| Objective:1.To determine the effect of 17β-estradiol(17β-E2)On the proliferation and elastin mRNA expression level of the vaginal wall fibroblasts2.To determine the effect of the 17β-estradiol on the proliferation and elastin mRNA expression level of the vaginal wall fibroblasts after the stress3.To analysis the role of estrogen replacement on the PFD4.To analysis the changes of the vaginal wall fibroblasts of the PFD patients under the effect of stress ,and the role of the changes on pathogenesy of the PFDMaterials and Methods:The 12 PFD patients admitted to surgical treatment for PFD are Selecting from The Second Hospital of HeBei Medical University during 2009.10-2010.09.The prolapse of All the patients were scored according to the International Continence Society Pelvic Organ Prolapse (POP-Q) Classification that at least a part of prolapse was III,Ⅳ.There are 5 patients with uterine prolapse combined anterior vaginal wall prolapse, 3 patients with uterine prolapse combined posterior vaginal wall prolapse,4 patients with uterine prolapse combined anterior and posterior wall vaginal prolapse. There are 9 women with POP and 3 women with POP incorporated SUI. The age of the patients were between 47-59 years old,and the average age of the patients wer(e53.17±4.20)years old,Delivery times wer(e3.67±1.23),body mass index were(23.78±1.90).All the patients had been excluded connective tissue diseases such as respiratory system,cardiovascular system and the cutis diseases,and all of them were not taking estrogen drugs before the surgery in 3 months. Getting the vaginal wall organization during the surgery,and the fibroblasts were primary cultured in vitro.The fibroblasts were applied with stretch with Flexcercell 4000 tensile stress loading system . And reverse transcription polymerase chain reaction(RT-PCR)was used to verify the mRNA levels of Elastin. The fibroblasts after stretch were cultured with different concentrations of 17β-estradiol,and then the mRNA levels of Elastin were verified. The fibroblasts before and after stretch were cultured with different concentrations of 17β-estradiol ,and the proliferative rates were measured by MTT assay and were compared.Results:1. In vitro, the mRNA level of elastin of fibroblasts after stretch was 0.4960±0.1928; the mRNA level of elastin of fibroblasts before stretch was 0.1862±0.0848.The level after stretch was higher(P﹤0.05).There was a promotion effect for stretch on the level of on Elastin mRNA of the fibroblasts of vaginal wall;2.In vitro ,the proliferation rates of the fibroblasts which were aadded a final concentrations of 1×10-4mol/L,1×10-6mol/L,1×10-8mol/L,1×10-10mol/L17β-estradiol were 0.54,0.38,0.38,0.23;after stretch the fibroblasts were added the same concentrations of 17β-estradiol to the before,and the proliferation rates of them were 0.17,0.10,0.07,0.06 and were lower then the fibroblasts before stretch.Comparing two sets of data showed that different concentrations of estrogen on the proliferation of vaginal wall fibroblasts were significantly different, P =0.02 < 0.05,and with the increasing of drug concentration, the proliferation rates increased,in which the 1×10-4mol / L group had the maximum rate of cell proliferation;The proliferations of the vaginal wall fibroblasts were significantly different ingroups with stretch and without stretch , P <0.01, it was statistically significant.3. In vitro,the mRNA level of elastin of fibroblasts with estrogen after stretch was 6437±0.1100,it was higher than the fibroblasts without estrogen after stretch(P﹤0.05).It showed that there was a promotion effect for estrogen on the level of on Elastin mRNA of the fibroblasts of vaginal wall. Conclusion:1.The growth direction of vaginal wall fibroblasts after stretch is the same to the force direction,and the fibroblasts become narrower and longer;2.The mRNA level of elastin of fibroblasts after stretch is higher than the level before stretch. It shows that there is a promotion effect for stretch on the level of on Elastin mRNA .The fibroblasts respond to stretch, and against the role of force to prevent the occurrence of prolapse by increasing the synthesis and secretion of elastin;3. The mRNA level of elastin of fibroblasts after stretch is higher than the level before stretch.It shows that there is a synergistic effect for estrogen to fibroblasts to against stretch.
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