Effect Of GnRHa On Release Of VEGF And TNF-α In Cultured Endometrial Cell From Patients With Adenomyosis

Objective1. To detect the release of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α(TNF-α) in the in-vitro eutopic endometrial cell of adenomyosis and the control normal endometrial cell.And investigate the role of these two cytokine in the pathogenesis of adenomyosis.2. To investigate the effect of Gonadotropin-realeasing hormone agonist (GnRHa) on the release of TNF-αand VEGF in the in-vitro eutopic endometrial cell of adenomyosis.Materials and methods1. SamplesThe endometrium from 20 patients who had undergone hysterectomy for adenomyosis in our department were experimental group, whose patho-result showed that theirs endometrium were in the secretory phase. The normal endometrium from 16 patients who had undergone oophorocystectomy for benign epithelial ovarian tumor were control group, which excluded the patients who combined adenomyosis,endometriosis and hysteromyoma. We gave them the uterine curetlage and took their endometrium before the operation. The patho-result showed that theirs endometrium were normal and were in the secretory phase. All the samples were diagnosed by pathology. No hormone was used within 3 months and no other case history as endocrine,immunological,metabolic diseases in all patients.All the patients we have chosed were no different in the age,pregnant history and intracavity operational history.The endometrium were in the secretory phase at the time of operation according to the last menstrual period of the patients.2. MethodsColleted endometrial cell were cultured with Triptorelin as GnRHa for 72h in the concentration of 10-7mol/L and 10-5mol/L. TNF-αand VEGF concentrations in culture supernatant were detected by commercial enzyme-linked immunosorbent assay (ELISA).3. Statistics analysisData were recorded as x±S. The results were analyzed by Student's t-test for independent means in the group comparison,and by analysis of variance (ANOVA) in the in-group comparision with SPSS13.0 statistical software.The relation of VEGF and TNF-αwas analyzed by Pearson correlation analysis. P values of less than 0.05 were considered as statistical significance.Results1. Both the eutopic endometrial cell of adenomyosis and the normal endometrium can release the cytokines of VEGF,TNF-α. The release levels were significantly higher in the eutopic endometrium cell than in the normal endometrium. The differences between each group were significant(P<0.05).2. In the eutopic endometrium group, according to the relative analysis, the correlation coefficient of VEGF and TNF-αwas r=0.814, P<0.05.3. The release of VEGF,TNF-αin the eutopic endometrial cell of adenomyosis and normal endometrium was downregulated by GnRHa in cultures in a dose-dependent manner.4. There was no significant difference between the depressant effect of GnRHa to the release of VEGF,TNF-αin the eutopic endometrial cell of adenomyosis and to the normal endometrium (P <0.05). Conclusions1. The increased release of VEGF,TNF-αin ectopic endometrium cell from patients with adenomyosis may play an important role in the genesis and development of adenomyosis.2. GnRHa appear to have a direct effect in endometrim cell.It can suppress the survival and growth of ectopic endometrial by decreasing the release of VEGF,TNF-αwhich relate to the adenomyosis angiogenesis.3. The difference in the release of VEGF,TNF-αbetween the eutopic endometrium cell of adenomyosis and the normal endometrium cell suggests that there are distinctions in the molecular and physiological characteristics between them, which provide experimental evidences for the original therapy.4. The expression of VEGF has a high correlation with the expression of TNF-α,which suggests that they could promote the development of adenomyosis Together. Therefore, they may become the new factor to the early diagnosis and therapy of adenomyosis.