The Significance And The Expression Of Desmin And Vimentin In The Levator Ani Muscle Of The Female Patients With Pelvic Organ Prolapse.

Objectives. Present work aimed to observe the relativity of the expression of desmin and vimentin in the levator ani muscle of the female patients with pelvic organ prolapse.to detect the mincro structure in the levator ani muscle of the patients with pelvic organ prolapse, and to explore whether the alteration in desmin and vimentin expression could contribute to the female patients with pelvic organ prolapse.Methods. Twenty patients with POP as research group,20 age-matched Rectal Cancer patients without POP or urinary incontinence as control group, biopsy samples were obtained from patients from the levator ani muscle. The change of desmin and vimentin was studied by immunohistochemical and electron microscopic techniques.Results.1.The image explains: muscle fibre in the structure of muscle tissue in control group are tight interrelate, there are collagen textile fiber, fibroblast ,vein and nerve in muscle bundle. Among them, muscle fibre is homogeneous dyeinged pink, cell nucleus locate in the border of muscle fibre, no muscle fibre shows :Degeneration and Necrosis. The density of muscle fibre in research groupis reduced, arrange comparatively sparse, A small amount show island shape scatter, be filled and replaced by comparatively rich fibre connective tissue, be infiltrated by Inflammatory cell. Muscle fibre shrink obviously,is uneven dyeinged, there are many center of cell nucleus are shifted,few musle fibre have vacuolation effect.2.The expression of desmin significantly reduced (P＜0.05) in research group,compared to the control group.3.The expression of vimentin was significantly reduced (P＜0.05) in research group,compared to the control group.Conclusions. In this study, the evidences which we found provide morphologic basis suggesting that the significantly reduced expression of desmin and vimentin contribute to the pathogenesis of POP.By microscope,we find that sarcomere of myofibril in the patients with POP arrange. chaos, cross striation of muscle cell become irregularly.by mechanics principle,we can speculate that lots of sarcomere can not contract in the same direction which will lead to the tention of levator ani muscle reduced, the prop up structure of pelvic floor's load support capability reduced, pelvic floor tissue prolapse by gravity.The experiment of animal show that the excess load move of skeletal muscle would induce to nonreversible reduce of desmin and vimentin in muscle cell,muscle fibres were eternal injured, the tention of muscle reduced obviously. Epidemiology survey point out that: many patient with pelvic organ prolapse and stress urinary incontinence have one common ground that they had the medical history of prolificacy,partus precipitatus,vagina's help at lambingor, abdomen pressure chronically heighten, levator ani muscle was eternal injured after excess load move state, the tention of muscle reduced obviously. This proves:It is one of key factor that levator ani muscle was injured by excess load move bring about POP.so,avoid levator ani muscle to be injured by excess load move is the key to prevent POP.Prospects. Done study show:the reduce of desmin could contribute to the hydrolysis faculty of ealpain.as a intermediate filament protein, is proved to be the substrate of calpain.the study of animal show glutamine supplementation can enhance the expression of desmin in mouse skeletal muscle, and can accelerates the recovery process Of exercise-induced muscle damage.so we may enhance the expression of desmin and vimentin by control the system of calpain, which could become one of new hypothesis to prevent and cure pop.