The Effects Of Mifepristone On The Morphology And Expression Of Bax, Bcl-2 In Decidua And Chorion Tissue Of Different Early Human Pregnancy

Objective:This study of mifepristone from the termination of early pregnancy mechanism,comparing the different early pregnancy time human decidua and chorion ultrastructure change,and using the immunohistochemistry technique to study the apoptosis and the expression of Bax,Bcl-2 in decidua and chorion tissue,and further approach the mechanism of mifepristone inducing apoptosis about the deidua and chorion of pregnancy,analyze the influence of mifepristone on the decidua and chorion tissue in differert time of early pregnancy. For clinical use early and provide a theoretical basis for the termination of early pregnancy.Methods:40 cases pregnant women within 39 days who volunteer to terminate the early pregnancy,were randomly divided into two groups:control group,taking mifepristone of group A,and 20 cases each.The control group used conventional vacuum aspiration termination of pregnancy.Then selected another 20 cases pregnant women within 40-49 days randomly.These cases were defined as taking mifepristone of group B.The medication groups take mifepristone 150mg at one time,and misoprostol 400μg were put into vagina 48 hours later, then after 2 hours,vacuum aspiration was operated.Each group's decidua and chorion collected respectively and observed the morphological change of decidua and chorion tissue by light microscope and transmission electron microscope and detected the apoptosis and expression of Bax,Bcl-2 in decidua and chorion tissue by immunohistochemistry technique and computer image analysis system.All data were analysed by SPSS(13.0).Results:1 Light microscope showed:The decidua tissue of control group contained decidual cell and granular cell.The structure is clear and the rank is compact. The taking mifepristone of group A showed that the decidual cell turn to degenerate and necrosis,interstitial edema, intercellular space become broadening.Granula of granular cell become reduced,blood capillary of interstitial expand and engorge,inflammatory cell infiltrate.The morphological change of taking mifepristone of group B is basically alike to the taking mifepristone of group A.The structure of chorion tissue of control group is clear, which the outer layer is syneytiotrophoblast and the inner layer is langhans cell.The taking mifepristone of group A showed that the cell degenerate,necrosis,even amotic,the chorion interstitial expand and edema,cell dispersing and anapetia,the inflammatory cell infiltrate.The change of taking mifepristone of group B is basically alike to the taking mifepristone of group A.2 Transmission electron microscope showed:The variation of group A by way of mifepristone showed that large decidual cell shrinkage,pseudopodlike protuberance increased,the decidual cell is full of many saccular dilatation rough endoplasmic reticulum and mitochondria,the amount of electron-dense granum reduced in the granular cell.Some of the syneytiotrophoblast of chorion tissue lamellar amotic,the quantity of microvilli decreased,even absence,the syneytiotrophoblast is full of many saccular dilatation rough endoplasmic reticulum,free ribosome reduced,lipid droplet increased,the bulk cristae of mitochondrium is mixed with membrane which turned to unclear or deletion.The langhans cell flatten and shrink,the outline of cell is unclear,the spaces between syneytiotrophoblast and langhans cell become widen. The change of taking mifepristone of group B is basically alike to the taking mifepristone of group A.3 Apoptosis results:All the threes groups' decidua and chorion tissue can be seen the positive cells,but the positive cells in control group is significantly reduced,and the apoptosis rate in control group is significantly lower than two medication groups.4 Immunohistochemical results:The expression of Bax in decidua tissue mainly was located in the endochylema of decidual cells and the glandular epithelium cells.The expression of Bax in taking mifepristone of group A is significant lower than control group(P＜0.05),and there is no statistical significance between the group A and the group B(P＞0.05).The expression of Bax in chorion tissue was located mainly in the endochylema of syneytiotrophoblast and langhans cells. The expression of Bax in taking mifepristone of group A is significant lower than control group(P＜0.05),and there is no statistical significance between the group A and the group B (P＞0.05).The expression of Bcl-2 in decidua tissue mainly was located in the endochylema of decidual cells and the glandular epithelium cells.The expression of Bcl-2 in taking mifepristone of group A is higher than control group(P＜0.05),and there is no statistical significance between the group A and the group B (P＞0.05).The expression of Bcl-2 in chorion tissue mainly was located in the endochylema of syneytiotrophoblast.The expression of Bcl-2 in taking mifepristone of group A is higher than control group(P＜0.05),and there is no statistical significance between the group A and the group B(P＞0.05).Conclusion:1 Pregnant within 39 days and 40-49 days pregnant women decidua and chorion tissue turn to degenerate and necrosis after 48 hours by the role of the mifepristone.2 Normal early pregnancy decidual and villous tissues in varying degrees of apoptosis happened,after 48 hours by the role of mifepristone,the apoptotic cells were significantly expressed.Description mifepristone may be through the promotion of apoptosis to achieve the purpose of anti-early pregnancy,induced abortion.3 The expression of Bax,Bcl-2 have been found both in the nomal decidua and chorion tissue.After 48 hours after mifepristone,the expression of Bax have been found significant increased in the decidua and chorion tissue,and the expression of Bcl-2 have been found declined,it may be show that mifepristone terminate the early pregnancy by heightening the expression of Bax and reducing the expression of Bcl-2 in deeiduas and chorion tissue.Confirmed the Bax/Bcl-2 balance for the maintenance of normal pregnancy has played an important role.4 After 48 hours by the role of mifepristone,pregnant within 39 days and 40-49 days of pregnancy decidua and chorion tissue of women's organizational structure changes, changes in apoptotic cells and Bax,Bcl-2 expression is not significantly different,suggesting mifepristone has the same effect to the decidua and chorion tissue of different early human pregnancy.