Abstract
Pelvic organ prolapse (POP) is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms with limited therapies available, and is associated with defects in connective tissue including elastic fibers. This study was designed to investigate the expression of fibulin-5 and lysyl oxidase-like 1 (LOXL1) in the cardinal ligament in samples taken from the POP group compared to the non-POP group. Specimens were obtained during abdominal hysterectomy from the cardinal ligament of 53 women with POP and 25 age- and parity- matched women with non-POP among post-menopausal women with benign gynecologic pathology. Protein expression was evaluated using the immunohistochemical staining method. For statistical analyses, chi-square test and Spearman's correlation were used with the statistical package SPSS13.0 system. Our results showed that both fibulin-5 and LOXL1 expressions were decreased in the cardinal ligament in the POP group compared to the non-POP group (P < 0.05). The expression of fibulin-5 and LOXL1 were correlated closely with the stage of POP, accompanied by stress urinary incontinence and frequency of vaginal delivery (P < 0.05), but had no relationship with post-menopausal state (P > 0.05). The expression of fibulin-5 was positively associated with LOXL1 in POP (P < 0.05). We conclude that changes in fibulin-5 and LOXL1 expression may play a role in the development of POP.
Highlights
Pelvic floor dysfunction (PFD), a disease with anatomical and/or functional abnormalities of pelvic organs due to weakened supporting tissues of the pelvic floor and dislocation of pelvic organs, is common in women and can considerably interfere with their quality of life
[11] Several studies have reported that elastic fibers are decreased in the cardinal ligaments or the vaginal wall with increased elastolytic activity in POP patients[12,13,14]
Fibulin-5[16] is known as FBLN5, DANCE, or EVEC, which is a member of the fibulin family in extracellular matrix (ECM)[16]
Summary
Pelvic floor dysfunction (PFD), a disease with anatomical and/or functional abnormalities of pelvic organs due to weakened supporting tissues of the pelvic floor and dislocation of pelvic organs, is common in women and can considerably interfere with their quality of life. This disease includes pelvic organ prolapse (POP) and stress urinary incontinence(SUI). The pathophysiology of pelvic floor disorders remains not well understood. The hypothesis of a defect of the connective tissues of the pelvic floor with aging due to collagen deficiency and/or elastic fiber degradation is often highlighted
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