The Significance Of Monocyte Chemoattractant Protein-1and Stromal Cell Derived Factor-1in Adenomyosis

Objective:To investigate the role of monocyte chemoattractant protein-1(MCP-1) in the pathogenesis of adenomyosis.Methods:MCP-1was detected by immunohistochemistry and Real-Time PCR in eutopic endometrium,ectopic endometrium and surrounding the lesion tissue of36adenomyosis cases,and compared with the corresponding controls.Results:1.Expression of MCP-1protein:MCP-1protein expression in adenomyosis ectopic lesions was significantly higher than that in eutopic endometrium and control endometrium (P<0.05); MCP-1protein expression in eutopic endometrium was significantly higher than that in control endometrium (P<0.05); MCP-1protein expression in various subgroups within the proliferative and secretory phase were not statistically different (P>0.05).Correlation analysis showed that MCP-1protein expression in eutopic endometrium and ectopic lesions have significant correlation (r=0.87, P<0.05).2.MCP-1mRNA content comparison:MCP-1mRNA content in adenomyosis group of eutopic endometrium, surrounding the lesion tissue and ectopic lesion tissue were higher than that in the corresponding controls,the differences have statistical significance (P<0.05);Adenomyosis ectopic lesions compared with eutopic endometrium and the lesion of the peripheral tissues, MCP-1mRNA content remarkably increased (P<0.05);MCP-1content in eutopic endometrium, lesions in the peripheral tissues and ectopic lesions showed increasing trend.Whether in eutopic endometrium and control endometrium,MCP-1content of proliferative and secretory phase were not statistically significant (P>0.05).Linear correlation analysis showed that MCP-1mRNA content in eutopic endometrial lesions and surrounding tissues,eutopic endometrium and ectopic lesions,lesions in the peripheral tissues and ectopic lesions have significant correlation (P<0.05). Conclusions:1. MCP-1is involved in the pathogenesis of adenomyosis;2. MCP-1may change the local microenvironment of immune state in the pathogenesis of adenomyosis;3. The detection of MCP-1content in eutopic endometrium may contribute to the early diagnosis of adenomyosis;4. Provide molecular evidence for adenomyosis recurrence after conservative operation. Adenomyosis after conservative operation should combined with drug therapy. Objective:To investigate the chemotactic factor CXCL12,namely the stromal cell derived factor1(SDF-1) in the pathogenesis of uterine adenomyosis.Methods:Using immunohistochemical method and Real-Time PCR assay for detection of CXCL12content in eutopic endometrium,ectopic endometrium and surrounding the lesion tissues of36cases of uterine adenomyosis,and compared with the corresponding control groups.Results:1. CXCL12protein expression:CXCL12protein expression in adenomyosis ectopic lesions was significantly higher than that in eutopic endometrium and control endometrium (P<0.05),eutopic endometrium was significantly higher than that in control endometrium (P<0.05).CXCL12protein expression in various subgroups within the proliferative and secretory phase were not statistically different (P>0.05).Correlation analysis showed that CXCL12protein expression in eutopic endometrium and ectopic lesions have significant correlation (r=0.78, P<0.05).2. CXCL12mRNA content:CXCL12mRNA content in adenomyosis group of eutopic endometrium, surrounding the lesion tissue and ectopic lesion tissue were higher than that in the corresponding controls,the differences have statistical significance (P<0.05);Adenomyosis ectopic lesion tissue compared with eutopic endometrium and the lesion of the peripheral tissues,CXCL12mRNA content remarkably increased(P<0.05);The content of CXCL12mRNA in eutopic endometrium lesions,in the peripheral tissues and ectopic lesions showed increasing trend.Whether in the eutopic endometrium or in control endometrium, CXCL12mRNA content in proliferative phase were higher than that in the secretory phase,but showed no significant difference (P>0.05).Linear correlation analysis showed that the CXCLI2mRNA content in eutopic endometrium and lesions in the peripheral tissues,eutopic endometrium and ectopic lesions,lesions in the peripheral tissues and ectopic lesions have significant correlation (P<0.05).3. MCP-1and CXCL12correlation analysis:MCP-1and CXCL12protein expression in eutopic endometrium and ectopic foci were significantly correlated(reutopic endometrium=0.486,p<0.05; rectopic foci=0.612,p<0.05);MCP-1mRNA and CXCL12mRNA content in eutopic endometrium,surrounding the lesion tissue and ectopic foci showed significant correlation (reutopic endometrium=0.493, p<0.05; rsurrounding the lesion tissue=0.439, p<0.05; rectopic foci=0.520, p<0.05).Conclusion:1.CXCL12is involved in the pathogenesis of adenomyosis;2.CXCL12may be through dissolve local extracellular matrix,promote local microvessel formation, participate the pathogenesis of adenomyosis;3.The detection of CXCL12content in eutopic endometrium may contribute to the early diagnosis of adenomyosis;4.Provide molecular evidence for adenomyosis recurrence after conservative operation. Adenomyosis after conservative operation should combined with drug therapy;5.MCP-1and CXCL12have synergistic effect during the pathogenesis of adenomyosis;6. Chemotactic factor CXCL12and its receptor CXCR4may become a very meaningful targets for adenomyosis treatment, which need further research. Objective:To investigate the prevention role of mifepristone on pathogenesis of uterine adenomyosis.Methods:Using immunohistochemical method and Real-Time PCR assay for detection of MCP-1and CXCL12content in the uterus endometrial tissue of30patients with adenomyosis after taking mifepristone, and compared with that before taking mifepristone.Results:MCP-1, CXCL12protein expression and mRNA content in endometrial tissue of patients with adenomyosis after mifepristone treatment were lower than that before treatment(P<0.05).Conclusion:1.Mifepristone inhibits MCP-1and CXCL12expression in adenomyosis eutopic endometrial tissue;2.Mifepristone may prevent uterine adenomyosis by inhibiting some cytokine synthesis and release associated with adenomyosis in the eutopic endometrial tissue;3.Taking mifepristone with little dosage, short course (10mg/day,30consecutive days) after injury of the endometrium may prevent the occurrence of uterine adenomyosis, its clinical effect still needs further study;4.Adenomyosis after conservative operation can be supplemented with mifepristone to prevent recurrence, the specific dosage and duration of medication needs further clinical studies.