The Relationship Between Lower Female Genital Tract Infection,the Concentration Of IL-1 And TNF-α In Pelvic,Oviduct Tissue TLR-4 Expression And Tubal Infertilily

ObjectiveTo make difference analysis for female tubal infertility patients and control individuals from multiple dimensions including genital tract pathogenic microorganisms,inflammatory mediators in pelvic flushing fluid,and peripheral blood inflammatory indexes;investigate the correlation of oviduct tissue Toll-like receptor-4(TLR-4)expression with tubal infertility;we analyzed whether there were correlations between multiple indicators related to tubal infertility.MethodsFrom January 2016 to December 2017,patients undergoing surgery for tubal infertility in Quanzhou maternal and child health care hospital and Fujian provincial maternal and child health hospital gynecology were collected as research group,and patients undergoing other gynecological surgeries were collected as control group,with 80 cases in each group.Twenty cases whose oviduct tissues could be obtained were collected from each group respectively for the detection of TLR-4mRNA.Feasibility conditions to obtain oviduct tissues: patients in research group underwent in vitro fertilization and embryo transfer(IVF-ET)preoperative pretreatment due to inflammatory hydrosalpinx,and the oviduct with hydrops was resected or ligated;patients in control group underwent resection of normal oviduct due to gynecological diseases or tubal ligation due to birth control.Study content and methods:(1)Peripheral venous blood of patients was collected for routine blood test and C reactive protein(CRP)test.(2)The Interleukin-1(IL-1)and Tumor necrosis factor-α(TNF-α)concentrations in pelvic flushing fluid were measured by enzyme linked immunosorbent assay(ELISA).(3)Secretion of cervical canal was collected for mycoplasma(MP),Chlamydia trachomatis(CT)and Neisseria gonorrhoeae(NG)detection by polymerase chain reaction(PCR).General bacterial culture and routine leucorrhea test were performed.(4)During surgery of specified subjects,the ampulla tissues or isthmus tissues of oviduct were collected and stored in liquid nitrogen.The TLR-4 expression in oviduct tissues was measured by real-time quantitative fluorescence PCR.Results1.The CT positive rate,MP positive rate and routine leucorrhea test abnormal rate of research group were higher than those of control group,P<0.01.There was no difference between research group and control group in general bacterial culture and NG positive rate,P>0.05.2.The IL-1,TNF-α and TLR-4 expressions in research group were all higher than those in control group,P<0.05.3.The r values of pearson correlation analysis for IL-1 and TNF-α against TLR-4 were 0.732 and 0.629,respectively,P<0.01,which indicated that IL-1 and TNF-α had positive correlation with TLR-4.4.The IL-1 and TNF-α expressions in routine leucorrhea test abnormal individuals were higher than those in leucorrhea normal individuals,P<0.05;the IL-1 and TNF-α expressions in CT,MP positive individuals were higher than those in negative individuals,P<0.05.5.TLR-4 expression in MP positive,CT positive and routine leucorrhea test abnormal individuals was higher than that in MP negative,CT negative and routine leucorrhea test normal individuals,P<0.05.ConclusionThe genital tract MP,computed tomography(CT)infection,abnormal leucorrhea,inflammatory mediators IL-1 and TNF-alpha in pelvic irrigating fluid and the expression intensity of TLR-4 in oviduct tissue are related to the occurrence of tubal infertility,and these research indicators have a positive correlation with each other.However,the specific pathogenic mechanisms and signal transduction pathways still need further study in order to provide a theoretical basis for intervention and prevention of tubal infertility.