三苯氧胺配伍米非司酮较单独使用米非司酮促进绒毛滋养细胞凋亡更强,这一作用与bcl-2蛋白表达下降、bax蛋白表达上升有关。     

米非司酮对人胎盘绒毛滋养层细胞周期动力学的影响

对正常早孕吸宫流产和顿服米非司酮１５０ｍｇ４８小时后的吸宫流产物的绒毛组织各２６例进行细胞周期动力学的分析。方法采用流式细胞分析技术进行分析。结果服用米非司酮后，其胎盘绒毛滋养层细胞的ＤＮＡ倍体水平无变化，而Ｇ０、Ｇ１期细胞明显增加、Ｇ２、Ｍ期明显降低。     

监测反复自然流产者血清HCMV IgM抗体及其绒毛组织DN…

采用酶联免疫吸附测定法对８５例反复自然流产妇女及１０７例无流产史早孕妇女的血清进行ＨＣＭＶ ＩｇＭ、ＨＣＭＶ ＩｇＧ检测，应用ＰＣＲ技术检测部分绒毛组织ＤＮＡ，直接法制备绒毛细胞染色体，结果显示：ＲＳＡ组ＨＣＭＶ ＩｇＭ阳性率（５８．８２％），明显高于对照组（１５．８９％），（Ｐ〈０．０１）。说明孕妇原发性ＨＣＭＶ感染与ＲＳＡ有相关性；ＨＣＭＶ ＩｇＭ阳性与流产次数有密切关系。ＨＣＭＶ可以通过胎盘     

监测反复自然流产者血清HCMVIgM抗体及其绒毛组织DNA的研究

采用酶联免疫吸附测定法（ＥＬＩＳＡ）对８５例反复自然流产（ＲＳＡ）妇女及１０７例无流产史早孕妇女的血清进行ＨＣＭＶＩｇＭ、ＨＣＭＶＩｇＧ检测，应用ＰＣＲ技术检测部分绒毛组织ＤＮＡ，直接法制备绒毛细胞染色体。结果显示：ＲＳＡ组ＨＣＭＶＩｇＭ阳性率（５８．８２％），明显高于对照组（１５．８９％）（Ｐ＜０．０１）。说明孕妇原发性ＨＣＭＶ感染与ＲＳＡ有相关性；ＨＣＭＶＩｇＭ阳性与流产次数有密切关系；ＨＣＭＶ可以通过胎盘屏障感染胎儿，导致流产     

孕早期绒毛染色体分析

目的 探讨先兆流产,习惯性流产的病因。方法 采用绒毛直接制备染色体的细胞遗传学方法,对５８例高危孕妇的孕早期流产绒毛进行了染色体分析。结果 有高际妇流产绒毛染色体异常发生率为１５．５２％,正常对照组染色体异常发生率为５．２６％,两组差异显著。结论对高危孕妇进行孕早期绒毛染色体分析是十分必要的。     

正常妊娠中细胞增殖细胞凋亡情况的研究

目的　研究细胞增殖和细胞凋亡在正常妊娠不同孕期胎盘绒毛、蜕膜生长发育中的作用。方法　对 40例正常早孕吸宫流产病例和 40例正常晚孕分娩病例的胎盘绒毛和蜕膜进行分析 :免疫组织化学链霉菌抗生物素蛋白 -过氧化物酶法 (S -P法 )检测细胞增殖 ;用DNA缺口原位末端标记技术 (TUNEL法 )检测细胞凋亡。结果　正常早孕绒毛细胞滋养细胞、合体滋养细胞、蜕膜中的增殖指数 (PI)分别为 (70 74± 1 34 ) %、0、(89 32± 1 75 ) % ,凋亡指数 (AI)分别为 (10 2 7± 0 35 ) %、(15 2 8± 2 43) %、(5 2 3± 1 35 ) %。正常晚孕胎盘细胞滋养细胞、合体滋养细胞和蜕膜中增殖指数 (PI)分别为 (2 10± 1 2 8) %、0、(2 0 4± 1 31) % ;凋亡指数 (AI)分别是 (1 0 6± 0 94) %、(41 79±1 48) %、(6 0 81± 1 41) %。即 :正常早、晚孕绒毛和蜕膜组织中都有一定量的细胞增殖和细胞凋亡发生 ,但早孕时以细胞增殖为主 (P <0 0 1) ,晚孕时以细胞凋亡为主 (P <0 0 1)。结论　细胞增殖和细胞凋亡都是细胞生长代谢的形式 ,随着妊娠进展 ,胎盘细胞增殖下降、细胞凋亡增加。提示 :细胞增殖和凋亡对胎盘绒毛的正常发育和老化起重要作用     

Characteristic differences in immunohistochemical localization of new placental proteins (PP1, PP19, PP21) in the human placenta

The immunohistochemical localization in the human placenta of new placental proteins PP1, PP19, and PP21 was clarified using modified indirect enzyme-labeled antibody method and compared with that of pregnancy-specific beta 1-glycoprotein (SP1). The major results are as follows: positive staining for PP1 was seen at the nucleus and cytoplasm of villous cytotrophoblasts, the X cells at the basal plate, and of chorionic trophoblasts, while the decidua cells and amnion were not stained. PP19 was characteristically seen in the nucleus and cytoplasm of syncytiotrophoblasts. X cells in basal plate, chorionic trophoblasts, and maternal leukocytes. The villous cytotrophoblasts, decidua cells, and amnion were not stained. PP21 localization was found at the microvilli and basal membrane of syncytiotrophoblasts and at the cytotrophoblast plasma membrane of the chorionic villus in early gestation. In late gestation, increased staining was seen at the syncytiotrophoblast microvilli and the villous basement membrane, and moderate staining at plasma membrane of the amniotic epithelium and chorionic trophoblasts. SP1 was found only at the syncytiotrophoblast cytoplasm of chorionic villi. Studies using these four placental proteins simultaneously may therefore provide a new key learning about unknown metabolic functions of trophoblasts.     

补肾益气方激活哺乳动物雷帕霉素靶分子(mTOR)通路影响人早孕细胞滋养层细胞生长

目的:研究补肾益气方对人早孕细胞滋养层细胞增殖和早期凋亡的影响及其可能的信号转导通路。方法:体外分离培养人早孕细胞滋养层细胞,并添加不同浓度的喂服3d补肾益气方中药的大鼠血清,培养48h,采用噻唑蓝(MTT)比色法测定细胞的增殖活力,流式细胞术检测增殖细胞核抗原(PCNA)表达、Annexin Ⅴ FITC/PI双染色法检测细胞早期凋亡。结果:与体积分数20%对照血清组(B2组)比较,体积分数10%(A1组)及20%(A2组)补肾益气方含药血清作用48h,上调细胞滋养层细胞增殖活力、促进PCNA表达、降低凋亡细胞百分率(P<0.05),上述指标均呈剂量-效应关系。哺乳动物雷帕霉素靶分子(mTOR)通路的特异性抑制剂雷帕霉素抑制20%含药血清诱导的细胞增殖活力及PCNA蛋白表达,增加凋亡细胞百分率。结论:补肾益气方对人早孕细胞滋养层细胞的生长具有促进作用,mTOR信号通路可能是中药促进细胞滋养层细胞增殖、减少细胞凋亡的主要信号转导通路之一。     

DNA ploidy and proliferative characteristics of human trophoblasts.

By using DNA cytofluorometry, DNA ploidy and the distribution pattern of human trophoblasts at different sites were studied throughout pregnancy, and the proliferative activity during cell differentiation of trophoblasts was discussed. In the first and second trimesters, cytofluorometric nuclear DNA analysis demonstrated that cytotrophoblasts in the tip of the anchoring villi (proximal portion of the cell column) consisted of proliferating diploid and tetraploid populations. Cytotrophoblasts in the distal portion of the cell columns consisted of non-proliferating diploid and tetraploid trophoblasts, as also did intermediate trophoblasts invading the maternal tissue. Villous trophoblasts consisted of proliferating diploid populations. In term placenta, villous trophoblasts were proliferating, diploid, whereas X-cells in the decidual tissue consisted of non-proliferating diploid and tetraploid populations. It was concluded that (1) trophoblasts in the generative zone consist of proliferating diploid and tetraploid populations, (2) intermediate trophoblasts having 4c DNA content were not proliferative, and (3) cytrotrophoblasts in the chorionic villi still had proliferative activity even in the term placenta.     

Identification of arginase in human placental villi

l-Arginine is the common substrate for arginase and nitric oxide synthase (NOS). Arginase converts l-arginine to urea and ornithine, which is the principal precursor for production of polyamines required for cell proliferation. Human placenta expresses endothelial NOS (eNOS) in syncytiotrophoblasts, but the expression of arginase has not been fully elucidated. Our aim was to investigate the expression and distribution patterns of arginase-I (A-I) and arginase-II (A-II) in human placental villi in the first trimester and at term using immunohistochemistry, RT-PCR and Western blot analysis. The arginase enzyme activity in placental villi was also measured. Immunohistochemistry showed different distribution patterns of the arginase isoforms during gestation: A-I was observed only in cytotrophoblasts, while A-II was observed in both cytotrophoblasts and syncytiotrophoblasts. RT-PCR and Western blot analysis showed expression of A-I and A-II in the first trimester and at term in human placental villi. Expression of A-II and arginase activity was greater in the first trimester than at term. Differentiation of cytotrophoblasts into syncytiotrophoblasts may be associated with l-arginine metabolism through modulation of l-arginine availability for eNOS and A-I. And elevated arginase activity in the early gestational period may be responsible for proliferation of trophoblasts by increasing polyamines production. These results suggest that the l-arginine-ornithine-polyamine and l-arginine-nitric oxide pathways play a role in placental growth and development.     

细胞凋亡和PCNA在早孕绒毛滋养细胞及蜕膜中的表达与自然流产的关系

目的 :研究细胞凋亡与细胞增殖在早孕绒毛滋养细胞和蜕膜中的表达及与自然流产的关系。方法 :对孕 3月内 2 0例正常妊娠、2 0例第 1次自然流产 (SA)和 15例反复自然流产 (RSA)的绒毛和蜕膜组织应用TdT介导的dUTP缺口原位末端标记技术(TUNEL)检测细胞凋亡 ,应用免疫组织化学SP法检测增殖细胞核抗原 (PCNA)。结果 :正常早孕绒毛细胞滋养细胞、合体滋养细胞和蜕膜中的凋亡指数分别为 7.2 1± 1.2 4、8.89±2 .5 2和 7.70± 0 .82 ;SA组为 15 .4 0± 6 .5 9、2 5 .83± 6 .83和 32 .0 3± 3.2 7;RSA组为 18.77±8.2 2、34.0 2± 13.4 9和 34.96± 5 .4 6。增殖指数在正常早孕绒毛细胞滋养细胞、合体滋养细胞和蜕膜中为 6 4 .13± 5 .90、0和 6 2 .0 8± 4 .76 ;SA组为 6 7.0 2± 6 .79、36 .13± 3.5 6和 6 4 .94± 4 .6 0 ;RSA组为 6 8.6 7± 8.4 5、33.6 7± 4 .0 8和 6 3.99± 5 .5 4。即孕 3月内正常妊娠的绒毛和蜕膜组织中均有一定量的细胞凋亡与细胞增殖存在。SA与正常早孕相比绒毛和蜕膜中的细胞凋亡均明显增加 (P <0 .0 1) ,RSA合体滋养细胞凋亡也较SA明显增加 (P <0 .0 5 ) ;细胞滋养细胞和蜕膜中的细胞增殖在自然流产与正常妊娠间无明显差异 (P >0 .0 5 )。结论 :细胞凋亡和增殖的平衡与妊娠维持?     

The In-Vitro Characterization of Induced Apoptosis in Placental Cytotrophoblasts and Syncytiotrophoblasts

Placental trophoblasts undergo apoptosis as part of normal epithelial turnover and placental ageing. Classically, the induction of apoptosis in in vitro preparations has utilized the cytokines TNFalpha and IFNgamma and has been measured using the TUNEL technique. The aim of this study was to compare apoptotic susceptibility of mononucleated and differentiated trophoblasts using a range of cytotoxic agents. To achieve this, an in vitro model of syncytialization was used, along with isolated placental cytotrophoblasts and an extravillous cytotrophoblast derived cell line (SGHPL-4). Cytotrophoblasts from term placentae (n=12), syncytiotrophoblasts (n=12) and SGHPL-4s (n=8) were cultured under reduced oxygen or with TNFalpha/IFNgamma, dexamethasone or staurosporine. Apoptosis assessments were made using TUNEL, Annexin V binding, fluorescence microscopy and ATP/ADP measurements.Each cytotoxic agent increased apoptosis in all three cell populations. For untreated cells, cytotrophoblasts showed the greatest levels of apoptosis in culture. With stimulation, these levels were significantly elevated using dexamethasone, TNFalpha/IFNgamma and staurosporine and further raised under hypoxic conditions. SGHPL-4 cells showed similar trends to those of cytotrophoblasts, however the syncytiotrophoblasts, although responsive to dexamethasone and TNFalpha/IFNgamma, showed lower levels of apoptosis with staurosporine and hypoxia. ADP : ATP measurements gave similar results to the other techniques and ratios of less than 1.0 were correlated with Annexin V measurements on the flow cytometer (P< 0.001). The typical morphological features of apoptosis i.e. chromatin margination, membrane blebbing and apoptotic body formation were detected in cytotrophoblasts and SGHPL-4 cells. However, only chromatin condensation could be recognized in syncytiotrophoblast preparations. Necrotic cell numbers were also increased under all cytotoxic conditions. Although elevated with dexamethasone, staurosporine and hypoxia, these levels were markedly raised in cytotrophoblasts and SGHPL-4 cells following incubations with TNFalpha/IFNgamma.These observations show variations in apoptosis between mononuclear trophoblasts and differentiated multinucleated syncytiotrophoblasts. Differential effects of stimuli may suggest disparate apoptotic pathways. These variations may reflect functional differences between placental cellular and syncytial components and may highlight the importance of exogenous stimulation in various stages of placental development.     

米非司酮对离体子宫肌瘤细胞PR、PCNA、Bcl-2表达的影响

目的　探讨米非司酮治疗子宫肌瘤的可能机制。并证实孕激素在子宫肌瘤发病中的作用及子宫肌瘤与细胞调亡的关系。方法　体外原代培养子宫肌瘤细胞并传代后 ,加入不同浓度的米非司酮 ,继续培养 ,观察细胞增殖情况 ,并以免疫细胞化学方法检测孕激素受体 (PR)、增殖细胞核抗原 (PCNA)及凋亡抑制基因(Bcl- 2 )蛋白的表达。结果　成功的进行了子宫肌瘤细胞的原代培养 ,加入 1 0 - 4mol L米非司酮后 ,细胞增殖活动减少 ,PR、PCNA、Bcl- 2在子宫肌瘤细胞中的表达均明显下降 (P <0 0 5 ,P <0 0 5 ,P <0 0 1 )。结论　米非司酮治疗子宫肌瘤的机制可能是 :①米非司酮可直接抑制肌瘤细胞生长。②米非司酮通过抗孕激素作用抑制肌瘤细胞生长。③米非司酮可促进子宫肌瘤细胞调亡。反证了孕激素是子宫肌瘤的生长因素之一 ,亦说明子宫肌瘤与细胞调亡有关     

Apoptotic and proliferative activities in first trimester placentae

Apoptosis and cell proliferation are widely recognized to be important physiological processes which together maintain tissue homeostasis. The apoptotic and proliferative processes in 38 first trimester placentae were quantified using terminal deoxynucleotidyl transferase mediated dUTP nick end-labelling (TUNEL) and an antibody against Ki-67 antigen, respectively. In 14 cases, the estimation of apoptotic index was repeated with sections stained with haematoxylin and eosin by identifying the morphological features of apoptosis. We found that the indices obtained by either method correlated well with each other although a lower rate was obtained with the haematoxylin and eosin stained sections. Apoptosis was found in clusters mainly in syncytiotrophoblasts in association with fibrinoid deposits while proliferating activity was limited to cytotrophoblasts and stromal cells. A significant inverse correlation was observed between the proliferative index and gestational age as well as the apoptotic index. While the extent of apoptosis decreased with advanced gestational age, the correlation was not statistically significant. These findings provide a potential explanation for villous remodelling during trophoblastic invasion in early pregnancy.