Abstract
Introduction. Prolapse of pelvic organs being extremely common in the female population, hence, it is important to search for factors of prolapse pathogenesis to identify markers of the optimal time for surgical intervention. The aim of the study is to investigate the molecular-morphological changes in the vaginal wall in case of inconsistency of the supporting apparatus of the pelvic organs to assess their contribution to the mechanisms of the development of POP. Materials and methods. Twenty randomly involved women of the reproductive age (35±5 years), were consulted with the diagnosis: «Pelvic floor insufficiency, old ruptures of the pelvic floor». The samples were taken from tissue of anterior and posterior walls of the vaginа. The presence, immunohistochemical response, as an area of positively stained collagen types I and III, elastin, smooth myocytes, expression of MMP-1, MMP-2, MMP-3, MMP-9, PDGFβ, and TNXB, as well as Caspase-3 and Caspase-9 were studied. The results of the study. The key features of the histo-biochemical picture of the vaginal wall with inconsistency of the pelvic floor are: a large number of protofibrils with a deficiency of type I collagen fibers (22,1±1,7% of the field of vision) and an excess amount of type III collagen (44,5±0,3%, p<0,05 in comparison with collagen I). I/Col.III=0,5; high activity of metalloproteinases (degradation of collagen molecules and other extracellular matrix proteins) – MMP-1: 1,75±0,17 cu, MMP-2: 2,1±0,19 cu, MMP-3: 2,89±0,21 cu, MMP-9: 1,94±0,14 cu – against a backdrop of low expression of such an inhibitor as TIMP1: 0,61±0,05 cu. Conclusions. At the heart of the events unfolding in the supporting tissues is the change in intracellular metabolism of fibroblasts at the molecular level as a consequence of oxidative stress.
Authors and affiliations
M.R. Orazov(1), L.R. Toktar(1), E.S. Silantyeva(2), G.A. Demyashkin(3), E.S. Campos(1) 1-Peoples` Friendship University of Russia, Miklukho-Макlay str., 6, Moscow, 117198, Russian Federation; 2-Clinical Hospital «Lapino», Uspenskoe Shosse, 111, Odintsovo, 143001, Russian Federation; 3-I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, Moscow, 119048, Russian Federation E-mail: omekan@mail.ru
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