Imbalance between sympathetic and sensory innervation in peritoneal endometriosis
Imbalance between sympathetic and sensory innervation in peritoneal endometriosis
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DOI：
10.1016/j.bbi.2011.08.004
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发表时间：
2012-01-01
影响因子：
15.1
通讯作者：
Mechsner, Sylvia
中科院分区：
文献类型：
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作者：
Arnold, Julia;de Arellano, Maria L. Barcena;Mechsner, Sylvia
为了探讨腹膜子宫内膜异位症患者疼痛病理生理的可能机制，我们对子宫内膜异位症患者的感觉和交感神经纤维发芽进行了临床研究。对腹膜病变（n = 40）和健康腹膜（n = 12）进行免疫染色，分别用抗蛋白基因产物9.5 （PGP 9.5）、抗P物质（SP）和抗酪氨酸羟化酶（TH）、完整神经纤维、感觉神经纤维和交感神经纤维特异性标志物进行分析，确定交感神经纤维和感觉神经纤维的比例。此外，我们还分析了免疫细胞在腹膜子宫内膜异位症病变中的浸润情况，神经生长因子（NGF）和白细胞介素(IL)-1 β的表达与神经纤维密度的相关性。子宫内膜异位症患者（n = 40）和无子宫内膜异位症患者（n = 20）的腹膜液用于体外神经元生长试验。用抗生长相关蛋白43 （anti-GAP 43）、抗sp和抗th染色培养鸡背根神经节（DRG）和交感神经节。与健康腹膜相比，我们可以检测到腹膜病变的感觉神经纤维密度增加而交感神经纤维密度减少。与无子宫内膜异位症患者相比，子宫内膜异位症患者的腹膜液诱导DRG感觉神经突的萌发增加，交感神经节神经突的生长减少。总之，本研究表明，在腹膜子宫内膜异位症中，交感神经纤维和感觉神经纤维之间存在不平衡，以及子宫内膜异位症患者的腹膜液对交感神经和感觉神经的调节改变，这可能直接参与炎症和疼痛的维持。(C) 2011爱思唯尔公司版权所有。
To investigate possible mechanisms of pain pathophysiology in patients with peritoneal endometriosis, a clinical study on sensory and sympathetic nerve fibre sprouting in endometriosis was performed.Peritoneal lesions (n = 40) and healthy peritoneum (n = 12) were immunostained and analysed with anti-protein gene product 9.5 (PGP 9.5), anti-substance P (SP) and anti-tyrosine hydroxylase (TH), specific markers for intact nerve fibres, sensory nerve fibres and sympathetic nerve fibres, respectively, to identify the ratio of sympathetic and sensory nerve fibres. In addition, immune cell infiltrates in peritoneal endometriotic lesions were analysed and the nerve growth factor (NGF) and interleukin (IL)-1 beta expression was correlate with the nerve fibre density.Peritoneal fluids from patients with endometriosis (n = 40) and without endometriosis (n = 20) were used for the in vitro neuronal growth assay. Cultured chicken dorsal root ganglia (DRG) and sympathetic ganglia were stained with anti-growth associated protein 43 (anti-GAP 43), anti-SP and anti-TH.We could detect an increased sensory and decreased sympathetic nerve fibres density in peritoneal lesions compared to healthy peritoneum. Peritoneal fluids of patients with endometriosis compared to patients without endometriosis induced an increased sprouting of sensory neurites from DRG and decreased neurite outgrowth from sympathetic ganglia.In conclusion, this study demonstrates an imbalance between sympathetic and sensory nerve fibres in peritoneal endometriosis, as well as an altered modulation of peritoneal fluids from patients with endometriosis on sympathetic and sensory innervation which might directly be involved in the maintenance of inflammation and pain. (C) 2011 Elsevier Inc. All rights reserved.