Expression Of Transforming Growth Factor β₁ And Collagen Ⅰ,Ⅲ In Pelvic Floor Tissues And Its Relationship With Pelvic Floor Dysfunction

Objective:The pelvic floor support tissue plays an important role in keeping pelvic organ in the normal anatomic position .Collagen is the main component of the pelvic connective tissue. And the TGF-β₁ is the most closely related to collagen metabolism. To observe the expression and relativity of Transforming Growth Factorβ₁ and Collagen I,III in the cardinal ligament from patients with pelvic floor dysfunction.To elaborate whether the molecular biology changes contribute to the development of FPD.Methods:1 All of the seventy women participated in the study were selected from Hebei People's Hospital Gynecology department.First ,experimental group 45 patients and they were divided into four groups as follow:13 premenopausal patients with POP;12 premenopausal patients with POP+SUI;9 postmenopausal patients with POP;11 postmenopausal Patients with POP+SUI.Second,control group 25 patients and they were divided into two groups as follow:12 premenopausal patients and 13 postmenopausal patients either SUI or POP. 2 The biopsy specimens in Cardinal ligament were obtained from 70 patients undergoing vaginal or abdominal hysterectomy.The histological structures in cardinal ligament tissues were examined with routine HE staining. TGF-β₁ and Collagen I,III were ev-aluated by immunohistochemical staining. 3 Analyze the data with SPSS13.0.Results:1 Light microscope histological features of cardinal ligament (HE stain) :In the experimental group,we observed the collagen fibers and smooth muscle losed its normal arrangement;the smooth muscle was fragmentary and interstice between bundles of smooth muscles became wider; We also saw the degeneration such as vacuolar degeneration,endochylema hydrosarca and amyloidosiss and Collagen fiber breakage, collagen density decreased.In the control group we saw that the arrangement of the collagen fibers was fasciculate and orderly. The smooth muscle was tightness .The arrangement was regularity .2 The expression of TGF-β₁ in the cardinal ligament.: TGF-β₁ positive staining rate in premenopausal POP, POP+SUI and control group were 30.8%,25.0%,83.3%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05). TGF-β₁ positive staining rate in postmenopausal POP, POP+SUI and control group were 22.2%,27.3%,76.9%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05).3 The expression of Collagen I in the cardinal ligament: Collagen I positive staining rate in premenopausal POP, POP+SUI and control group were38.5%,33.3%,83.3%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05).Collagen I positive staining rate in postmenopausal POP, POP+SUI and control group were 22.2%,36.4%,76.9%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05).The expression of Collagen I in the Cardinal ligament.4 The expression of Collagen III in the cardinal ligament:Collagen III positive staining rate in premenopausal POP, POP+SUI and control group were 23.1%,16.7%,75.0%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05).Collagen III positive staining rate in postmenopausal POP, POP+SUI and control group were33.3%,18.2%,84.6%,It was significantly lower in POP group and POP +SUI group than that in control group(P<0.05), and it wasn't significantly lower in POP group than that in POP+SUI group (P>0.05).5 The correlation of TGF -β₁ and CollagenI, III: In the premenopausal groups ,TGF-β₁ and Collagen I correlation coefficient r = 0.662 P=0.000(P<0.05).So the TGF-β₁ was positively correlated with the Co1lagen I; TGF-β₁ and Collagen III correlation coefficient r=0.713,P=0.000(P<0.05),So the TGF-β1 was positively correlated with the Co1lagen III. In the postmenopausal groups ,TGF-β₁ and Collagen I correlation coefficient r=0.817,P=0.000(P<0.05).So theTGF-β₁ was positively correlated with the Co1lagen I; TGF-β₁ and Collagen III correlation coefficient r=0.632,P=0.000(P<0.05),So the TGF-β1 was positively correlated with the Co1lagen III.Conclusion:1 In this study,we found that both the premenopausal and the postmenopausal women with POP With/without SUI had a significant decrease of Collagen I,III(P<0.05). This directly caused the Cardinal ligament of the uterus less supportive and unable to maintain the uterus in normal anatomic position, through this mechanism may be involved in the occurrence of PFD.2 Both the premenopausal and the postmenopausal women with POP With/without SUI had a significant decrease of TGF-β₁ (P<0.05).The decrease of TGF-β₁ was positively correlated to Collagen I,III.TGF-β₁ can increase the quality of the protein synthesis in transcription, transcription and translation level.The decrease of TGF-β₁ indirectly caused the connective tissue less tensile strength and more likely to prolapse and break,this may be an important reasonin the occurrence of PFD.