The Expressions Of TGF-β1 And MMP-3 And TIMP-3 In Vaginal Wall Connective Tissue With Pelvic Floor Dysfunction

Objective Present work aimed to observe the expression of TGF-β1 ,MMP-3 and TIMP-3mRNA in vaginal wall connective tissue with pelvic floor dysfunction (PFD),to detect biochemical changes in vaginal wall connective tissue,and to explore whether the alteration in TGF-β1 ,MMP-3 and TIMP-3mRNA in vaginal wall expression could contribute to pelvic floor dysfunction.Methods Transvaginal biopsies were obtained from vaginal wall connective tissue in PFD and comparable control.Fifty women participated in the study.They were divided into 4 groups as follows:17 premenopausal patients with PFD(group 1), 12 premenopausal patients without PFD (group 2), 11 postmenopausal patients with PFD(group 3), and 10 postmenopausal patients without PFD(group 4). Reverse transcription polymerase chain reaction (RT-PCR)was used to quantitatively determining the mRNA level of TGF-β1, MMP-3 and TIMP-3mRNA.Results1 The expression of TGF-β1 and TIMP-3 were significantly reduced (p<0.05) in both premenopausal and postmenopausal patients with PFD(including group 1 and 3),compared to the control group (including group 2 and 4). The expression of MMP-3 was significantly high (p<0.01) in both premenopausal and postmenopausal patients with PFD(including group 1 and 3),compared to the control group (including group 2 and 4). We found that the expression of TGF-β1 has the high relativity to the variability of MMP-3 in both premenopausal and postmenopausal patients with PFD . The correlation coefficients were -0.735 (premenopausal) and -0.621 (postmenopausal) respectively.2 The ratio of MMP-3/ TIMP-3 was significantly high(P < 0.01)in both premenopausal and postmenopausal patients with PFD(including group 1 and 3),compared to the control group (including group 2 and 4). The relative value were 1.50±0.56 (premenopausal) and 1.91±0.64 (postmenopausal) respectively.Conclusion1 The expression of TGF-β1 decline in anterior vaginal wall of both premenopausal and postmenopausel patients with PFD. TGF-β1 decline cause anterior vaginal wall atrophic and anterior vaginal wall can not support urethra helping it keeping normal. TGF-β1 decline correlated with PFD in premenopausal and postmenopausal patients.2 The expression of MMP-3 increace and TIMP-3 decline in anterior vaginal wallof both premenopausal and postmenopausel patients with PFD. MMP-3 increace and TIMP-3 decline lead to the content of collagen impairment in vaginal wall connective tissue and result in the dysfunction of peivic floor structure.These alterations suggest that they might be involved in the effluence and development of PFD.Based these investigations,we reached the conclusion that the collagen metabolism in vaginal wall is not the synthesis but the degradation.3 The expression of significant increase in MMP-3 and significant decrease in TIMP-3 in anterior vaginal wall of both premenopausal and postmenopausel patients with PFD lead to the ratio increace.The proportion of MMP-3and TIMP-3 was overbalanced . The increased ratio of MMP-2 / TIMP-2 may play an important role in the onset and development of PFD.4 We also found the strong correlation between the expression of TGF-β1 and MMP-3 in anterior vaginal wall of both premenopausal and postmenopausel patients with PFD, suggesting anomalism at the level of genetic transcription.They might be participate in the onset and development of PFD in common.