Expression of L-selectin ligand MECA-79 as a predictive marker of human uterine receptivity
Expression of L-selectin ligand MECA-79 as a predictive marker of human uterine receptivity
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DOI：
10.1007/s10815-007-9151-8
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发表时间：
2007-07-01
影响因子：
3.1
通讯作者：
Prakobphol, Akraporn
中科院分区：
文献类型：
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作者：
Foulk, Russell A.;Zdravkovic, Tamara;Prakobphol, Akraporn
反复植入失败(RIF)的问题患者代表了患有不明原因不孕症的夫妇的一个亚群。人胚泡利用L-选择素与子宫内膜表面糖蛋白上的寡糖部分组成的配体结合，从而启动着床。方法采用免疫组织化学方法检测20例育龄妇女和20例复发性着床失败患者血清中L选择素配体的表达。于排卵后第6天取子宫内膜活检标本。在固定后，根据诺伊斯的说法确定他们的日期。用针对L选择素配体的MECA-79抗体进行免疫定位。结果生育组均检测到L选择素配体。在那些患有RIF的人中，有5人的配体呈阴性，尽管平均连续移植了5次胚胎，但从未怀孕。15例肾间质纤维化患者L-选择素配体阳性，其中10例随后受孕。作为缺乏该配体的RIF患者的筛查试验，其预测价值为100%，敏感性为50%，特异性为100%。阳性预测值为100%，阴性预测值为87%。结论L-选择素及其配体在早期人类植入中起重要作用。筛选配体缺失可能有助于许多RIF患者避免重复失败的治疗周期。
Problem Patients with repeated implantation failure (RIF) represent a subgroup of couples who suffer from unexplained infertility. Human blastocysts utilize L-selectin to initiate implantation by binding to endometrial ligands composed of oligosaccharide moieties on the surface glycoproteins. The absence of these ligands could lead to recurrent implantation failure (RIF) in some of these couples.Methods Twenty fertile women and 20 patients with RIF were tested for the presence of the L-selectin ligands by immunohistochemistry. Endometrial biopsies were obtained on the sixth day post ovulation. After fixation, they were dated according to Noyes. Immunolocalization was performed using the MECA-79 antibody which is directed against ligands of L-selectin.Results The fertile group all showed the presence of the L-selectin ligand. Of those with RIF, five were negative for the ligand and never, despite an average of five successive embryo transfers, became pregnant. Fifteen RIF patients were positive for the L-selectin ligand, of whom ten subsequently conceived. As a screening test for RIF patients who lack the ligand, the predictive value was 100% with a sensitivity of 50% and specificity of 100%. The positive predictive value was 100% and negative predictive value is 87%.Conclusions L-selectin and its ligands play a vital role for early human implantation. Screening for the absence of the ligand may help many patients with RIF to avoid undergoing repeated failed treatment cycles.