Preliminary Study Of Fibrosis Markers,estrogen Receptor Αand SDF-1/CXCR-4 Axis Inthe Mechanism Rats Intrauterine Adhesions

ObjectivePreliminarily explore the expressions and significance of fibrosis markers(TGF-β1,MMP-9),estrogen receptor α(ERα)and SDF-1 / CXCR-4 axis in the model of intrauterine adhesions.Intrauterine adhesions are mainly characterized by the formation of intrauterine fibrosis adhesion that makes uterine out of shape after severe endometrial damage with intrauterine operation.In clinical,trans-cervical resection of adhesion(TCRA)combined with estrogen and other means are employed to promote the normal repair of endometrium.The purpose of this study is:1.The preliminary detection of intrauterine adhesions during the formation of fibrosis-related factors is to lay a foundation for the next step that inhibits excessive endometrial fibrosis.2.The expression of ERα in the process of intrauterine adhesions is helpful to guide the selection of estrogen dose for patients with intrauterine adhesions.3.To provide a certain theory for the study that the treatment mechanism of bone marrow mesenchym stem cells(BMSCs)on intrauterine adhesions by dynamically detecting the changes of SDF-1 / CXCR-4 axis.Method1.95% ethanol was used to continuously inject the uterine cavity in the rats for 5 min in estrous period,endometrium in control group and in experimental groups that at the 1d,3d,the first estrous,the second estrus,the third estrus,the forth estrous and the fifth estrus were obtained for the following experiments.2.Morphological changes in endometrium were detected by histochemical staining(HE,Masson,IHC).The expressions of keratin,Vimentin and CD34 were detected by immunohistochemistry(IHC).Reverse transcription real-time quantitative PCR(RT-q PCR),Western blot and immunohistochemistry(IHC)were used to detect the m RNA and protein levels of TGF-β1,MMP-9,ERα and SDF-1 / CXCR-4 in endometrium of rats with intrauterine adhesions.Results1.Rat model with intrauterine adhesions were successfully established(P <0.05).The endometrial epithelial cell marker keratin,stromal cell marker Vimentin and microvessel density markers CD34 were significantly lower than those in the control group(P <0.05).With the passage of time,the rat endometrial fibrosis tissue was significantly proliferated,and gradually replaced and covered the original normal endometrium until the formation of intrauterine adhesions(P <0.05).2.The expressions of TGF-β1,MMP-9 and ERα during endometrium restoration after surgery was significantly higher than those in control group(P <0.05).SDF-1 showed a gradual increase in early postoperative and climbed to the top at the second estrus(P <0.05),but there was no significant increase of CXCR-4 in experimental groups compared with that in control group(P> 0.05).Conclusion1.The clinical treatment of intrauterine adhesions estrogen dose selection needs to follow the individual principle;2.The formation and development of intrauterine adhesions may be related to the abnormal expressions of TGF-β1 and MMP-9 in endometrial injury,while autologus chemotactic CXCR-4(+)bone marrow mesenchym stem cells(BMSCs)for SDF-1 provides little effect for endometrium restoration.