title: Expression of apoptotic factors in vaginal tissues from women with urogenital prolapse.
abstract: OBJECTIVE
  Increased apoptotic activity in pelvic tissues may contribute to development of pelvic floor disorders. We evaluated expression of apoptotic factors (Bcl-2 family) in vaginal tissues from women with pelvic organ prolapse (POP) and how these factors correlate with severity of prolapse.
  
  
  METHODS
  mRNA and protein expression of anti-apoptotic and pro-apoptotic factors in vaginal tissues from subjects and controls were determined by real-time PCR and Western blot. Severity of prolapse was staged using POP-Q criteria.
  
  
  RESULTS
  Differential expression of Bcl-2 family factors was observed in protein rather than in gene expression. During the secretory phase, the anti-apoptotic (Bcl-2, Bcl-xl) and pro-apoptotic protein (Bax) were upregulated in controls compared to cases (P < 0.05). The ratios of Bcl-2/Bax and Bcl-2/Bad, which determine cellular sensitivity to induction of apoptosis, were higher in controls versus cases. Higher ratios indicate reduced cellular sensitivity to apoptosis. Protein expression of Bax and Bad was higher in women with severe compared to mild prolapse (P < 0.05).
  
  
  CONCLUSIONS
  Increased expression of Bad, Bax, and decreased ratios of Bcl-2/Bax, Bcl-2/Bad suggest increased apoptotic activity or sensitivity to induction of apoptosis in vaginal tissues of women with POP.
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA. yanwen@stanford.edu
authors.forename: Yan
authors.initials: Y
authors.lastname: Wen
authors.forename: Jason Yen-Ping
authors.initials: JY
authors.lastname: Ho
authors.forename: Mary Lake
authors.initials: ML
authors.lastname: Polan
authors.forename: Bertha
authors.initials: B
authors.lastname: Chen
mesh_terms: D000328:Adult; D017209:Apoptosis; D015153:Blotting, Western; D002140:California; D016022:Case-Control Studies; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis* / Q000235:genetics; D012333:RNA, Messenger / Q000032:analysis; D060888:Real-Time Polymerase Chain Reaction; D012720:Severity of Illness Index; D014621:Vagina / Q000737:chemistry* / Q000473:pathology; D051028:bcl-2-Associated X Protein / Q000032:analysis; D051025:bcl-Associated Death Protein / Q000032:analysis; D051020:bcl-X Protein / Q000378:metabolism
chemical_list: C494819:BAD protein, human; C494826:BAX protein, human; C494811:BCL2L1 protein, human; D019253:Proto-Oncogene Proteins c-bcl-2; D012333:RNA, Messenger; D051028:bcl-2-Associated X Protein; D051025:bcl-Associated Death Protein; D051020:bcl-X Protein