The Study Of Gap Junctional Intercellular Commuinication In Endometriosis

Endometriosis is a common and constant disease in women of reproductive years. The incidence of this disease is moving up gradually. The symptoms arose by endometriosis, such as dysmenorrhea, chronic pelvic pain and infertility, have most severe effect on the healthiness and life quality of these women. The etiology of this disease still confuses most of researchers. Although endometriosis is a benign disease, its' biologic action is the same as malignant tumors. The ectopic endometrium often invade the peritoneum or the surface of other organs, stick tightly to and destroy them, even migrate to distant place. In addition, the malignant transformation rate of endometriosis is as high as 0.7%~1.0%. In 1988, Lagrenade and Silverberg found the heteromorphism of endometrial gland, and malignant transformation of it, then brought forward the conception of atypic ovarian endometriosis for the first time. Malignant tumors also have the same characteristic of invasion, metastasis and the change from atypic proliferation to malignant transformation. From the similarity between endometriosis and neoplasma in biologic action, we speculated that endometriosis has neoplastic potential, and the etiology of endometriosis may have consistency to some extent with malignant tumor. Recently, studies show that the inhibition of gap junction intercellular communication (GJIC) among neoplastic cells was responsible for the proliferation, differentiation and enhancement of invasive ability and metastasis of malignant tumors. A hypothesis came to us, the GJIC among endometrial epithelial and stromal cells may have comparability with malignant tumors to some extend and it may have effect on ectopic implantation and malignant transformation, So, making the similarity between endometriosis and malignant tumors as a cut-in point, we study the GJIC in endometriosis for the first time to discuss the etiologic mechanism of it in a new point of view. And it's a basis for the new treatment of endometriosis. PART ONE THE EXPRESSION AND SIGNIFCANCE OF CONNEXINS' PROTEIN AND MRNA IN EUTOPIC ENDOMETRIUM OF ENDOMETRIOSIS Objective: To study the expression of connexins' protein and mRNA in the eutopic endometrium of endometriosis, in order to disclose the characteristic of GJIC in it. Method: 20 cases of eutopic endometrium samples of endometriosis and 21 cases of normal endometrium as a control of other disease were collected from Gynecologic Department of Chong Qing Medical University Affiliated No 1.Hospital during Nov,2003 and July ,2004. Immunohistochemistry to test the expression of connexin26, connexin32, connexin43 protein and RT-PCR to test mRNA of connexins was done. Result: Connexin43 mainly expressed in epithelial cells, less in stromal cells. But connexin 26 and connexin32 expressed both in epithelial cells and stromal cells. They all expressed in the plasm and membrane of the cells, don't in the nucleolus. The expression of protein and mRNA of these 3 connexins in endometriosis was less than that in the control group(p<0.05).Conclusion: For the location of these three connexins, we can speculate that CX43 protein was a media mainly among endometrial epithelial cells, CX32 and CX26 were medias both among endometrial epithelial cells and among stromal cells. The decreased expression of connexin proteins and mRNA in eutopic endometrium of endometriosis may cause the enlargement of gap junction among cells, and may company with diminution of GJIC among these cells. The transmission of small molecular substance and signal molecular is obstructed or lost. This may be the reason for its' adhesion and invasion to other place after retrogradation. PART TWO THE ESTABLISHMENT OF ENDOMETRIOSIS CELL MODEL IN VITRO Objective: To establish a multicellular model of endometriosis in vitro by separating epithelial cell and stomal cell from endometrium. Method: Eutopic endometrium of endometriosis and other benign disease was collected. Primary culture of endometrial cells was performed by high concentration collagenase digestion m...