人血清及卵泡液中巨噬细胞集落刺激因子水平的测定

目的 :观察巨噬细胞集落刺激因子 (M CSF)在人血清和卵泡液中的表达相 ,进一步了解M CSF在生殖中的作用。方法 :收集 1998年 12月至 1999年 8月在德国Kiel大学妇产科医院为辅助生育技术而接受超促排卵治疗的 80例患者取卵日的血清和卵泡液 ,用酶联免疫吸附法、酶免疫法分别测定M CSF、雌二醇 (E2 )和孕酮水平。其中 4例在超促排卵周期中数次采血以观察M CSF的动态变化。结果 :取卵日卵泡液M CSF水平为34 0 6.1± 12 4 .6ng L ,血清M CSF水平为 373.8± 38.3ng L(P <0 .0 0 1)。在超促排卵周期中血清M CSF水平逐渐升高 ,取卵日达峰值。血清与卵泡液中M CSF与E2 水平呈显著正相关关系 (r =0 .30 3,P <0 .0 1;r =0 .32 1,P <0 .0 1) ,与孕酮水平无相关性。妊娠组 2 0例血清M CSF水平为 313.7± 33.5ng L ,非妊娠组 60例为 4 0 2 .8± 2 8.9ng L(P <0 .0 5 )。结论 :卵泡是血清中M CSF的主要来源 ,血清中的M CSF水平可能也受E2 调节。血清中M CSF水平较低可能有利于受精卵的着床及生长。M CSF可能参与颗粒细胞的增殖、分化及排卵过程。

Measu r ement of macrophage colony-stimulating factor in human serum and follicular flu id.

Objective:To analyze the expression patterns of macrophage colony-stimulating factor(M-CSF),estradiol(E 2) and progesterone(P) in serum and follicular fluid(FF) of patients undergoing gonadotropins stimulation for assisted reproductive techniques and explore the role of M-CSF in human reproduction.Methods:Serum and FF were obtained from 80 patients at the time of transvaginal oocyte retrieval after ovulation induction for in-vitro fertilization (IVF),intracytoplasmatic sperm injection(ICSI) and embryo transfer(ET).Four of these 80 subjects had serial sera obtained on several occasions.M-CSF levels in the serum and FF were measured in duplicate by a solid phase enzyme-linked immunosorbant assay(ELISA).E 2 and progesterone levels were measured by an enzyme immunoassay(EIA).Results:The concentration of M-CSF in FF was substantially(9 times) higher than that in the serum(P<0.001).In all the four women,assay of serial serum samples spanning their stimulation cycles showed upregulation of M-CSF in the serum and revealed a consistent change in M-CSF concentration over the course of the stimulation cycle.A positive correlation was found between the levels of M-CSF and the levels of E 2 in the serum and FF (r=0.303,P<0.01;r=0.321,P<0.01,respectively).No positive correlation was found between the levels of M-CSF and the levels of progesterone in the serum and FF.A positive correlation was found between the levels of E 2 and the levels of progesterone(r=0.316,P<0.01).A significant difference in M-CSF levels of the serum between pregnant 313.7±33.5pg/ml(n=20),and non-pregnant patients 402.8±28.9ng/ml(n=60)was observed(P<0.05).Conclusions:Follicles are major source of M-CSF in the serum.The level of M-CSF in serum may be regulated by E 2.M-CSF may play a role in proliferation and differentiation of granulosa cells,and may be involved in the follicle development and ovulation via an autocrine/paracrine mechanism within the follicular microenviroment.Low levels of M-CSF in the serum may benefit the implantation and growth of fertilized oocytes.