人子宫内膜组织中缺氧诱导因子-1α(HIF-1α)基因和蛋白的表达

目的:探讨人子宫内膜组织中缺氧诱导因子-1α(hypoxia inducible factor 1α,HIF-1α)的表达。方法:30例人子宫内膜组织石蜡标本,分为增生早期组(n=7),增生中-晚期组(n=8),分泌早期组(n=6)和分泌中-晚期组(n=9),应用免疫组织化学方法检测子宫内膜HIF-1α蛋白的表达。15例子宫内膜组织,分为增生期组(n=7)和分泌期组(n=8),采用逆转录聚合酶链反应法和Western blot-ting法检测HIF-1α基因和蛋白的表达及其变化。结果:子宫内膜上皮(包括腺上皮与腔上皮)细胞和间质细胞的胞质可见HIF-1α蛋白表达。在月经周期中,增生中-晚期组HIF-1α蛋白表达水平最高,分泌中-晚期组的表达水平最低(P<0.05);但增生早期组与增生中-晚期组的比较、分泌早期组与分泌中-晚期组比较,HIF-1α蛋白表达水平无显著性差异(P>0.05)。增生期上皮组织中HIF-1αmRNA和蛋白的表达显著高于分泌期(P<0.01;P<0.05)。结论:人子宫内膜HIF-1αmRNA和蛋白在增生期的表达较高,其表达水平升高可能与子宫内膜的修复再生有关。     

缺氧诱导因子(HIF)-lα在稽留流产患者绒毛中的表达

目的:探讨缺氧诱导因子-1α(HIF-1α)在稽留流产中的作用。方法:经B超及β-hCG动态监测证实为稽留流产患者50例,其中不明原因组30例,有原因组20例;根据胚胎停止发育后稽留宫内时间不同又分为A组、B组和C组,分别为胚胎停止发育≤2周、3-4周和≥5周。选取同时期经B超证实为活胎,因非意愿妊娠在门诊要求行人工流产的早孕妇女20例为对照组。应用免疫组织化学方法比较各组绒毛组织中HIF-1α的表达。结果:HIF-1α的表达主要位于绒毛滋养细胞胞浆和胞核;与正常早孕妇女绒毛组织相比较,稽留流产患者绒毛组织中HIF-1α表达明显降低(P<0.05);但A、B、C组间HIF-1α表达无统计学差异(P>0.05)。结论:HIF-1α在绒毛组织中的低表达可能是导致稽留流产的原因之一。     

缺氧诱导因子(HIF)-1a在稽留流产、患者绒毛中的表达

目的:探讨缺氧诱导因子-1α(HIF-1α)在稽留流产中的作用.方法:经B超及β-hCG动态监测证实为稽留流产患者50例,其中不明原因组30例,有原因组20例;根据胚胎停止发育后稽留宫内时间不同又分为A组,B组和C组,分别为胚胎停止发育≤2周、3-4周和≥5周.选取同时期经B超证实为活胎,因非意愿妊娠在门诊要求行人工流产的早孕妇女20例为对照组.应用免疫组织化学方法比较各组绒毛组织中HIF-1a的表达.结果:HIF-1a的表达主要位于绒毛滋养细胞胞浆和胞核:与正常早孕妇女绒毛组织相比较,稽留流产患者绒毛组织中HIF-1α表达明显降低(P＜0.05):但A、B、C组间HIF-1α表达无统计学差异(P＞0.05).结论:HIF-1α在绒毛组织中的低表达可能是导致稽留流产的原因之一.     

血管内皮生长因子和缺氧诱导因子-1α在妊娠高血压综合征患者胎盘组织中的表达

目的:探讨胎盘组织中血管内皮生长因子(VEGF)和缺氧诱导因子-1α(HIF-1α)表达水平与妊娠高血压综合征(PIH综合征)患者严重程度的相关性。方法:采用免疫组织化学EliVision法对35例PIH综合征患者和40例正常产妇(对照组)胎盘组织中VEGF和HIF-1α的表达水平进行检测分析。结果:VEGF和HIF-1α在胎盘滋养细胞和血管内皮细胞中均有的表达,VEGF在轻度PIH综合征患者胎盘中的表达水平与对照组相比无显著差异,VEGF在中度和重度PIH综合征患者胎盘中的表达水平则较对照组显著下降(P0.05),HIF-1α在PIH综合征组患者胎盘中的表达水平显著高于对照组(P0.05),且重度高于中度、中度高于轻度。结论:PIH综合征患者胎盘中VEGF的表达水平降低,而HIF-1α的表达水平升高,并均与病情的严重程度相关,提示其可能参与调控PIH综合征的发生和发展过程。     

稽留流产绒毛中HIF-1α、VEGF和PLGF的表达及意义

目的:检测缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及胎盘生长因子(PLGF)在稽留流产(MA)绒毛组织中的表达,探讨3种因子在维持正常妊娠中的作用.方法:选取昆明市第一人民医院产科收治的MA患者36例(研究组)及行人工流产的正常早孕妇女28例(对照组).应用免疫组化法检测两组绒毛组织中HIF-1α、VEGF和PLGF的表达.结果:研究组绒毛水肿,细胞滋养细胞增生、数量增加,合体滋养细胞明显减少,甚至断裂消失.HIF-1 α、VEGF、PLGF在两组妇女绒毛滋养细胞的胞浆均有表达,但研究组HIF-1α、VEGF、PLGF的阳性表达率均低于对照组(16.67 vs 57.14％,66.67％ vs 100.00％,77.78％ vs 100.00％,P＜0.05).结论:HIF-1a、VEGF和PLGF与正常妊娠的维持有关,其表达异常可能导致MA.     

缺氧/复氧对卵巢癌SKOV3细胞增殖能力的影响

目的:探讨缺氧/复氧后卵巢浆液性囊腺癌细胞株SKOV3增殖能力的改变及其相关机制。方法:SKOV3细胞分别缺氧24h及缺氧后复氧培养不同时间。用MTT法检测细胞的增殖,流式细胞仪检测细胞周期;Western blot和RT-PCR检测缺氧诱导因子-1α(HIF-1α)的表达。用HIF-1α抑制剂雷帕霉素(Rapamycin)预处理细胞30min后,检测上述各指标的变化。结果:复氧24h细胞增殖率增加(1.38±0.60,P=0.023);复氧48h细胞增殖率恢复为常氧培养水平(0.67±0.28,P=0.48)。流式细胞仪分析显示复氧24h时S期细胞增加[(48.45±1.15)%,P=0.013],G1期细胞减少[(45.71±2.28)%,P=0.044]。常规培养的SKOV3稳定表达HIF-1α,缺氧可使HIF-1α蛋白表达增加(P=0.0045),复氧8h,HIF-1α表达迅速下降。Rapamycin可以使细胞周期停滞于G0~G1期,从而降低细胞的增殖能力。结论:缺氧/复氧可增强卵巢癌细胞株SKOV3的增殖能力,HIF-1α通路可能在其中起重要作用。     

缺氧微环境下HIF-1α对卵巢癌A2780细胞侵袭转移的影响及分子机制

目的:探讨缺氧微环境下HIF-1α在卵巢癌细胞系A2780侵袭转移中的作用。方法:常氧及缺氧微环境培养卵巢癌A2780细胞;RT-PCR及Western blot法检测缺氧诱导因子-1α(HIF-1α)和基质金属蛋白酶13(MMP13)mRNA及蛋白的表达;siRNA干扰HIF-1α表达,检测干扰效率及MMP13表达的变化;Transwell小室侵袭实验检测siRNA干扰前后卵巢癌细胞侵袭转移能力。结果:缺氧诱导卵巢癌A2780细胞HIF-1α及MMP13表达上调,细胞侵袭数明显增多;siRNA能有效抑制HIF-1α表达及缺氧引起的MMP13增多,降低细胞侵袭能力。结论:HIF-1α通过调控MMP13表达增强缺氧环境下卵巢癌细胞的侵袭能力。     

缺氧诱导因子-1α与妇科肿瘤

缺氧诱导因子-1α(HIF-1α)是缺氧诱导基因表达的中心调节子,与肿瘤的发生、发展密切相关.其表达受缺氧、肿瘤基因及多种因子的调节,可调控有关肿瘤血管生成、糖类代谢等多种靶基因的转录,促进肿瘤生长、浸润及转移.就HIF-1α与妇科肿瘤的关系进行探讨.     

缺氧对体外培养的早孕期细胞滋养细胞中缺氧适应相关部分基因表达及细胞浸润能力的调控

目的:探讨缺氧对细胞滋养细胞表达缺氧诱导因子-1α(HIF-1α)及氧感受器缺氧诱导因子脯氨酸羟化酶1、2(HPH/PHD1、2)和抑制缺氧诱导因子-1(FIH-1)的调控,以及缺氧对体外培养的细胞滋养细胞浸润能力的调节。方法:用RT-PCR和Western blot法检测在常氧、缺氧再复氧及持续缺氧等条件下,细胞滋养细胞中HIF-1α、HPH/PHD1、2和FIH-1 mRNA和蛋白表达的变化;并用体外侵袭实验检测缺氧再复氧、持续低氧对细胞滋养细胞浸润能力的影响。结果:(1)持续缺氧条件下培养的细胞滋养细胞HIF-1α和HPH/PHD2 mRNA和蛋白表达显著高于常氧组(P<0.01);HPH/PHD1和FIH-1 mRNA和蛋白表达显著低于常氧组(P<0.01)。缺氧再复氧后培养的细胞滋养细胞HIF-1α和HPH/PHD2 mRNA和蛋白表达显著高于常氧组(P<0.05),但显著低于持续缺氧组(P<0.05);HPH/PHD1和FIH-1 mRNA和蛋白表达均显著低于常氧组(P<0.05),但显著高于持续缺氧组(P<0.05)。(2)持续缺氧显著抑制细胞滋养细胞的浸润能力,与常氧组比较明显降低(P<0.01);缺氧后再复氧细胞滋养细胞的浸润能力居中,与常氧组比较明显降低(P<0.05);与持续缺氧组比较明显升高(P<0.05)。结论:滋养细胞可感受氧分压变化,HIF-1α、HPH/PHD1、HPH/PHD2和FIH-1相互作用与滋养细胞浸润能力调节有关。     

Screening for coeliac disease in women with a history of recurrent miscarriage or infertility.

Because subclinical coeliac disease may decrease fertility or complicate pregnancy, we screened women with recurrent miscarriage of unknown aetiology (n = 63), unexplained infertility (n = 47) and infertility with a known cause (n = 82), for anti-endomysium antibodies in serum to find undiagnosed coeliac disease. One woman (1-6%) with recurrent miscarriage, another woman (2.1%) with unexplained infertility and one woman (2.0%) in the control group (n = 51), were considered to have coeliac disease. We could not demonstrate a higher frequency of coeliac disease in women with infertility or recurrent miscarriage, but suggest that undiagnosed coeliac disease is common in women.     

High serum luteinizing hormone and testosterone concentrations do not predict pregnancy outcome in women with recurrent miscarriage

OBJECTIVE: To investigate the relationship between Day 8 serum luteinizing hormone (LH) and testosterone (T) concentrations, and body mass index (BMI) with pregnancy outcome in women with recurrent miscarriage. DESIGN: Prospective observational study. SETTING: National recurrent miscarriage clinic. PATIENT(S): Three hundred forty-four women (median age 32 years; range 18-44) with a history of recurrent first trimester miscarriage (median 4; 3-14; <12 weeks gestation) who conceived spontaneously and who received no pharmacological treatment during pregnancy were studied. All women were antiphospholipid antibody negative and had a normal peripheral karyotype as did their partners. INTERVENTION(S): Outcome of untreated pregnancies. MAIN OUTCOME MEASURE(S): Day 8 serum LH and T concentrations and BMI were correlated with pregnancy outcome. RESULT(S): One hundred and ninety-two (55.8%) women had a live birth and 152 (44.2%) women miscarried. Polycystic ovarian morphology was diagnosed in 174 women (50.6%). There was no significant relationship between follicular phase LH concentrations and pregnancy outcome. Pregnancy outcome was similar in women with normal and high serum T concentrations. BMI value was not significantly different between women who had a live birth and those who miscarried. CONCLUSION(S): The analysis of this large cohort of women with recurrent miscarriage demonstrates that prepregnancy Day 8 serum LH and T concentrations, and BMI do not have a statistically significant relationship with pregnancy outcome.     

Screening for coeliac disease in women with a history of recurrent miscarriage or infertility

Because subclinical coeliac disease may decrease fertility or complicate pregnancy, we screened women with recurrent miscarriage of unknown aetiology (   n = 63  ), unexplained infertility (   n = 47  ) and infertility with a known cause (   n = 82  ), for anti-endomysium antibodies in serum to find undiagnosed coeliac disease. One woman (1.6%) with recurrent miscarriage, another woman (2.1%) with unexplained infertility and one woman (2.0%) in the control group (   n = 51  ), were considered to have coeliac disease. We could not demonstrate a higher frequency of coeliac disease in women with infertility or recurrent miscarriage, but suggest that undiagnosed coeliac disease is common in women.     

Histologic and immunologic study of uterine biopsy tissue of women with incipient abortion

Biopsy specimens taken from the region of the placental bed were examined for the presence of phloxinophilic granulated mononuclear cells in women with a history of recurrent miscarriage and who would eventually miscarry a current pregnancy. They were compared with biopsy specimens from women with intact pregnancies presenting for elective termination of pregnancy and those with "missed abortion." Cells with large cytoplasmic granules (greater than or equal to 1 micron) were abundant in the group of ongoing pregnancies whereas cells with smaller granules (less than 1 micron) that were similar to large granular lymphocytes were more abundant relative to cells with large granules in the biopsy specimens from failing pregnancies. Immunosuppressive activity was tested in the supernatants of cultured biopsy samples of each group and found to be significantly lower in the incipient miscarriage group. These findings could represent alterations associated with the process of miscarriage, such as inflammation, or there may be deficient suppressor cell activity at the fetomaternal interface as the reason for "rejection" of the early embryo.     

Factor V Leiden and G20210A prothrombin mutations are risk factors for very early recurrent miscarriage

Objective To determine whether there is an association between early recurrent miscarriage (before 10 weeks of pregnancy) and Factor V Leiden and G20210A prothrombin mutations.
Design A prospective study.
Setting Department of Gynaecology and Obstetrics, Saint Antoine Hospital, Paris, France.
Population Two groups of women: those with early unexplained recurrent miscarriage before 10 weeks of pregnancy (   n =260  ) and control healthy women without a previous history of thromboembolism (   n =240  ).
Methods Screening for defects in the protein C anticoagulant pathway was performed using the anticoagulant response to agkistrodon confortrix venom (ACV test). Protein C and Factor V Leiden mutation testing was performed for each low ACV level. Each sample was tested for the G20210A prothrombin mutation.
Results Factor V Leiden and G20210A mutations were found to be associated with early recurrent spontaneous miscarriage before 10 weeks of pregnancy, the odds ratios being 2.4 (95% CI 1–5) and 2.7 (95% CI 1–7), respectively. Similar results were found whether or not women had had a previous live birth.
Conclusions Early recurrent miscarriage before 10 weeks of pregnancy is significantly associated with Factor V or G20210A prothrombin mutations. These results indicate a possible role for anticoagulant prevention in these early miscarriages.     

Abnormal immunoglobulin subclass patterns in women with a history of recurrent miscarriage.

OBJECTIVE: To determine whether IgG subclass patterns differed between nonpregnant women, healthy pregnant women, and pregnant women with a history of recurrent miscarriage. DESIGN: Controlled clinical study. SETTING: An academic setting. PATIENT(S): Group 1 was comprised of 10 nonpregnant women, group 2 of 10 healthy pregnant women, group 3 of eight pregnant women with a history of recurrent miscarriage and whose pregnancies on this occasion went to term, and group 4 of 10 women with a history of recurrent miscarriage whose pregnancies again failed later in the first trimester. INTERVENTION(S): None of the patients received any medication. MAIN OUTCOME MEASURE(S): Serum levels of total IgG and IgG 1, 2, 3, and 4. RESULT(S): The results obtained showed that normal pregnancy was associated with a significant increase in total IgG production and an increase in IgG subclasses 1, 2, and 3. Women with a history of miscarriage, but who had a successful pregnancy on this occasion, showed a similar pattern of IgG subclasses. Women with a history of miscarriage and whose pregnancy again ended in miscarriage showed a different IgG subclass pattern. CONCLUSION(S): Pregnancies that ended in miscarriage showed a different pattern of IgG subclasses than those that continued to term. The changes seen in immunoglobulin patterns could be linked to changes in cytokine production.     

Evaluation of KIR genes in recurrent miscarriage

Purpose

Natural killer (NK) cells express killer immunoglobulin-like receptors (KIRs) which recognize HLA class I molecules on trophoblasts. KIRs could either activate NK cells or inhibit them to produce soluble factors necessary for the maintenance of pregnancy, thus they are suspected of being involved in the causes of recurrent miscarriage. The aim of this study was to evaluate whether there is any possible association between KIR genes, genotypes and recurrent miscarriage.

Methods

The present study was carried out on 40 women who had unexplained recurrent miscarriage and 90 controls. Sequence-specific oligonucleotide probes analysis were used to investigate 16 KIR genes. All data were statistically analyzed by Fisher Exact Test.

Results

The rate of Bx genotypes that consists elevated number of activating KIR genes was significantly higher (p = 0.014) in women with recurrent miscarriage when compared with the control group. Additionally, the frequency of AA genotype (AA1) of the subjects in the study group was significantly lower than the frequency of the subjects in the control group (p = 0,014). Furthermore, there were no statistically significant differences in the frequencies of the individual KIR genes between women with recurrent miscarriage and the control group.

Conclusions

Inclined balance of KIRs toward an activating state in NK cells may contribute to recurrent miscarriage.     

不同年龄和流产次数的复发性流产患者绒毛染色体核型分析

目的:了解复发性自然流产胚胎染色体异常发生情况。方法:2008年1月至2011年12月,在我院诊治并成功行绒毛染色体核型分析的自然流产患者235例,根据自然流产次数分为复发性流产组(125例)和偶发性流产组(110例)。比较两组绒毛染色体异常发生率和类型的差异,不同流产次数的胚胎染色体异常发生情况,以及不同年龄患者绒毛染色体异常的发生情况。结果:复发性流产组,绒毛染色体异常发生率显著低于偶发性自然流产组(47.2%vs 70.9%,P<0.05)。复发性流产组中三体占异常染色体的66.1%(39/59),显著高于偶发性流产组(44.8%,35/78)(P<0.05)。随着自然流产次数的增加,绒毛染色体异常发生率降低,差异有统计学意义(χ2=15.266,P=0.004)。复发性流产组中,年龄≥35岁者的绒毛染色体异常发生率明显高于年龄<35岁者(60.9%vs39.2%,P<0.05)。偶发性自然流产组中,年龄≥35岁者的绒毛染色体异常发生率亦明显高于年龄<35岁者(88.9%vs 62.2%,P<0.05)。结论:胚胎染色体异常是引起复发性流产的一个重要原因,随着流产次数的增加,流产胚胎染色体异常的发生率降低。无论是复发性流产还是偶发性流产,高龄均是引起胚胎染色体异常的高危因素。     

低分子肝素钠治疗复发性流产对前置胎盘及早产的影响

目的:探讨低分子肝素钠治疗复发性流产对前置胎盘及早产的影响。方法:回顾性分析2015年1月至2016年1月就诊我院并分娩的孕妇中,符合纳入及排除标准的50例有复发性流产史的孕妇,予以低分子肝素钠治疗为治疗组,既往有复发性流产史,未予低分子肝素钠治疗的孕妇50例为对照组,随机选取同期我院正常分娩的孕妇200例为正常组。对照组给予常规保胎治疗,治疗组在对照组的基础上给予低分子肝素钠治疗;比较3组病例前置胎盘、产后出血及早产发生率。结果:对照组前置胎盘发生率(30%)明显高于治疗组(12%),两者比较差异有统计学意义(P0.05);治疗组早产发生率(0)明显低于对照组(14%),差异有统计学意义(P0.05);对照组前置胎盘、产后出血及早产发生率均高于正常组,差异有统计学意义(P0.05)。结论:复发性流产患者前置胎盘、产后出血及早产发生率比正常妊娠孕妇高,应用低分子肝素钠有可能降低复发性流产患者前置胎盘和早产的发生率。