The MRNA Expressions Of Cathepsin B And Cystatin C In Vaginal Anterior Wall Tissue From Patients With Pelvic Floor Dysfunction

Objective This study was conducted to evaluate the probable effects of cathepsin B(CB)and cystatin C(CC)on pathogenesis of pelvic floor dysfunction (PFD)by investigating the mRNA expressions of CB and CC in vaginal anterior wall fascia tissue from the patients with pelvic organ prolapse(POP)and stress urinary incontinence(SUI).Methods Transvaginal biopsy specimens were collected from the vaginal anterior wall fascia tissue of POP,SUI,both POP and SUI patients and comparable controls.Seventy-six women participated in the study and they were divided into eight groups as follow:7 premenopausal patients with POP(group 1),11 menopausal patients with POP(group 2),9 premenopausal patients with SUI(group 3),7 menopausal patients with SUI(group 4),8 premenopausal patients with either POP and SU(group 5)I,9 menopausal patients with either POP and SUI(group 6),13 premenopausal patients without neither SUI nor POP(group 7),12 postmenopausal patients without neither SUI nor POP(group 8).The real-time fluorescent quantitative reverse transcription-polymerase chain reaction(FQ-RT-PCR)technique was applied to detect the mRNA expressions of CB and CC in vaginal anterior wall fascia tissue. Results The results showed that the mRNA expressions of CB were significantly increased,while that of CC were decreased both in premenopause and menopause POP groups,SUI groups and both POP and SUI groups,as compared with that of controls(P＜0.05).The mRNA expressions of CB was 29%,31%,and 26%higher in the premenopausal women with POP,SUI,and both POP and SUI,separately, compared to the premenopausal controls.The mRNA expressions of CB was 47%, 50%,and 58%higher in the menopausal women with POP,SUI,and both POP and SUI,separately,compared to the menopausal controls.The mRNA expressions of CC was 26%,24%,and 27%lower in the premenopausal women with POP,SUI,and both POP and SUI,separately,compared to the premenopausal controls.The mRNA expressions of CC was 22%,18%,and 19%lower in the menopausal women with POP,SUI,and either POP and SUI,separately,compared to the menopausal controls.There were no significant differences of the mRNA expressions of CB and CC between POP groups,SUI groups or either POP and SUI groups pre- and postmenopause(P＞0.05).The mRNA expressions of CB were significantly increased, while that of CC were decreased in the stagesⅢgroup premenopause,compared with that in the stageⅡgroup(P＜0.01).The mRNA expressions of CB were significantly increased,while those of CC were decreased in the stagesⅢand stageⅣgroup in menopause,compared with that in the stageⅡgroup(P＜0.05).There was no significant differences in the mRNA expressions of CB or CC between stagesⅢand stageⅣgroup menopause(P＞0.05).There were no significant differences in the mRNA expressions of CB or CC among all types of SUI premenopause and menopause.Conclusion In this study,we found that both the premenopausal and the postmenopausal women with POP had a significant more mRNA expression of CB in the vaginal anterior wall fascia tissue and that the expression of CCis significantly reduced,suggesting that CB and its inhibitory CC might be incolved in the pathogenesis of POP by increasing the degradation of extracellular matrix.The disturbance expressions of CB and CC might result in the occurrence of POP.In this study,we found that both the premenopausal and the postmenopausal women with SUI had a significant more mRNA expression of CB in the vaginal anterior wall fascia tissue and that the expression of CC is significantly reduced, suggesting that CB and its inhibitory CC might be incolved in the pathogenesis of POP by increasing the degradation of extracellular matrix.The disturbance expressions of CB and CC might lead to the occurrence of SUI.In this study,we also found that both the premenopausal and the postmenopausal women with POP,SUI and both POP and SUI had no significant differences of the mRNA expression of CB and CC in the vaginal anterior wall fascia tissue,suggesting that POP might not be the reason that aggravate the grade of SUI.The effects of CB and CC to the occurrences of POP and SUI might be no differences.Both the premenopausal and the postmenopausal women with different types of SUI had no significant differences of the mRNA expression of CB and CC in the vaginal anterior wall fascia tissue,suggesting that CB and CC might not be the reason for the different types of SUI.