Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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mRNA Expression Differences of uPA, uPAR in Eutopic Endometrium of Advanced Stage Endometriosis Patients

중증 자궁내막증 환자의 자궁내막과 정상인 자궁내막에서 uPA, uPAR mRNA 발현의 차이에 관한 연구

  • Hur, Sung Eun (Department of Obstetrics and Gynecology, Konyang University, School of Medicine) ;
  • Lee, Ji Young (Department of Obstetrics and Gynecology, College of Medicine, Konkuk University) ;
  • Lee, Woon Jung (Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University) ;
  • Chung, Hye-Sung (Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University) ;
  • Chung, Hye Won (Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University)
  • 허성은 (건양대학교 의과대학 산부인과학교실) ;
  • 이지영 (건국대학교 의과대학 산부인과학교실) ;
  • 이운정 (이화여자대학교 의과대학 산부인과학교실) ;
  • 문혜성 (이화여자대학교 의과대학 산부인과학교실) ;
  • 정혜원 (이화여자대학교 의과대학 산부인과학교실)
  • Published : 2006.12.31
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Abstract

Objective: We investigated the expression of uPA and uPAR in eutopic endometrium of advanced stage endometriosis and control patients. Methods: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29-44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage Ill and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression of uPA and uPAR from eutopic endometrium were analyzed by RT-QC PCR. Results: The mRNAs of uPA and uPAR were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. Uterine endometrium from women with endometriosis expresses significantly (p<0.05) higher levels of u-PA mRNA than endometrium from normal women without endometriosis in the proliferative phase. There were no significant differences in expression of uPAR in eutopic endometrium between controls and endometriosis patients. Conclusion: These results suggest that eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater u-PA mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one etiology for the invasive properties of the endometrium resulting in the development of endometriosis.

목 적: 자궁내막증에서 그 병태생리를 연구함에 있어서 fibrinolytic system과의 연관성을 알아보기 위해서 자궁내막증 환자와 자궁내막증이 아닌 대조군의 자궁내막에서 urokinase plasminogen activator (u-PA)와 urokinase type plasminogen activator receptor (u-PAR)의 mRNA의 발현의 차이를 알아보고자 하였다. 연구방법: 본원 산부인과를 방문한 한국인 여성 중 수술을 통해 자궁내막증을 진단 받은 33명의 환자와 난소 낭종 등의 양성 질환으로 개복술이나 골반경 수술을 시행한 환자 중 자궁내막증이 없음을 확인한 여성 32명을 대조군으로 하였다. 각각의 대상으로부터 얻은 자궁내막 조직에서 RNA를 추출하여 RT-QC PCR을 시행하여 얻고자 하는 대상의 mPNA 양을 정량화하여 두 군 간에 차이가 있는지를 생리주기에 따라 비교하였다. 결 과: u-PA와 u-PAR의 mPNA는 자궁내막증 환자 및 대조군에서 모두 발현하였으며, 자궁내막증 환자에서의 u-PA mPNA는 증식기 자궁내막에서 대조군에 비해 통계적으로 유의하게 높게 발현됨을 관찰하였다. u-PAR mPNA는 두 군 사이에서 생리주기 전반에 걸쳐 비교했을 때 통계적으로 유의한 차이는 없었다. 결 론: 자궁내막증의 병태생리와 관련하여 u-PA와 u-PAR의 mPNA 발현에 대해서 조사한 결과 u-PA mPNA가 자궁내막증 환자에서 대조군보다 통계적으로 유의하게 높게 발현되었고 이것은 자궁내막증 환자의 자궁내막의 성격이 좀 더 침습적이고, 이로써 복막에의 침습에도 더 유리한 역할을 가진다고 볼 수 있다. 자궁내막증에 대한 기본적인 병태생리로 볼 때, 자궁내막 자체가 가장 중요한 역할을 하리라고 보며, 이를 단백질 분해능과 연관지어 생각해 볼 때, u-PA 발현의 dysregulation이 자궁내막의 침습에 중요한 병태생리라고 생각된다.

Keywords

Acknowledgement

Supported by : 한국과학재단

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