Studies Of Relations Of The Expression Of OTR, ER And PR In Adenomyosis With Algomenorrhea

Adenomyosis,used to be call intrauterine endometriosis,is a kind of non-malignant disease charactering the invasion of endometrial glands and stroma into the myometrium. the mucosal invasion of other places is generally called extrauterine endometriosis. Recently, it's found that intrauterine endometriosis differs from extrauterine endometriosis in many aspects and therefore has been listed as an independent kind of uterine disease whose mechanism has not been fully clarified. Research results have shown that it might have something to do with prostaglandin,neuroendocrine hurmone,Zi body hormone,immune fator,pelvic conglutination and the place of endometriotic nodule. So far, there is no an effective cure. Short-term medication couldn't eradicate the root cause while long-term treatment would yield severe side-effect. For serious cases, patients have to undergo hysterectomy to alleviate pain, hampering women's life qualityOTR may have been involved in the origination and development process of pain symptoms of endometriosis by facilitating the release of PGF2a, inducing the increase of cytoplasm's calcium ion intensity, stimulating the contraction of smooth muscle and igniting over-contraction of uterus through phosphatidylinositol signal system in the cell. Then a great amount of fiber connector is secreted by activating macrophage to form adhesions and cause pain to adenomyosis patients. After the integration with receptor estrogen can alter the conduction gateway of destructive information stimulation, downsizing the mRNA level of opium-like receptor and facilitating the synthesis or restraining the decomposition of PGF2a. synthesis of PR and the transition process of ER compound in the nucleus are closely relevant, demonstrating a parallel relation in number, therefore, progestogens might have been coordinating in estrogen'role in this aspect.In this experiment, Immunohistochemistry is adopted to measure the OTR expression of AM and group for control in the endometrial in position and endometriotic lesion. The results show that there is no discrepancy of OTR expression in the proliferative and secretory phases of menstrual cycle illustrating that there is no periodic change of OTR expression in Adenomyosis tissue. We find that OTR expression of AM group in the endometrial in position and endometriotic lesion is clearly higher than that of group for control in the endometrial in position and the myometrium, OTR expression of AM dysmenorrhea group is clearly higher than that of group without dysmenorrhea, however, OTR expression of group without dysmenorrhea is only a little higher than that of group for control. The above facts show that dysmenorrhea of AM is strongly relevant to the OTR expression in AM tissue. The experiment also shows that OTR expression of AM in lesion tissue is clearly higher than that in the endometrial in position, illustrating that dysmenorrhea depends heavily on the intensity of OTR expression in lesion tissue. It's also found that the intensity of OTR expression in the endometrial in position and lesion tissue is proportional to the degree of pain. The discrepancy between any two groups is obvious other than that in the light and middle dysmenorrheal group. A comparison of OTR expression drawn among AM lesion tissue of no pain mild,mediate and severe group yields a result of P <0. 05, meaning there is clear discrepancy. These results further show that there exists a proportional relationship between the degree of dysmenorrhea groups and the intensity of OTR expression. We also find that OTR not only expresses in gland epithelioid cell, but also expresses in smooth muscle cell a medium expression not far from that in gland epithelioid cell. However, when compared with that in myometrium of group for control, clear discrepancy can be seen. The high intensity of OTR expression in smooth muscle cell close with lesion tissue may help estrogen to facilitate the secretion of PGF2αand contribute to the development of AM dysmenorrhea.Measuring results of ER and PR expression in the endometrial and myometrium of group for control and the endometrial in position and lesion tissue show that ER and PR appear in lesion and the nucleus of endometrial gland and stroma cell. Expression of ER and PR in the endometrial in position is higher than that in lesion and the endometrial of group for control, showing that lesion tissue differs from the endometrial in position. The low level of ER and PR expression indicates that the regulation in the dystopia endometrial is not as good as that in the endometrial in position, therefore leading to a immature growth of lesion tissue . the dystopia endometrial cell is a kind of basal layer intima, being immature and low susceptibility to endogenous hormone. This causes a imperfect secretion and a slower development than that in the endometrial in position in the same period. Lower level of ER and PR expression in lesion tissue leads to a low susceptibility to hormone and this may be a reason for bad reaction to treatment. Analysis of ER and PR expression in dysmenorrhea groups of different degrees and group without dysmenorrhea demonstrates that ER and PR expression in the endometrial in position of AM of dysmenorrhea groups is clearly higher than that in group without dysmenorrhea. In addition, ER and PR expression in severe dysmenorrhea group is higher than that in mediate,mild and no dysmenorrhea groups ; ER and PR expression increases with the seriousness of dysmenorrhea of AM, indicating that dysmenorrheal of AM has something to do with the intensity of ER and PR expression in lesion tissue of AM and dysmenorrheal is mainly relevant to the ER and PR expression in the endometrial in position of AM。There are also ER and PR expression surrounding smooth muscle cells which are positive at lesion tissue of AM, indicating a relationship between OTR expression and estrogen,progestogen adjustment, and gonadal hormone enhances OTR expression through corresponding acceptant body. OTR,ER and PR expression intensity is proportional to the degree of dysmenorrhea of AM with the three coordinating with each other. There is no clear discrepancy between OTR expression in the endometrial in position of AM at mediate and mild dysmenorrhea groups; ER expression in the endometrial in position of AM at mediate and mild dysmenorrhea groups; PR expression in the endometrial in position of AM at mediate and mild dysmenorrhea groups. These may be attributed to the following reasons: experiment sample collection; staining and explaining; subjectivity in evaluation of seriousness of pain and not enough sample cases. OTR and its signaltransforming channel are comprehensively involved in the growth of AM lesion and the occurrence of pain, therefore, they are playing an important role in multiple links of AM and relevant pain development. With a combination between ER,PR and their , OTR expression can be facilitated. The coordinative role among the three elements plays a very important role in the AM and relevant pain development.There is no concerning report so far at home and abroad. There are very few basic research report on pain of AM domestically, and therefore no formulary on how to evaluate or deal with it. In recent years, the conservative treatment for AM has become a hotspot, acceptant body medicine to block specificilly expression under painfulness is mainly chosen or else genetic instrument is adopted to block specificilly expression at a genetic level. The experiment shows that selectively OTR blocker could alleviate the pain caused by EM, laying a theory ground for medical treatment of AM.The final conclusions of the research are as the follows:1.There is no periodical change of OTR expression in the endometrial in position of AM. 2. Dysmenorrhea of AM is relevant to the intensity of OTR expression in tissue of AM, particularly to the intensity of OTR expression in lesion tissue of AM.3. Dysmenorrhea of AM is relevant to the intensity of ER and PR in tissue of AM, particularly to the intensity of ER and PR in the endometrial in position.4. OTR,ER and PR expression in the endometrial in position and lesion tissue show a feature of positive correlation and the coordination among the three elements may affect the occurrence and development of dysmenorrhea of AM.