Objective. Intrauterine adhesions affect menstruation and fertility, and endometrial fibrosis is the final manifestation of IUA. MMP-9 is closely related to fibrosis. The purpose of the study was to assess the role of MMP-9 in intrauterine adhesion (IUA) in rats and patients. Methods. 40 rats and 24 women were enrolled in this study. 40 rats were randomly divided into 3 groups: IUA group ( n = 20 ), sham group ( n = 10 ), and control group ( n = 10 ). Rat IUA models were established by intrauterine mechanical and chemical injured. In this study, 12 patients of intrauterine adhesions were detected and underwent TCRA (transcervical resection of adhesion) surgery, and endometrial tissue specimens were obtained during operation. One month later, an office hysteroscopy procedure was performed, and endometrial tissue specimens were obtained during operation again (postoperative group). A group of 12 normal age-matched control individuals served as controls underwent hysteroscopy and endometrial sampling. We used immunohistochemistry to detect MMP-9 expressions in rats and human endometrial tissues and to detect MMP-9 protein levels by Western blotting. In addition, we detected mRNA expression levels with qRT-PCR. Results. The expression of MMP-9 in the IUA rats was reduced compared with that in the sham group and Ctrl group ( P < 0.05 ), and the expression of MMP-9 was also reduced in the IUA patients compared with that in the Ctrl group ( P < 0.05 ). The mRNA levels of MMP-9 in the endometrium reflected similar results ( P < 0.05 ). The MMP-9 clearly increased even in the endometrium after TCRA surgery ( P < 0.05 ). Conclusion. Our study suggests that MMP-9 may play an important role in IUA. In the future, more in-depth research should be conducted on MMP-9.
Objective C-X-C motif chemokine ligand 5 (CXCL5), a member of the chemokine family, is associated with remodeling of connective tissues. However, its role in formation of intrauterine adhesions (IUA) remains unclear. We aimed to investigate the expression and mechanism underlying the role of CXCL5 in IUA. Methods Expression of CXCL5 in IUA was detected by immunohistochemistry in a rat model of IUA and by real-time PCR and western blotting in patients with IUA. The protein levels of matrix metalloproteinase 9 (MMP9) and transcription factor p65 in human endometrial cells were assessed by western blotting after CXCL5 overexpression. Results Protein expression of CXCL5 was significantly decreased in the endometria of IUA rats compared with that of control and sham-operated rats. Real-time PCR and western blotting in patients with IUA showed similar results to those from the rat model. After overexpression, CXCL5 significantly upregulated expression of MMP9 and slightly upregulated expression of p65 in human endometrial cells. Conclusions CXCL5 plays an important role in IUA formation after endometrial injury. We propose a molecular mechanism to explain formation of IUA, including downregulation of MMP9 by low CXCL5 expression. These findings provide valuable information for the prevention and targeted therapy of IUA.
Background Intrauterine adhesion (IUA) is a consequence of endometrium damage, leading to infertility, recurrent miscarriage, and various complications of pregnancy. IUA usually occurs after an infection or injury-related inflammation of the endometrium. CXCL5, a member of chemokines, is associated with the remodeling of connective tissues, but its roles in the formation of IUA remain uncertain. This study aims to investigate the expression and effect of CXCL5 in the development of IUA. Results CXCL5 protein level in the endometrium of IUA rat is significantly decreased compared with that in normal and sham-operated endometria of rats (P < 0.001). Furthermore, real-time PCR and western blotting assays also show that the CXCL5 expression in endometrial tissues from IUA patients is much lower than that in normal endometrium (P < 0.01), which is consistent with the results based on the rat model. CXCL5 significantly up-regulates MMP9 expression and slightly up-regulates p65 expression in human endometrial cells after CXCL5 overexpression. Conclusions These results show that CXCL5 plays an important role in the inhibition of IUA formation after injury by modulating MMP9 expression and therefore has a protective effect of CXCL5 in the adhesion formation of IUA. These findings provide valuable information for evaluating prognosis and guiding therapy of intrauterine adhesions.
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