子宫腺肌病在位/异位内膜Toll样受体表达与炎症病理相关性的研究

【摘 要】 目的：检测子宫腺肌病在位/异位内膜Toll样受体（Toll-like receptors，TLRs）表达，探讨TLRs表达与组织炎症病理的相关性。方法：标本选自同济大学附属杨浦医院收治的子宫腺肌病手术患者24例，分别取在位内膜（eutopic endometrium，EU）、异位内膜（ectopic endometrium，EC），并以正常子宫内膜（control endometrium，CE）为对照。检测CE、EU、EC组中TLRs mRNA及蛋白表达，同时检测白细胞介素（IL）-6、IL-8 mRNA表达。结果：逆转录聚合酶链反应（RT-PCR）检测显示：IL-6、IL-8 mRNA在EC、EU组中表达均高于CE组（P＜0.01），且EC组高于EU组（P＜0.01）。TLR1～6、8、9 mRNA在EC、EU组中表达高于CE组（P＜0.05），除外TLR2，其余TLRs在EC组中表达高于EU组（P＜0.01）。TLR7 mRNA在EU组中表达高于CE组（P＜0.05），而EC组与CE组、EU组与EC组之间差异无统计学意义。蛋白质印迹（Western blot）检测显示：TLR1、4～6、8、9在EC、EU组中表达高于CE组（P＜0.01），且EC组高于EU组（P＜0.01）。TLR2在EC组中表达高于CE组（P＜0.05），而EU组与CE组、EU组与EC组之间差异无统计学意义。TLR3、7在EC组中表达高于EU组及CE组（P＜0.05），而EU组与CE组之间差异无统计学意义。Pearson相关性分析显示，子宫腺肌病EU、EC组TLRs mRNA与IL-6、IL-8均呈正相关；其中TLR2、4、5、9与IL-6、IL-8均呈正相关（P＜0.05）。结论：子宫腺肌病病灶处于炎症病理状态，腺肌病EU、EC组TLRs整体呈高表达，并与IL-6、IL-8具有良好的相关性，提示TLRs信号介导免疫炎性体系可能涉及子宫腺肌病炎症病理形成及发展。

The Expression of Toll-like Receptors in Eutopic and Ectopic Endometrium and Its Implication in the Inflammatory Pathogenesis of Adenomyosis

Objective:To investigate the expression profiles of Toll-like receptors (TLRs) in eutopic endometrium (EU) and ectopic endometrium (EC) and its imphcation in the inflammatory pathogenesis of adenomyosis.Methods:A total of 24 adenomyosis patients who underwent laparoscopy were recruited in this study.The mRNA and protein expressions of TLRs,and the mRNA expression of IL-6 and IL-8 in EU and EC of adenomyosis patients,and the control endometrium without adenomyosis (CE) from healthy women were detected.Results:The mRNA expression of IL-6,IL-8 in EU was significantly higher than that in CE,and was the highest in EC (P＜0.01).The mRNA expression of TLR1-6,8,9 in EU was significantly higher than that in CE (P＜0.05),and were the highest in EC except TLR2 (P＜0.01).The mRNA expression of TLR7 in EU was significantly higher than that in CE (P＜0.05),but there was no significant difference in TLR7 expression between EC vs.CE,EU vs.EC.The protein expression of TLR1,4-6,8,9 in EU was significantly higher than that in CE,and was the highest in EC (P＜0.01).The protein expression of TLR2 in EC was significantly higher than that in CE (P＜0.05),but there was no significant difference between EU vs.CE,EU vs.EC.The protein expression of TLR3,7 in EC was significantly higher than that in EU and CE (P＜0.05),but there was no significant difference between EU vs.CE.Pearson correlation analysis showed that the expression of TLR2,4,5 and 9 in EU and EC was positively correlated with that of IL-6 and IL-8 (P＜0.05).Conclusions:Our results showed that adenomyosis was a state of inflammatory pathology.High expression of TLRs in EU and EC were positively correlated with IL-6 and IL-8,which may be involved in the inflammatory pathogenesis of adenomyosis.