Expression And Significance Of Human Leukocyte Antigen E In Adenomyosis

BackgroundAs a common gynecological benign disease,adenomyosis occurs mostly in childbearing age women,and often combined with endometriosis and uterine myoma.The pathology of adenomyosis is the endometrial glands and stroma are present in the myometrium.But the cause of adenomyosis is not yet clear.Most researchers believe that adenomyosis is a result of the myometrium's hypertrophy and hyoerplasia,caused by the endometrial basal cells migrate into the myometrium.The high risk factors of adenomyosis include multiple pregnancy or childbirth,abortion,cesarean section,endometrial inflammation,high estrogenemia and so on.The most common cl ini cal symptoms of adenomyosis have menstrual changes and progressive aggravated difficult menstruation.Gynecological examination can found enlarged,hardened uterus.And the patients often feel painful when the pathological uterus be touched.The most commom pain caused by adenomyosis is progressively aggravated dysmenorrhea,and some patients may even have sexual intercourse pain and infertility,but about 35%of patients without any clinical symptoms.The diagnosis of adenomyosis is mainly based on the clinical symptoms and signs.Besides,imaging methods can be used as a reference.But the definite diagnosis depends on pathological examination.In recent years,with the in-depth study of the etiology of adenomyosis,a large amount of literature at home and abroad show that abnormal immune function which leads to the body can not clear heterotopic endometrium,has a certain relevance with the incidence of this disease.The human leukocyte antigen(HLA)gene is located on the short arm of chromosome 6,in which HLA-1 molecules are divided into classical HLA-I molecules(including HLA-A,HLA-B,HLA-C)and non-classical HLA-I molecules(Including HLA-E,HLA-F,HLA-G and so on).As a nonclassical HLA-I molecule,the human leukocyte antigen-E(HLA-E)has characteristic of non-polymorphism and conservatism.The significance of the expression of HLA-E protein in normal tissue cells is not yet clear.In recent years,more and more laboratory and clinical studies have confirmed that the up-regulation of HLA-E protein expression is involved in the immunological changes during the development of tumor.Meanwhile,the relation between HLA-E protein and adenomyosis is researched rarely.Therefore,this study-aims to investigate the expression of HLA-E protein in adenomyosis,and to study its expression level and clinical value.ObjectiveThe expression of HLA-E protein in ectopic and eutopic endometrium and soluble human leukocyte antigen E(sHLA-E)protein of patients with adenomyosis were measured.The measurement results were compared with the expression level of healthy population.To analyze the differences in expression,we investigated the significance of HLA-E protein expression in the development and progression of adenomyosis in immune tolerance,and evalued the scientific and clinical significance.MethodsThe immunohistochemical staining technique was used to detect HLA-E protein in ectopic and eutopic endometrium of patients with adenomyosis and normal endometrium of healthy population.The expression of HLA-E protein was evaluated by H-score scoring method.And the expression of sHLA-E in the serum was measured by enzyme Jinked immunosorbent assay(ELISA).Finally,the results of the above two steps were analyzed using IBM SPSS Statistics 22 software.Results1.Immunohistochemical staining resultsThe expression of HLA-E protein in tissue cells is mainly located in the cytoplasm and cell membrane.In the normal endometrial tissue,HLA-E protein almost no expression.In patients with adenomyosis,HLA-E protein was highly expressed in ectopic and eutopic endometrial gland epithelial cells,but there was a significant difference between the two groups(p<0.01).And the expression of HLA-E in ectopic endometrial glandular epithelium of adenomyosis was higher than that in normal endometrial glandular epithelial cells(p<0.01).Meanwhile,the expression level of HLA-E in eutopic endometrial glandular epithelial cells of adenomyosis was significantly higher than that in the normal endometrium(p<0.01),and the difference was statistically significant(p<0.01)2.The ELISA resultsCompared with the group of normal endometrium,the expression of sHLA-E protein in the serum of patients with adenomyosis showed a high level.And the difference of sHLA protein expression between the two groups was statistically significant(p<0.01).After received excision of uterine body and metroplasty,there is a significant decline on the expression of sHLA-E in serum of adenomyosis(p<0.01).ConclusionsThrough the two parts experimental results,it was confirmed that the expression of HLA-E protein in the endometrial glandular epithelium cells and serum of the patients with adenomyosis are unusually high.And the up-regulation of HLA-E expression could lead to abnormal immunological changes.Thus we speculated that the high expression of HLA-E protein may part icipate in the occurrence of adenomyosis,by means of the immunosuppression against ectopic endometrium of adenomyosis.