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胎膜早破患者胎膜中EMMPRIN MMP-2的表达及意义
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摘要
目的:检测细胞外基质金属蛋白酶诱导因子(extracellular matrix metalloproteinase inducer, EMMPRIN)和基质金属蛋白酶-2(matrix metalloproteinase-2, MMP-2)在胎膜组织中的定位情况;探讨EMMPRIN及MMP-2在正常妊娠晚期胎膜组织中的表达及意义;研究EMMPRIN及MMP-2在胎膜早破中的相关性并分析二者在其发病机制中的作用。
     方法:随机采集2006年9月至2007年7月在河北医科大学第二医院妇产科病房住院,临产前行剖宫产分娩的初产妇胎膜组织,其中足月胎膜早破者12例,足月前胎膜早破者10例和正常完好胎膜10例作对照组。所有受试对象排除有其他妊娠并发症、临床感染征象及近期抗生素应用史者。(1)应用半定量逆转录-多聚酶链反应(reverse transcription-polymerase chain reaction, RT-PCR)技术测定各组胎膜中EMMPRIN及MMP-2的mRNA表达水平并比较二者在各组间有无差异;在每一组中分析EMMPRIN mRNA与MMP-2 mRNA的相关性。(2)采用免疫组织化学SP方法检测各组胎膜组织中EMMPRIN和MMP-2的蛋白定位情况及表达水平;比较二者在各组间有无差异;在每一组中,分析二者的蛋白表达水平有无相关性。(3)依据常规苏木素-伊红(HE)染色后的组织学结果,将所有胎膜标本切片划分为绒毛膜羊膜炎组和非绒毛膜羊膜炎组,比较两组胎膜组织中EMMPRIN的蛋白表达水平有无差异。数据用SPSS 13.0软件作统计学处理,采用F检验、q检验、t检验及直线相关分析,P<0.05为差异有显著性意义。
     结果:
     1 EMMPRIN、MMP-2mRNA和蛋白在足月胎膜早破,足月前胎膜早破及正常妊娠晚期胎膜组织中均有表达。
     2 EMMPRIN和MMP-2的蛋白表达部位:EMMPRIN主要表达于羊膜上皮细胞和绒毛膜滋养细胞的胞膜;MMP-2表达于羊膜上皮细胞和绒毛膜滋养细胞的胞浆。
     3 MMP-2mRNA和蛋白的表达:对照组MMP-2mRNA的相对表达量为:[(63.50±9.53)×10-2],低于足月胎膜早破组[(80.75±7.02)×10-2](P<0.01)和足月前胎膜早破组[(77.30±6.31)×10-2](P<0.01),差异有统计学意义;对照组MMP-2的蛋白表达量为:[(20.01±1.83)×10-2],低于足月胎膜早破组[(23.33±2.81)×10-2](P<0.01)和足月前胎膜早破组[(22.60±2.99)×10-2](P<0.05),差异有统计学意义;但MMP-2mRNA和蛋白的表达在足月与足月前胎膜早破组之间差异无统计学意义(P>0.05)。
     4 EMMPRIN mRNA和蛋白的表达:对照组EMMPRIN mRNA的相对表达量为:[(118.76±10.88)×10-2],低于足月胎膜早破组[(135.00±9.27)×10-2](P<0.01)和足月前胎膜早破组[(128.50±9.49)×10-2](P<0.05),差异有统计学意义;对照组EMMPRIN的蛋白表达量为:[(24.40±3.63)×10-2],低于足月胎膜早破组[(29.92±3. 23)×10-2](P<0.01)和足月前胎膜早破组[ (27.30±2.36)×10-2](P<0.05),差异有统计学意义。但EMMPRIN mRNA和蛋白的表达在足月与足月前胎膜早破组之间差异无统计学意义(P>0.05)。
     5 EMMPRIN与MMP-2的mRNA相对表达量的相关性:在足月和足月前胎膜早破组中,二者存在显著正相关(r=0.639, P<0.05; r=0.645, P<0.05);在对照组中,相关性无统计学意义(r=0.178, P>0.05)。
     6 EMMPRIN与MMP-2的蛋白表达量的相关性:在足月和足月前胎膜早破组中,二者存在显著正相关(r=0.585, P<0.05;r=0.681, P<0.05);在对照组中,相关性无统计学意义(r=0.268, P>0.05)。
     7绒毛膜羊膜炎组EMMPRIN蛋白表达量为:([29.69±2.40)×10-2],高于非绒毛膜羊膜炎组[(26.00±3.74)×10-2],差异有统计学意义(P<0.01)。
     结论:
     1 EMMPRIN、MMP-2在足月胎膜早破,足月前胎膜早破及正常妊娠晚期胎膜组织中均有表达,EMMPRIN表达位置为羊膜上皮细胞及绒毛膜滋养细胞的胞膜。MMP-2表达于羊膜上皮细胞和绒毛膜滋养细胞的胞浆。
     2正常妊娠晚期,EMMPRIN可能通过翻译后改变自身糖基化的程度,调节MMPs的水平参与妊娠的维持。
     3在胎膜早破中,EMMPRIN在炎症等一种或几种因素的作用下,其转录水平被上调,并且可能通过诱导MMP-2而参与胎膜早破的病理过程。
Objective: To detect the locations of EMMPRIN and MMP-2 in fetal membranes;To study the expressions of EMMPRIN and EMMPRIN in fetal membranes of normal pregnancy , and to investigate the correlation between EMMPRIN and MMP-2, and evaluate their functions in the pathogenesis of premature rupture of fetal membranes.
     Methods: The amniochorion (fetal membranes) samples were collected from 32 nulliparous women: 12 cases of term premature rupture of membranes (tPROM), 10 cases of preterm premature rupture of membranes (pPROM) and 10 cases of term intact membranes as controls. The caesarean sections were operated on all the patients before the urinary constriction in the Obstetrics of the Second Hospital of HeBei Medical University from September 2006 to July 2007. We excluded women with other pregnancy complication, clinical infections and/or undergoing antibiotic treatment. (1) The reverse transcription-polymerase chain reaction (RT-PCR) was performed to assay the mRNA levels of EMMPRIN and MMP-2 in fetal membrane samples in order to show whether there are differences among their concentrations of each group, and in order to study the relationship between EMMPRIN mRNA and MMP-2 mRNA in every group; (2) The protein levels of EMMPRIN and MMP-2 in fetal membranes were documented with s-p immunohistochemistry, and were compared among the three groups, respectively. Their correlation in every group was studied also. (3) The hematoryline and eosin (HE) staining was used to divide all fetal membranes samples into two groups: with chorioamnionitis and without chorioamnionitis, and the protein level of EMMPRIN was compared between them. Results were analyzed with use of F test、q test、t test、and linear correlation; For these analyses, P<0.05 was considered statistically significant.
     Results:
     1 EMMPRIN and MMP-2, not only their mRNA, but also their protein, were expressed in all of the three groups.
     2 The localization of EMMPRIN and MMP-2 proteins: EMMPRIN-positive staining was found in the amniotic epithelial cells and chorionic cytotrophoblast cells, and which all presenced on cell membranes. MMP-2-positive staining was found in the amniotic epithelial cells and chorionic cytotrophoblast cells, and all presenced in cell plasma.
     3 The mRNA and protein levels of MMP-2: The mRNA level of MMP-2 in control was: [(63.50±9.53)×10-2], significantly lower than tPROM [(80.75±7.02)×10-2](P<0.01) and pPROM[(77.30±6.31)×10-2](P<0.01). The protein level of MMP-2 in controls was: [(20.01±1.83)×10-2], significantly lower than tPROM[(23.33±2.81)×10-2](P<0.01) and pPROM[(22.60±2.99)×10-2](P<0.05). The expression of MMP-2 mRNA and protein in tPROM and pPROM has no statistically significant difference (P>0.05).
     4 The mRNA and protein levels of EMMPRIN: The mRNA level of EMMPRIN in controls was:[(118.76±10.88)×10-2], significantly lower than tPROM[(135.00±9.27)×10-2](P<0.01) and pPROM [(128.50±9.49)×10-2](P<0.05); The protein level of EMMPRIN in controls was:[(24.40±3.6)×10-2], significantly lower than tPROM[(29.92±3. 23)×10-2](P<0.01) and pPROM [(27.30±2.36)×10-2] (P<0.05). The expression of EMMPRIN mRNA and protein in tPROM and pPROM has no statistically significant difference (P>0.05).
     5 The relationship between EMMPRIN mRNA and MMP-2 mRNA: EMMPRIN mRNA and MMP-2 mRNA was positively correlated in term and preterm premature rupture of fetal membranes (r=0.639, P <0.05; r=0.645, P <0.05), whereas no significant differences between them in control group(r=0.178, P>0.05).
     6 The relationship between the EMMPRIN protein and MMP-2 protein: EMMPRIN protein and MMP-2 protein was positively correlated in term and preterm premature rupture of fetal membranes (r=0.585, P <0.05; r=0.681, P <0.05), whereas no significant differences between them in control group (r=0.268, P>0.05).
     7 The levels of EMMPRIN protein in the group with chorioamnionitis was [(29.69±2.40)×10-2], significantly higher than that of the group without chorioamnionitis [(26.00±3.74)×10-2] (P<0.01).
     Conclusion:
     1 EMMPRIN and MMP-2 expressed in all of the three groups, and EMMPRIN appeared mainly on cell membranes of the amniotic epithelial cells and chorionic cytotrophoblast cells, and MMP-2 localized in cell plasma of the same cells.
     2 EMMPRIN may regulate MMPs by altering its level of glycosylation during normal pregnancy, and which may be helpful for pregnancy.
     3 In premature rupture of membranes, EMMPRIN may have changed in transcriptional level, influenced by one or several factors, such as inflammation and so on, and it may participate in the pathogenesis of premature rupture of fetal membranes by stimulating MMP-2.
引文
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