Neuroimmunomodulatory Alterations in Non-Lesional Peritoneum Close to Peritoneal Endometriosis
Neuroimmunomodulatory Alterations in Non-Lesional Peritoneum Close to Peritoneal Endometriosis
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DOI：
10.1159/000342163
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发表时间：
2013-01-01
影响因子：
2.4
通讯作者：
de Arellano, Maria Luisa Barcena
中科院分区：
文献类型：
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作者：
Arnold, Julia;Vercellino, Giuseppe Filiberto;de Arellano, Maria Luisa Barcena
目的：最近研究表明，腹膜子宫内膜异位病灶（pEL）中感觉神经纤维与交感神经纤维（NF）密度之比不平衡，并导致这样的假设：感觉促炎环境的优势是子宫内膜异位症疼痛的主要原因。因此，在子宫内膜异位症患者远端未受影响的腹膜中确定感觉和交感神经纤维的密度，以便能够检测未受影响的腹膜中可能的变化。研究方法：在连续pEL切片（n = 40）中，对来自非子宫内膜异位症患者（n = 15）的病变和匹配的未受影响的腹膜以及健康腹膜（HP）进行化学分析，以鉴定蛋白质基因产物9.5-、P物质和酪氨酸羟化酶阳性NF（分别为完整的、感觉的和交感神经NF）。此外，免疫细胞浸润的数量和神经生长因子（NGF）和白细胞介素（IL）-1 β在腹膜炎标本的神经中的表达进行了比较，在HP。结果如下：与HP和pEL相比，子宫内膜异位症患者的非病变、未受影响的腹膜中的总体NF密度显著降低，而感觉NF保持不变;与HP相比，交感神经NF密度显著降低，但仍高于接近pEL的密度。与HP相比，在远端未受影响的腹膜中，神经中的免疫细胞浸润以及NGF和IL-1 β表达显著升高。结论：在子宫内膜异位症患者的非病变、未受影响的腹膜中，NF密度的改变提示了对子宫内膜异位症的发展和子宫内膜异位症疼痛管理的新认识。版权所有（C）2012 S. Karger AG，巴塞尔
Objectives: An imbalance in the ratio of sensory to sympathetic nerve fibre (NF) density in peritoneal endometriotic lesions (pEL) has recently been demonstrated and leads to the assumption that this preponderance of the sensory proinflammatory milieu is a major cause of pain in endometriosis. Therefore, the density of sensory and sympathetic NFs was determined in distal unaffected peritoneum of endometriosis patients to be able to detect possible alterations in unaffected peritoneum. Methods: In serial pEL sections (n = 40), lesional and matching unaffected peritoneum as well as healthy peritoneum (HP) from patients without endometriosis (n = 15) were immunohistochemically analysed to identify protein gene product 9.5-, substance P-and tyrosine hydroxylase-positive NFs (intact, sensory and sympathetic NFs, respectively). In addition, the amount of immune cell infiltrates and the expression of nerve growth factor (NGF) and interleukin (IL)-1 beta in nerves of peritoneal endometriotic specimens were compared to those in the HP. Results: The overall NF density in the non-lesional, unaffected peritoneum of endometriosis patients is significantly reduced in comparison to both HP and pEL, while sensory NFs remain the same; the sympathetic NF density is significantly decreased compared to HP, but is still higher than the density close to the pEL. Immune cell infiltrates as well as NGF and IL-1 beta expression in nerves is significantly elevated in distal unaffected peritoneum in comparison to HP. Conclusion: The altered NF density in the non-lesional, unaffected peritoneum of endometriosis patients suggests new aspects in the understanding of the development of endometriosis and pain management in endometriosis. Copyright (C) 2012 S. Karger AG, Basel