Analysis Of Gonadal Steroid Receptors In Cardinal Ligaments Of Patients With Pelvic Organ Prolapse

Pelvic Organ Prolapse(POP)is defined as the descent of the pelvic organ into the vagina and dysfunction,which mainly results from dysfunction of the pelvic floor muscles,ligaments and fascia.It mainly occurs in middle-aged women.Due to its diversified pathogenesis and complicated pathogenesis,it has brought great problems to many scholars.Studies at home and abroad have confined that with the increase of age,the incidence of POP and the degree of prolapse are gradually increasing,indicating that aging and decreased levels of sex hormones are important factors for POP.Sex hormones include estrogen,progesterone,and androgen,which exert biological effects by binding to specific receptors in their target tissues.Previous studies have shown that the expression of sex hormone receptors in pelvic floor tissue is closely related to the occurrence and development of pelvic organ prolapse,but its specific mechanism has not been clearly elucidated.Collagen is a major component of the extracellular matrix,and Collagen I(COL1)accounts for 80%~90% of total collagen,supporting pelvic floor tissue.Studies have shown that the content of collagen in the pelvic floor support structure of female POP patients is reduced and the structure is changed,suggesting that the loss of collagen or abnormal metabolism causes the pelvic floor support tissue to be weak,thus promoting the occurrence of POP.ObjectiveBy detecting the expressions of estrogen receptor alpha(ER?),estrogen receptor beta(ER?),progesterone receptors(PR),androgen receptors(AR)and collagen type I(COL1)in the cardinal ligament tissues of women with pelvic organ prolapse and controls and observing the changes of collagen fibers,we preliminarily explored their function and mechanism in POP,providing new ideas and theoretical basis for prevention and treatment of POP.Materials and methodsDuring the period of January 2017 to April 2018,19 patients who underwent vaginal hysterectomy with vaginal anterior(posterior)wall repair or pelvic floor reconstruction in the Third Affiliated Hospital of Zhengzhou University and 18 patients with High-Grade Squamous Intraepithelial Lesion or gynecological benign tumors underwent abdominal or laparoscopic hysterectomy in our hospital were divided into case group(n=19)and control group(n=18).The Cardinal ligament tissues of both sides were taken during hysterectomy.HE staining and Masson staining were performed.Immunohistochemistry was used to detect the localization and expression of ER?,ER?,PR and AR.Western-blot and RT-qPCR were used to detect protein and mRNA expression of ER?,ER?,PR,AR and COL1.SPSS 21.0 and Graphpad prism 6 software were used to analyze the data.The measurement data using t test,it is represented by?x±s.P<0.05 was considered statistically significant.Result1 The results showed more hypodensity,widen,irregular collagen fibers and smooth muscle in POP group.2 The collagen fibers were lightly stained,sparsely distributed,and arranged irregularly in POP group.3 ER? were found in the nuclei of smooth muscle cells and fibrocytes,while ER? were found in the cytoplasm of fibrocytes and vascular endothelial cells.PR were l found in the nuclei of fibrocytes,while AR were found in the cytoplasm of smooth muscle cells,fibrocytes,vascular endothelial cells.4 ER? mRNA expression in POP group was significantly higher,while PR and COL1 mRNA expressions were significantly lower(P<0.05).5 ER? and ER? protein expressions in POP group were significantly higher,while PR,AR and COL1 protein expressions were significantly lower(P<0.05).ConclusionThe expressions of ER? and ER? in the cardinal ligament tissues of POP patients were elevated,which may be related to the process of injury repair,and the expressions of PR,AR and COL1 were decreased,which may promote the occurrence and development of POP.