The Implications Of Expressions Of COX2/PGE2 In Uterosacral Ligaments With Pelvic Organ Prolapse

Objective: To examine the expression of COX2/PGE2 in uterosacral ligaments with POP,and analyze its relationship with collagen metabolism and clinical characteristics,speculating its role in the development of POP and providing a theoretical basis for the treatment of POP.Pelvic organ prolapse(POP)is a disease about weakening pelvic floor support tissue caused by various reasons,leading to abnormal position and function of the organs.The studied risk factors include the number of vaginal delivery,age,and increased chronic abdominal pressure and other related factors.In recent years,the studies on the risk factors of pelvic organ prolapse have important significance for its etiology,but its pathogenesis has not been clearly explained.POP not only seriously affects female psychological and social activities,but brings great social and economic pressure to individuals.Therefore,the study of its pathogenesis contributes to the prevention and treatment of pelvic organ prolapse.We refer to the state of stress or dysfunction of the tissue as para-inflammation.POP is also a disease in which the pelvic floor tissue fails to meet the requirements and becomes dysfunctional after long-term stress.So it can be considered to have para-inflammation.COX2 and PGE2 are important inflammatory factors,and the COX2/PGE2 signal pathway can also sense stress stimulation signals.At the same time,studies have shown that COX2/PGE2 plays an important role in the formation of collagen fibers,and also affects collagen metabolism related to the changes factors,such as matrix metalloproteinases(MMPs)and tissue inhibitor of metalloproteinases(TIMPs).As a result,COX2 and PGE2 are main objective proteins in our study.Methods: 1.Collect uterosacral ligament tissues close to the cervix in the abandoned tissue of patients undergoing hysterectomy at Shengjing Hospital of China Medical University from January 2016 to March 2018.There were 41 patients in the control group and 40 patients in the POP group with stage III or IV.2.After the collected tissue samples were processed,the expressions of COX2 and PGE2 were detected by immunohistochemistry and Western-blot methods in two groups.Analyze the relation between them with the expressions of COLI and COLIII.According to the senescence of tissue by expression of p16,decide whether there were different expressions of COX2 and PGE2 of various ages.Analyze the relationship between the amount and the general characteristics of the patient,such as age,BMI,and number of vaginal delivery.3.The experimental data were analyzed by SPSS23.0 software.The results of immunohistochemistry were analyzed by cc2 test and Spearman correlation analysis.The results of Western-blot were analyzed by t test and Pearson correlation.P<0.05 was considered statistically significant.Results: 1.The expression levels of COX2 and PGE2 in the POP group were higher than those in the control group.COX2 is positively correlated with PGE2 expression.2.The expression levels of COLI and COLIII in POP group were lower than those in control group,and negatively correlated with COX2 and PGE2 expression.3.The expression levels of COX2 and PGE2 in tissues of patients aged 60 years or older were not significantly different from those in <60 years old group.The expression levels of COLI and COLIII in tissues of patients aged 60 years or older were lower than those in the <60 years old group.The expression level of p16 in tissues of patients ≥60 years old was higher than that of <60 years old group.4.The expression levels of COX2 and PGE2 in patients with BMI≥24 were not significantly different from those in BMI<24 group.5.There was no significant difference of expression levels of COX2 and PGE2,between vaginal delivery ≥ 3 times group and <3 times group.Conclusion: COX2/PGE2 is highly expressed in POP tissues and participates in the metabolism of type I and type III collagen fibers.It has no obvious relationship with age,BMI or parity factors,which may indicate the correlation between the occurrence of POP and the increase of inflammatory factors after tissue injury.It can provide new ideas for the future development mechanism of POP.