Study On The Expression Of Transforming Growth Factor-β1 And Matrix Metalloproteinase Land Tissue Inhibitors Of Metalloproteinase 1 In Paries Anterior Vaginase For Postmenopausal Female Pelvic Organ Prolapse

Background and objective:When the support function of the pelvic floor muscles, fascia and ligaments is very weak because of a variety of causes, the pelvic organs (uterus, vagina, bladder, urethra, rectum and small intestine) can break away from their normal anatomical structure,which is called pelvic organ prolapse(POP). POP is a common disease in middle age and aged women, often associated with stress urinary incontinence (SUI), referred to pelvic floor dysfunction (PFD). At present the pathogenesy of POP is still not very clear, so it is very important to study of the pathogenesy of POP for its diagnosis, treatment and prognosis.Recently,a large number of studies have shown that the changes of collagen in pelvic floor leading to pelvic floor relaxation, which is the main reason for POP mainly by the pelvic floor connective tissue is mainly composed of type I and type III collagen. Matrix metalloproteinases (MMPs) is a group of zinc ion-dependent endopeptidase. Researchers have found 28 species of MMPs. MMPs is the main protease to degrade extracellular matrix (ECM) in the protease. MMP-1 degrades type I to type III collagen mainly. Tissue inhibitors of matrix metalloproteinases (TIMPs) is physiological inhibitor of MMPs,TIMP1 mainly combines with and MMP1 and MMP8 to inhibit of degradation of type I and type III collagen. Transforming growth factor-β1 (TGF-β1) plays an important biological role in regulating collagen synthesis and degradation.The biological effects of TGF-β1 can take by regulating the expression of MMP1/TIMP1 in part, and there are few reports about the interaction of the three in the pathogenesis of POP in present.To explore the relationship between TGF-β1,TIMP1 and MMP1 with the occurrence of pelvic organ prolapse (POP) through analysis on TGF-β1 and TIMP1 and MMP1 in paries anterior vaginase for postmenopausal female pelvic organ prolapse. TGF-β1 and TIMP1and MMP1 in structures in paries anterior vaginase was evaluated by immunohistochemical staining.This study may provide a theoretical basis of the diagnosis and treatment of POP.Materials and methods:1 The tissues:the biopsy specimens of paries anterior vaginase were taken from 30 cases of postmenopausal POP patients undergoing hysterectom (test group), and 20 cases of postmenopausal patients without POP and SUI (control group) undergoing hysterectom because of gynecological benign tumor, hospitalized in department of gynecology and obstetrics of the People's Hospital of Henan province from July 2008 to May 2009. All of them were not accepted endocrine therapy. All of the cases were signed informed consent before operation.The control group and the test group were accepted vaginal hysterectomy or abdominal hysterectomy. The biopsy specimens were obtained from upper anterior vaginal wall,abaut 1.0cm×0.5cm X 0.2cm in size,and then were put into the 10% neutral formalin for 24 hours,routine dehydration,embedded in paraffin, made in 2μm slices.The histological structure in paries anterior vaginase were examined with routine HE staining.2 Methods:The expression of TGF-β1, TIMP1 and MMP1 were detected by immunohistochemistry SP method. TGF-β1 and TIMP1 and MMP1 in structures in paries anterior vaginase was evaluated by immunohistochemical staining.3 Statistical analysis:All the date was computed by SPSS13.0 statistics software. The difference of average in two groups was compared with t-test,application SPSS13.0 statistical software to analyze data comparison between the two groups using t test. The correlations of TGF-β1 and TIMP1, TIMP1 and MMP1 were analysised by pearson correlation.The criterion for statistical significance was a=0.05.Results1 TGF-β1 and TIMP1 were stained in brown, mainly located in the cytoplasm, TGF-β1 positive staining luminance in paries anterior vaginase was 93.09 in POP group,123.94 in contral group, respectively.It was significantly lower in POP group than that in control group (P<0.05).TIMP1 positive staining luminance in paries anterior vaginase was 88.45 in POP group,139.21 in contral group, respectively. It was significantly lower in POP group than that in control group (P<0.05). MMP1 was also mainly located in the cytoplasm, MMP1 positive staining luminance in paries anterior vaginase was 136.03 in POP group,90.83 in contral group, respectively.It was significantly higher in POP group than that in control group (P< 0.05).2 Between TGF-β1 and TIMP1 was analysised by pearson correlation,and r=0.67 (p<0.05) indicated that they are linear positive correlation. Between TIMP1 and MMP1 was analysised by pearson correlation,and r=-0.779 (p<0.05) indicated that they are linear negative correlation.Conclusions:1 TGF-β1 and TIMP1 declined in paries anterior vaginase of postmenopausal POP patients, and MMP1 increased in paries anterior vaginase of postmenopausal POP patients,These may correlate with POP in postmenopausal women.2 There is maybe a new approach to therapy postmenopausal POP to adjust TGF-β1,TIMP1 and MMP1 in pelvic tissue of postmenopausal POP patients.