The Expression And Role Of XIAP, XAF1 And TNF-α In Endometriosis

OBJECTIVE:Purpose 1.To study the difference and relationship between X-chromosome-linked (XIAP) and XIAP Associated Factor 1 (XAF1) in endometrium of non endometriosis (EMs), eutopic endometrium and ectopic endometrium with ovario-EMs. To discuss the role that apoptosis plays in the development of EMs.2.To discuss the role that the change of physico-chemical property in peritoneal fluid plays in the genius morbi of endometriosis by observing the different levels of tumor necrosis factor- alpha (TNF -α) in peritoneal fluid of non endometriosis(EMs) and ovario-Ems.3. To discuss the importance of apoptosis in the mechanism of endometriosis(EMs), which is defined as a benign disease with malignant behaviour by analysising the relatioship between XIAP, XAF1 and TNF-αin EMs.Methods 1. Study object:①study group: from February 2007 to April 2008,we collected eutopic endometrium and ectopic endometrium in 80 patients who were suffering endometriosis , and the stages were III or IV ,according to rAFS. Among them, there were 40 cases in proliferative stage, 40 cases in progestational stage, 48 cases in stage III, 32 cases in IV. Peritoneal fluid of 72 cases were collected, 36 cases in proliferative stage, 36 cases in progestational stage, 40 cases in stage III, 32 cases in IV. The average ages was 30.8±5.2.②control group: eutopic endometrium , ectopic endometrium and peritoneal fluid from 55 infertilize women duing to ductus Mueller obstrucal who treated by laparoscopic operation during February 2007 to April 2008. There were 30 cases in proliferative stage, 25 cases in progestational stage. The average ages was 31±4.4. The average ages between two groups was no different. And all cases were not taking hormone drugs in 3 month,not suffering other disease.2.Apoptosis rate between normal endometriun of control group and eutopic endometrium, ectopic endometrium were test by flow cytometry.3.The expressions and relationship of XIAP and XAF1 in normal endometrium, eutopic endometrium and ectopic endometrium had been examined by immunohistochemical assay.4 TNF-αin peritoneal fluid of non endometriosis(EMs) and ovario-Ems. had been test by ELISAResults: 1 Cell apoptosis rate(AR) In control group, AR of proliferative stage was higher than progestational stage. In study group, there were not different between proliferative stage and progestational stage in normal endometrium, eutopic endometrium and ectopic endometrium. In proliferative stage, AR of ectopic endometrium was lower than eutopic endometrium and normal endometrium.There was no significant between eutopic endometrium lower than normal endometrium. In progestational stage, AR of ectopic endometrium was lower than eutopic endometrium and normal endometrium. AR of eutopic endometrium was lower than normal endometrium.2 XIAP: The expression of XIAP was local in endochylemain of cellula epithelialis and mesenchymal cell of endometrium.①The expression of XIAP in proliferative stage was significant higher than progestational stage, no matter in endometrium of contrial group and the eutopic endometrium of study group. But XIAP in ectopic endometrium, there was no significant between proliferative stage and progestational stage.②In proliferative stage the expression of XIAP in endometrium of contrial group were different from that in eutopic endometrium and ectopic endometrium (P<0.05)。There were no different of expression of XIAP between eutopic endometrium and ectopic endometrium in proliferative stage(P>0.05).③In proliferative stage,there were difference of the expression of XIAP among any two group of control endometrium , eutopic endometrium and ectopic endometrium (P<0.05)。④The expression of XIAP in eutopic endometrium of rAFS-III and rAFS-IV, there were no difference in menstrual cycle. (P>0.05)。The expression of XIAP in ectopic endometrium of rAFS-III and rAFS-IV, there were no difference in menstrual cycle. (P>0.05)。 3 XAF1 The expression of XAF1 was local in cell nucleus of cellula epithelialis and mesenchymal cell of endometrium.①The expression of XIAP in proliferative stage was significant higher than progestational stage, no matter in endometrium of contrial group and the eutopic endometrium of study group. But XIAP in ectopic endometrium, there was no significant between proliferative stage and progestational stage.②In proliferative stage, there were no difference of the expression of XAF1 among any two group of control endometrium , eutopic endometrium and ectopic endometrium (P>0.05)。③In progestational stage,there were difference of the expression of XAF1 among any two group of control endometrium , eutopic endometrium and ectopic endometrium (P<0.05)。④The expression of XAF1 in eutopic endometrium of rAFS-III and rAFS-IV, there were no difference in menstrual cycle. (P>0.05)。The expression of XAF1 in ectopic endometrium of rAFS-III and rAFS-IV, there were no difference in menstrual cycle. (P>0.05)。4 TNF-αIn both control group and rAFS-III, rAFS-IV of study group, there was no significant difference of TNF-αin peritoneal fluid in menstrual cycle. In proliferative stage,there level of TNF-αin peritoneal fluid of rAFS-III, rAFS-IV stage were higher than control group(P<0.05).While there was not different between rAFS-III stage and rAFS-IV stage (P>0.05)。And there was not different between proliferative stage and progestational stage. 5 The correlation between XIAP and XAF1: There were negative correlations between proliferative stage and progestational stage in control endometrium and eutopic endometrium and ectopic endometrium(P<0.05)。6 The correlation between XAF1 in endometrium and TNF-αin peritoneal fluid:In proliferative stage, there were no significant between XAF1 in normal endometrium and TNF-αin peritoneal fluid .And in progestational stage, there were no significant between XAF1 in ectopic endometrium and TNF-αin peritoneal fluid .While,there were negative correlate between XAF1 and TNF-αin control group during progestational stage, eutopic endometrium during both proliferative stage and progestational stage, and ectopic endometrium during proliferative stage(P<0.05)。Conclusion: In endometriosis, the increased expression of apoptosis inhibiting geneXIAP and decreased expression of apoptosis trigger gene was benefite for locally and distantly metastatic of ectopic endometrium. While overexpress of TNF-αin peritoneal fluid restricted the growth of ectopic endometrium unlimited. So endometriosis is a benign disease. At the same time, TNF-αby activating caspase cascade to promote the target cell apoptosis. In a certain extent, also inhibit excessive XIAP expression.