Expression of androgen receptor in the vaginal wall and cardinal ligament of patients with pelvic organ prolapse

Abstract

To evaluate the role of androgen and its receptor in the pathogenesis of prolapse of pelvic floor. Specimens of right cardinal ligament and vaginal wall were collected from 38 patients with prolapse, aged (64 +/- 3) (45 - 79), all menopausal, and 23 women, aged (50 +/- 2)(45-57), with obstetric or gynecologic diseases other than prolapse (as controls), all undergoing total hysterectomy. The 38 prolapse patients were divided into 2 groups: Group > or = 60, aged (66 +/- 6), and Group < 60, aged (52 +/- 5). Western blotting and immunohistochemistry were used to detect the expression of androgen receptor (AR) in the tissues. Peripheral blood samples were collected from all patients to examine the levels of serum testosterone and sex hormone binding globulin (SHBG) by chemiluminescent labeling. There were no significant differences in the serum concentrations of testosterone and SHBG between the prolapse and the control groups. The AR positive rates in the cardinal ligament and vaginal wall tissues of the prolapse patients aged > or = 60 were (49 +/- 15)% and (49 +/- 10)% respectively, both not significantly different from those of the control group [(43 +/- 15)% and (42 +/- 3)% respectively, both P > 0.05]. ears, The AR expression rates in the tissues of cardinal ligament and vaginal wall of the prolapse patients were (42 +/- 3)% and (43 +/- 15)% respectively, both significantly higher than those of the control group [(29 +/- 7)% and (29 +/- 6)% respectively, both P < 0.001]. Western blotting showed that the positive rate of the AR with the relative molecular weight of 45 000 in the cardinal ligament of the prolapse group was 4.41%, significantly higher than that of the control group (2.1%, P = 0.02), however, the positive rate of the AR with the relative molecular weight of 45 000 in the vaginal wall tissue of the prolapse group was 3.34%, not significantly different from that of the control group (2.28%, P = 0.2). There were no significant differences in the in the straps of 110 000 and 90 000 detected by C-terminal polyantibodies of AR in the cardinal ligament and vaginal wall tissues between the prolapse patients and the control group (both P > 0.05). The increasing expression of AR in the tissue of vaginal wall and cardinal ligament of the prolapse patients with pelvic floor dysfunction may play an important role in the etiology of pelvic floor dysfunction.