卵泡刺激素对多囊卵巢综合征患者卵巢颗粒细胞分泌抗苗勒管激素的影响

目的 研究卵泡刺激素(FSH)对多囊卵巢综合征(PCOS)患者卵巢颗粒细胞分泌抗苗勒管激素(AMH)的影响.方法 选择2008年8月至2009年12月于中山大学附属第六医院生殖中心就诊的33例PCOS患者,从其直径为8～10 mm的窦卵泡中分离颗粒细胞,并分为以下3组进行培养:未经FSH刺激的颗粒细胞(未刺激组,n=12);外源性FSH刺激的颗粒细胞(体外刺激组,n=12),此组颗粒细胞来源同未刺激组;对患者行FSH促排卵治疗,采集FSH体内刺激的颗粒细胞(体内刺激组,n=21).分别采用ELISA法和实时荧光定量PCR技术检测培养液中颗粒细胞分泌的AMH水平,及AHM mRNA表达水平;构建AMH荧光报告载体,检测卵巢颗粒细胞中AMH启动子的活性.结果 培养液中颗粒细胞分泌的AMH水平,未刺激组为(11.4±4.0)μg/L,体外刺激组为(7.9±1.1)μg/L,体内刺激组为(5.6±1.7)μg/L,体内、体外刺激组分别与未刺激组比较,差异均有统计学意义(P均＜0.05).AMH mRNA表达水平未刺激组为2.5±1.2,体外刺激组为1.5±0.5,体内刺激组为1.1±0.7,未刺激组高于体内、外刺激组,分别比较,差异均有统计学意义(P均＜0.05).未刺激组颗粒细胞中AMH启动子的活性为11.5±2.3,体外刺激组为8.7±2.4,体内刺激组为6.8±2.4,未刺激组高于体内、外刺激组,分别比较,差异均有统计学意义(P均＜0.05).结论 FSH可能通过抑制PCOS患者卵巢颗粒细胞中AMH的启动子活性及其mRNA表达,抑制AHM的过度分泌,促进卵泡的生长发育.

Effect of follicle stimulating hormone on the secretion of anti-mullerian hormone in the granulosa cells in patients with polycystic ovarian syndrome

Objective To study the effect of follicle stimulating hormone(FSH)on the secretion of anti-mullerian hormone(AMH)in granulosa cells in patients with polycystic ovarian syndrome(PCOS).Methods From Aug.2008 to Dec.2009,33 patients with PCOS in Reproductive Medicine Research Center,Sixth Affiliated Hospital of Sun Yat-sen University were collected from 8-10 mm antral follicles and classified into the following three groups: FSH-unstimulated granulosa cells(unstimulated group,n =12),exogenous FSH-stimulated granulosa cells(exo-stimulated group,n =12)and internal FSH-stimulated granulosa cells(int-stimulated group,n =21).ELISA and real-time PCR were relatively used to measure protein and mRNA level of AMH.Luciferase reporting vector was constructed to detect the promoter activity of AMH.Results The levels of AMH secretion in PCOS granulosa cells were(11.4 ± 4.0)μg/L in unstimulated group,(7.9 ± 1.1)μg/L in exo-stimulated group and(5.6 ± 1.7)μg/L in int-stimulated group.Both the external and internal stimulation of FSH may suppress AMH secretion significantly(P ＜0.05).The mRNA level of AMH in PCOS granulosa cells were 2.5 ± 1.2 in unstimulated group,which were higher than 1.5 ± 0.5 in exo-stimulated group and 1.1 ± 0.7 in int-stimulated group significantly(P ＜0.05).The luciferase activity of AMH in PCOS granulosa cells were 11.5 ± 2.3 in unstimulated group,8.7 ± 2.4 in exo-stimulated group and 6.8 ± 2.4 in int-stimulated group.The luciferase activity of AMH in unstimulated group was significantly higher than those in exo-stimulated and int-stimulated groups(P ＜0.05).Conclusion FSH may inhibit the excessive secretion of AMH and stimulate follicle growth in PCOS granulosa cells by suppressing activity and expression of promoter.