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目的探讨促肾上腺皮质激素释放激素(CRH)、c-Fos 和间隙连接蛋白43(Cx43)在足月妊娠子宫平滑肌细胞中的表达变化及其与分娩发动的相关性。方法选择2006年2—9月在中南大学湘雅二医院住院的足月临产产妇30例(临产组),足月未临产产妇30例(未临产组),因宫颈上皮内瘤样病变行子宫切除术患者30例(对照组)。应用放射免疫方法测定3组妇女静脉血中 CRH 的水平;用核酸原位杂交技术和免疫组化链霉菌抗生物素蛋白-过氧化物酶连接(SP)法检测3组妇女子宫平滑肌细胞中 c-Fos、Cx43 mRNA 及其蛋白的表达水平。结果 (1)CRH 水平在临产组产妇为(81.8±11.9)pmol/L,未临产组为(34.5±18.6)pmol/L,对照组为(1.3±0.7)pmol/L,临产组明显高于未临产组及对照组,未临产组明显高于对照组,差异均统计学意义(P<0.05)。(2)c-Fos mRNA及其蛋白的阳性染色主要定位于子宫平滑肌细胞核内,少量位于细胞质内;子宫平滑肌细胞中 c-FosmRNA 及其蛋白表达水平,临产组分别为5.4±1.7及5.4±1.5,未临产组分别为4.1±0.9及3.9±0.9,对照组分别为1.0±0.4及1.2±0.4,临产组明显高于未临产组及对照组,差异有统计学意义(P<0.05);未临产组也明显高于对照组(P<0.05)。(3)Cx43 mRNA 及其蛋白的阳性染色定位于子宫平滑肌细胞质内;子宫平滑肌细胞中 Cx43 mRNA 及其蛋白表达水平,临产组分别为5.5±1.4及5.6±1.3,未临产组分别为4.1±0.6及4.1±0.5,对照组分别为1.5±0.6及1.1±0.6,临产组明显高于未临产组及对照组,差异有统计学意义(P<0.05);未临产组也明显高于对照组(P<0.05)。(4)3组妇女的 CRH 水平与子宫平滑肌细胞中 c-Fos mRNA 及其蛋白的表达水平呈明显正相关(r_1=0.61,r_2=0.50;P<0.05);与子宫平滑肌细胞中 Cx43 mRNA 及其蛋白的表达水平呈明显正相关(r_3=0.52,r_4=0.68;P<0.05);子宫平滑肌细胞中 c-Fos mRNA 及其蛋白的表达水平与 Cx43 mRNA 及其蛋白的表达水平也呈明显正相关(r_5=0.51,r_6=0.60;P<0.05)。结论产妇血浆中 CRH 水平、子宫平滑肌细胞中 c-Fos 和 Cx43的表达与分娩发动有一定的关系,且3者间水平变化均呈明显正相关。
Objective To investigate the expression changes of corticotropin-releasing hormone (CRH), c-Fos and connexin 43 (Cx43) in uterine smooth muscle cells of term pregnant women and its relationship with labor onset. Methods From January to September in 2006, 30 full-term pregnant women were enrolled in the Second Xiangya Hospital of Central South University (term group), 30 full term unproductive women (non-labor group), uterine cervix endometrial neoplasia Thirty patients underwent resection (control group). The levels of CRH in venous blood of 3 groups of women were measured by radioimmunoassay. The levels of c-CRH in 3 groups of women’s uterine smooth muscle cells were detected by in situ hybridization and immunohistochemical streptavidin-peroxidase (SP) -Fos, Cx43 mRNA and its protein expression level. Results (1) The CRH level in the labor group was (81.8 ± 11.9) pmol / L, in the non-labor group was (34.5 ± 18.6) pmol / L and in the control group was (1.3 ± 0.7) pmol / L, Non-labor group and control group, non-labor group was significantly higher than the control group, the differences were statistically significant (P <0.05). (2) The positive staining of c-Fos mRNA and its protein mainly located in the nucleus of uterine smooth muscle cells, a small amount located in the cytoplasm; uterine smooth muscle cells c-Fos mRNA and protein expression levels of 5.4 ± 1.7 and 5.4 ± 1.5 , 4.1 ± 0.9 and 3.9 ± 0.9 in the non-labor group and 1.0 ± 0.4 and 1.2 ± 0.4 in the control group, respectively, which were significantly higher in the labor group than in the non-labor group and the control group (P <0.05) The labor group was also significantly higher than the control group (P <0.05). (3) The positive staining of Cx43 mRNA and protein located in the uterine smooth muscle cytoplasm; Cx43 mRNA and protein expression levels in uterine smooth muscle cells in the labor group were 5.5 ± 1.4 and 5.6 ± 1.3, non-labor group were 4.1 ± 0.6 And 4.1 ± 0.5 in the control group and 1.5 ± 0.6 and 1.1 ± 0.6 in the control group, respectively, which were significantly higher in the labor group than those in the non-labor group and the control group (P <0.05); those in the non-labor group were also significantly higher than those in the control group P <0.05). (4) There was a significant positive correlation between CRH level and the expression of c-Fos mRNA and protein in uterine smooth muscle cells (r 1 = 0.61, r 2 = 0.50, P <0.05) (R_3 = 0.52, r_4 = 0.68; P <0.05). The expression of c-Fos mRNA and protein and the expression of Cx43 mRNA and protein in uterine smooth muscle cells were also significantly positive (R_5 = 0.51, r_6 = 0.60; P <0.05). Conclusions The level of CRH in maternal plasma and the expression of c-Fos and Cx43 in uterine smooth muscle cells have a certain relationship with the onset of labor, and there is a positive correlation between the level of c-Fos and Cx43.