The Study On The Mechanism Of Regulating The VEGF/Akt Pathway In Endometrium Of The Obese PCOS Female Rats With Kidney-nourishing And Phlegm-removing Method

Objective:To observe the effects of kidney-tonifying and phlegm-resolving method(KNPR)through the VEGF/Akt signaling pathway on the endometrium of the obese polycystic ovary synd rome(PCOS)model rats and preliminarily discuss the mechanism of KNPR in regulating the obese PCOS endometrium.Methods:A total of 123 female rats with SPF grade SD were selected at the age of 7 to 8 w eeks.Vaginal smear was used to screen 120 female rats with normal estrus cycle.Twenty rats were randomly reserved as the blank control group,and the remaining rats were given letrozole combined with high-fat emulsion for 28 days to establish the obese PCOS ani mal model.The successful model rats were selected and randomly divided into model control group,low,medium,high and metformin dose group according to the ratio of 1:1:1:1:1.The low,medium and high dose groups were given the same volume of the corresponding concentration of traditional Chinese medicine,the metformin group was given equalvolume metformin suspension,and the blank group was given the same volume of distilled water.Weight growth rate was calculated after 21 days of TCM intervention,ovarian tissue was taken for HE staining in pathological sections,Serum sex hormone PROG and T levels and VEGF levels in uterine homogenate were detected by ELISA,the expressions of ER,PR and VEGFR-2 in uterine tissues were detected by immunohistochemical method,and the levels of p-PDK1 and p-Akt levels in uterine tissues were detected by Western blotting method.the data was processed by SPSS25.0 statistical software.Results:1.Effect of KNPR on the growth rate of body weight of the obese PCOS rats: com pared with the blank control group,the growth rate of female body weight in the model control group was higher(P<0.05).Compared with the model control group,the growth rate of body weight in the high-dose,medium-dose and positive groups were decreased(P<0.05).2.Effect of KNPR on serum sex hormones of obese PCOS rats: compared with the blank control group,P concentration in the serum of female rats in the model control group was significantly reduced(P<0.01),while the serum T concentration was significantly increased(P<0.01);Compared with the model control group,the serum Pconcentration of female rats in the high-dose group was increased(P<0.05),while the T concentration was decreased(P<0.05).3.Effect of KNPR on ovaries of the obese PCOS rats: compared with the blank control group,the interstitial fibrous tissue in female ovaries proliferated,the follicular granulo sa became thinner,the follicular membrane cell layer significantly thickened,the number of atretic follicles increased,and the number of corpus luteum decreased in the model control group;Compared with the model control group,the follicular granulosa cell layer was thickened and the number of atretic follicles was reduced.Primary,secondary and even mature follicles at different developmental stages could be seen.The number of corpus luteum was increased in the high dose group.4.Effect of KNPR on endometrium of the obese PCOS rats: compared with the blank control group,The VEGF concentration in the uterus of rats in the model control group was significantly increased(P<0.01).The average optical density of ER was increased(P<0.05),PR and VEGFR-2 were aslo significantly increased(P<0.01),the relative expression of p-PDK1 was increased significantly(P<0.01)and p-Akt was increased too(P>0.05).Compared with the model control group,The VEGF concentration was decreased(P<0.05),the average optical density of ER was significantly decreased(P<0.01),and PR,VEGFR-2 were aslo decreased(P<0.05),the relative expression of p-PDK1 was decreased signific antly(P<0.05)and p-Akt decreased(P>0.05)too in the high-dose group rats.Conclusion:1.KNPR can control the continuous increase of body weight of female PCOS model rats,so as to improve the obesity status of female PCOS rats.2.KNPR can regulate the reproductive endocrine disorder of obese PCOS model female rats,reduce obese PCOS ovarian lesions and promote follicular development.3.KNPR can down-regulate the expression of key molecules in the VEGF/Akt signaling pathway,such as ER,PR,VEGF,VEGFR-2,p-PDK1 and p-Akt to regulate this pathway,Furthermore,to inhibit the local abnormal proliferation and differentiation of obese PCOS endometrium,and then regulate the microenvironment of obese PCOS endometrium.