Changes in expression of fibulin-5 and lysyl oxidase-like 1 associated with pelvic organ prolapse.
OBJECTIVE
Pelvic organ prolapse is associated with defects in connective tissue including elastic fibers. The purpose of this study was to investigate expression of fibulin-5 and lysyl oxidase-like 1, which play an essential role in synthesis and assembly of elastic fibers in the uterosacral ligament, in samples taken from women with advanced pelvic organ prolapse compared with controls.


METHODS
Specimens were obtained prospectively during abdominal hysterectomy from 30 women with advanced pelvic organ prolapse and 30 controls matched to the study group for age and parity among postmenopausal women with benign gynecologic pathology. Expression levels of protein and mRNA of fibulin-5 and lysyl oxidase-like 1 in uterosacral ligaments were measured by Western blot analysis and real-time quantitative polymerase chain reactions. For statistical analyses, Student's t-test, chi-square test, Mann-Whitney U test, Fisher's exact test and Spearman's correlation were used.


RESULTS
Significant decrease in the expression of mRNA of fibulin-5 was found in patients with prolapse (P-value=0.042; 0.743+/-0.229 and 1.061+/-0.537). The expression of mRNA of lysyl oxidase-like 1 was increased in the patient group (P-value=0.017; 4.099+/-2.832 and 1.816+/-1.602). Similar results were shown in Western blot analysis. Differences in expression of fibulin-5 and lysyl oxidase-like 1 were noted according to stage of prolapse (P-value=0.037 and 0.009).


CONCLUSIONS
There was decreased expression of fibulin-5 and increased expression of lysyl oxidase-like 1 in uterosacral ligaments in patients with pelvic organ prolapse, which suggests the possibility of defects in elastin synthesis.
Jung
Hyun Joo
HJ
Department of Obstetrics and Gynecology, Yonsei University Health System, Seoul, South Korea.
Jeon
Myung Jae
MJ
Yim
Ga Won
GW
Kim
Sei Kwang
SK
Choi
Jong Rak
JR
Bai
Sang Wook
SW
D000368:Aged; D000594:Amino Acid Oxidoreductases / Q000378:metabolism*; D016022:Case-Control Studies; D003238:Connective Tissue / Q000378:metabolism; D004547:Elastic Tissue / Q000378:metabolism; D004549:Elastin / Q000378:metabolism; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007723:Korea; D008022:Ligaments / Q000378:metabolism*; D008875:Middle Aged; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism; D014596:Uterine Prolapse / Q000378:metabolism*
D016326:Extracellular Matrix Proteins; C492373:FBLN5 protein, human; D012333:RNA, Messenger; D004549:Elastin; D000594:Amino Acid Oxidoreductases; C445313:LOXL1 protein, human