title: Decreased expression of elastin, fibulin-5 and lysyl oxidase-like 1 in the uterosacral ligaments of postmenopausal women with pelvic organ prolapse.
abstract: OBJECTIVE
  Pelvic organ prolapse is associated with defects in connective tissues, including elastic fibers. The purpose of this study was to investigate the expression of fibulin-5 and lysyl oxidase-like 1 (LOXL1), which play an essential role in the synthesis and assembly of elastic fibers, in the uterosacral ligaments of women with advanced pelvic organ prolapse (POP) compared with controls.
  
  
  METHODS
  Specimens were obtained prospectively during transvaginal or abdominal hysterectomy from 30 women with advanced pelvic organ prolapse and 30 controls matched to the POP group for age and parity among postmenopausal women with benign gynecologic diseases. The expressions of elastin, fibulin-5 and LOXL1 in uterosacral ligaments were measured by immunohistochemistry.
  
  
  RESULTS
  We detected a decreased, sometimes absent, expression of fibulin-5 and LOXL1 in the uterosacral ligaments of women with POP, despite a positive expression of elastin. There was a decrease in positive percentage of LOXL1 in the POP group (23.3%) compared with the controls (60%) (P = 0.004). With immunolabeling intensity classified as negative, weak, moderate or strong, there was a decrease in the expression of fibulin-5 in the POP group (P = 0.049). We also detected a significantly decreased expression of LOXL1 in the POP group (P = 0.001).
  
  
  CONCLUSIONS
  There was decreased expression of fibulin-5 and LOXL1 in the uterosacral ligaments of patients with pelvic organ prolapse, while the elastin expression was equivalent, which may suggest the possibility of defects in elastic fiber remodeling in the postpartum period and contribute to POP.
authors.affiliation: Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Bai-hui
authors.initials: BH
authors.lastname: Zhao
authors.forename: Jian-hong
authors.initials: JH
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000594:Amino Acid Oxidoreductases / Q000378:metabolism*; D015331:Cohort Studies; D015536:Down-Regulation; D004549:Elastin / Q000378:metabolism; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008022:Ligaments / Q000378:metabolism* / Q000601:surgery; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D017698:Postmenopause; D011446:Prospective Studies; D012447:Sacrum / Q000378:metabolism*; D012720:Severity of Illness Index; D014599:Uterus / Q000378:metabolism* / Q000601:surgery
chemical_list: D016326:Extracellular Matrix Proteins; C492373:FBLN5 protein, human; D004549:Elastin; D000594:Amino Acid Oxidoreductases; C445313:LOXL1 protein, human