Eutopic/ectopic endometrial apoptosis initiated by bilateral uterine artery occlusion: A new therapeutic mechanism for uterus-sparing surgery in adenomyosis.
Eutopic/ectopic endometrial apoptosis initiated by bilateral uterine artery occlusion: A new therapeutic mechanism for uterus-sparing surgery in adenomyosis.
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DOI：
10.1371/journal.pone.0175511
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Cheng Z
中科院分区：
文献类型：
--
作者：
Chen L;Li C;Guo J;Luo N;Qu X;Kang L;Liu M;Cheng Z
本研究的目的是探讨子宫腺肌病患者行腹腔镜双侧子宫动脉阻断术（LUAO）前后在位和异位子宫内膜（埃厄/EE）中异位相关因子表达的差异。选取10例接受LUAO治疗的子宫腺肌病患者作为研究对象，分别于治疗前后取埃厄和EE组织，采用PT-PCR和Western blot检测埃厄和EE中凋亡相关分子的表达，并通过电镜观察线粒体结构的变化。将正常子宫内膜间质细胞（NESC）和子宫腺肌病患者的埃厄/EE间质细胞置于1%O2、5%CO2培养箱中培养，建立物理缺氧状态的体外间质细胞模型。在缺氧0、6、12、24和48 h观察缺氧相关分子的表达。结果显示，LUAO后及体外缺氧条件下，埃厄和EE中凋亡相关因子的表达均显著增加，提示短暂性缺血缺氧参与了子宫腺肌病病变的凋亡过程，子宫动脉阻断可通过细胞减灭作用在组织/细胞水平去除子宫腺肌病病变，从而达到有效治疗子宫腺肌病的目的。
The objective of the present study was to investigate differences in the expression of apoptosis-related factors in the eutopic and ectopic endometrium (EuE/EE) in women with adenomyosis before and after laparoscopic bilateral uterine artery occlusion (LUAO). Ten patients with uterine adenomyosis who received LUAO were selected as the research subjects, from whom EuE and EE tissues were obtained before and after LUAO and detected for the expression of apoptosis-related molecules in EuE and EE by PT-PCR and Western blot, and changes in the mitochondrial structure by electron microscopy. Normal endometrial stromal cells (NESC), and EuE/EE stromal cells in women with adenomyosis were cultured in a 1% O2, 5% CO2 incubator to establish a physical anoxia state in an in vitro stromal cell model. The expression of apoptosis-related molecules was observed at 0, 6, 12, 24 and 48h of hypoxic. The results showed that the expression of apoptosis-related factors in EuE and EE were increased significantly after LUAO and under hypoxic conditions in vitro, suggesting that transient ischemia and hypoxia were involved in the apoptosis of adenomysis lesions, and that uterine artery occlusion could remove adenomyosis lesions on tissue/cell level by cytoreduction, thus reaching the goal of treating adenomyosis effectively.