Effect Of TGF-?1/Smad3 Pathway On Foreskin Lichen Sclerosus

Objective:To understand the pathologic morphological features of male genital LS.To assess the expression of transforming growth factor?1(TGF-?1)and Smad3,which are key factors in TGF-?1/Smad3 signaling pathway,in normal prepuce,foreskin lichen sclerosus(LS),urethral LS,urethral plate from hypospadias,and scar tissue from boys.The aim is to evaluate the role of TGF-?1/Smad3 signaling pathway in pathogenesis of foreskin LS in boys.Methods:Specimen of foreskin LS was retrieved in surgery from 8 boys,urethral LS from 6,scar from 6,normal foreskin from 8,and hypospadiac urethral plate from 6.Paraffin-embedded and HE stained slides were viewed for histopathologic evaluation.TGF-?1 and Smad3 expression was assessed via immunohistochemistry staining.Results:Boy's genitals LS pathological morphology characterized by excessive epidermal keratinization,base layer cell vacuoles degeneration,leather shallow occurrence oedema,collagen fiber ribbon homogenizing,elastic fibers decreased,and its lower part is mainly lymphocytes chronic inflammatory cell infiltration,infiltration with the sooner the nearer the skin represents the lesion degree;The average optical density and positive score of TGF-?1 were higher in scar group than those in normal foreskin,foreskin LS,urethral LS,and hypospadias urethral plate with statistical significance.No significance was noticed in these two indices among groups of normal foreskin,foreskin LS,urethral LS,and hypospadias urethral plate.Similar results of Smad3 expression was observed as higher average optical density and positive score were detected in scar group than those in the other groups,with no significance noticed among the other groups.Conclusion: The pathomorphology of male genital LS was consistent with the typical LS pathological morphological features reported in the literature;Expression of TGF-? 1 and Smad3 was not elevated in foreskin LS and urethral LS as significantly lower than those in scar group and not different from those in normal foreskin group.