Efects Of Eleng Capsule On The Expression Of MMPs, TIMPs And VEGF In Ectopic And Eutopic Endometrium From Endometriosis

ObjectiveThis study was to investigate association between endometriosis and the expression of matrix metalloproteinase (MMP) , tissue inhibitor of metalloproteinase (TIMP)and vascular endothelial growth factor (VEGF), and to assess the effect of eleng capsule on the the secretion of MMPs, TIMPs and VEGF in ectopic and eutopic endometrium from women with endometriosis. Method75 patients with endometriosis were recruited and divided randomly into three groups, The eleng group(25 patients) were administered eleng capsule for three months, the nemestran group(25 patients)were administered nemestran for three months , and the blank control group(25 patients) were not administered any medical treatment for three months before conservative surgery by laparoscopy. Immunohistochemical method was employed to detect the expression of MMP-2, MMP-7, MMP-9, TIMP-1, TIMP-2, TIMP-3 and VEGF in ectopic and eutopic endometrium from women with endometriosis and the normal controls (17 cases of infertile women with the disturbance of fallopian tube). The changes of symptoms and signs were recorded before and after treatment, the serum levels of EMAb, CA125 and PRL were also examined at the same time. ResultsCompared with the normal control women, the patients with endometriosis (the blank control group) had higher levels of MMP-2, MMP-7, MMP-9, and VEGF and lower levels of TIMP-1, TIMP-2, TIMP-3 in their ectopic and eutopic endometrium (P<0. 05) .The ectopic and eutopic endometrium from the eleng group's women expressed lower levels of MMP-2 , MMP-7, MMP-9 and VEGF than did the ectopic and eutopic endometrium from the blank control group' s women (P<0. 05) . The nemestran group had also lower levels of MMP-2, MMP-7 and VEGFin ectopic endometrium and MMP-9 in eutopic endometrium than the blank control group. But there aren' t any significant diference between the eleng group and the nemestran group (P>0. 05). The levels of TIMP-1, TIMP-2 andTIMP-3 in ectopic endometrium from the eleng group' s women were higher than those in ectopic endometrium from the blank control group' s women. Meanwhile, the levels of TIMP-1 and TIMP-2 in eutopic endometrium from the eleng group' s women were higher than those from the blank control group' s women . The TIMP-1, TIMP-2 andTIMP-3 levels in ectopic endometrium and the TIMP-1, TIMP-2 levels in eutopic endometrium from the nemestran group' s women were higher in comparison to the blank control group' s women (P<0. 05) while TIMP-3 levels in eutopic endometrium is not present. After the treatment, scores of dysmenorrhea were significantly reduced (P<0. 0 5), and the size of ovarian endometrial cysts obviously decreased (P< 0. 0 5), and the high serum levels of PRL, CA125 and EMAb were significantly reduced (P<0. 05) in both the eleng group and the nemestran group. ConclusionMMP-2, MMP-7, MMP-9, TIMP-1, TIMP-2, TIMP-3and VEGF might play an important role in formation and development of endometriosis. Eutopic and ectopic endometrium from patients with endometriosis may be more invasive and prone to peritoneal implantation because of greater expression of MMP-2, MMP-7, MMP-9and VEGF and lower expression of TIMP-1, TIMP-2, TIMP-3, compared with endometrium from women without endometriosis. eleng capsule might down-regulate MMP-2, MMP-7, MMP-9and VEGF and up-regulate TIMP-1, TIMP-2 and TIMP-3 to inhibit the formation and development of endometriosis. Eleng capsule not only significantly relieves the symptoms and signs of patients with endometriosis , but also shows a good regulation on patients' serum levels of PRL, CA125 and EMAb . Eleng capsule was one of effective path to treat endometriosis.