Expressions Of Elastin, Lysyl Oxidase And Elafin In The Cardinal Ligament Of Women With Pelvic Organ Prolapse

[Objective] To investigate the Elastin, lysyl oxidase (LOX) and Elafinexpression in cardinal ligament of women with pelvic organ prolapse (POP) so as to determine the alteration that contributes to POP.[Methods] The cardinal ligament samples were obtained from 60 POPsubjects and 60 non-POP control women underwent hysterectomy. Women with a history of connective tissue disorders were excluded. We selected only tissue samples from participants in the proliferative phase of menses for this study. Menstrual phase was confirmed by endometrial histology. Reverse transcription polymerase chain reaction (RT-PCR) was used to verify the mRNA level of Elastin, LOX and Elafin. The protein concentration of the three genes was determined by Western blotting technique, electrophoretic separation and quantification.[ Results ] In all patiens, the POP group demonstrated a significant decreaseof expressions of Elastin and LOX in cardinal ligament than control group (P<0.05). There was an identical tendency in protein level of these two genes (P<0.05). In the POP group, the expressions of Elastin and LOX was significantly lower in postmenopausal patients than premenopausal patients(P<0.05). Inversely, the POP group demonstrated increase expression of Elafin than control group both in premenopausal and postmenopausal group (P<0.05). There was no significantly difference in the expression of Elafin between premenopausal POP group and postmenopausal group (P>0.05). There was a positive correlation between Elastin and LOX expressions in the two groups (P<0.05), but there was no correlation between Elastin and Elafin expressions (P>0.05).[Conclusions] The present results suggest that, in POP patients, thedecrease expressions of Elastin and LOX in the cardinal ligaments may influence the formation of elastic fiber, destroy the metabolism and cross-linking of collagen and elastin, the increase expression of Elafin may interference the decomposition of aged elastin, all of these can reduce the stability of connective tissue of pelvic floor which leads to the development of POP. In addition, the low expression of estrogen in postmenopausal women may indirectly contribute to this process through influenceing the expression of LOX.