新型雌激素受体GPR30在ICP患者胎盘中的表达及意义

发布时间：2019-02-22 14:52

【摘要】：目的：通过对ICP及正常孕妇胎盘组织GPR30的表达及其与外周血清胆汁酸、雌二醇水平以及胎儿预后的关系,初步探讨GPR30与ICP病情发展及胎儿预后的关联。方法：利用酶联免疫吸附试验(ELISA)技术检测30例ICP孕妇(分轻度、重度组各15例)及15例正常妊娠对照组孕妇血清中雌二醇浓度；利用实时荧光定量(RT-PCR)和免疫印迹法(western blot)分别检测三组孕妇胎盘中GPR30mRNA相对表达量和蛋白的表达水平,同时收集以上病例围生儿不良结局相关指标,将以上数据进行统计学分析。结果： 1.重度ICP组外周血清中TBA浓度为(48.51±8.39)μmol/L轻度ICP组为(22.04±7.11)μmol/L,正常孕妇组为(3.42±1.31)μmol/L;两两比较均具有统计学意义(P0.01)。 2.重度ICP组外周血清中E2浓度为(33.58±1.70)ng/ml,轻度ICP组为(28.66±1.66)ng/ml,正常孕妇组为(23.83±1.16)ng/ml;两两比较均具有统计学意义(P0.01)；三组孕妇外周血清E2与TBA水平呈正相关,r=0.862。 3.重度ICP组胎盘组织中GPR30mRNA的相对表达量(2.78±0.53),轻度ICP组为(1.99±0.27),正常孕妇组为(1.27+0.24)；两两比较均具有统计学意义(P0.01)。 4.重度ICP组胎盘组织中GPR30蛋白的相对灰度值为(0.54±0.09),轻度ICP组为(0.40±0.55),正常孕妇组为(0.32±0.04)；两两比较均具有统计学意义(P0.01)。 5.三组孕妇胎盘组织GPR30mRNA相对表达量与外周血E2水平呈正相关,r=0.812；三组孕妇胎盘组织GPR30蛋白表达量与外周血E2水平呈正相关,r=0.741。 6.三组孕妇胎盘组织GPR30mRNA相对表达量与外周血TBA水平呈正相关,r=0.819；三组孕妇胎盘组织GPR30蛋白表达量与外周TBA水平呈正相关,r=0.796 7.三组孕妇胎盘组织GPR30mRNA相对表达量与GPR30蛋白表达量呈正相关,r=0.829。 8.出现围生儿不良结局和无围生儿不良结局孕妇胎盘组织GPR30mRNA相对表达量分别为(2.41±0.531)和(1.69±0.71),两组比较差异有统计学意义(P0.01)；两组胎盘组织GPR30蛋白表达相对灰度值分别为(0.48±0.10)和(0.35±0.12),两组比较差异有统计学意义(P0.01)。结论： 1.ICP孕妇外周血清E2水平升高,且升高程度与病情严重程度相关。 2.晚孕期胎盘组织中均有GPR30的表达；ICP患者胎盘组织GPR30在mRNA及蛋白水平均较正常孕妇升高,且均与外周血清TBA呈正相关,提示GPR30可能与ICP病情发展相关。 3.胎盘组织GPR30的表达与外周血E2水平呈正相关,提示ICP孕妇升高的雌激素水平可能通过促进胎盘GPR30的表达,进一步增加了胎盘对雌激素的敏感性。 4.胎盘组织GPR30的表达与胎儿不良预后相关,提示GPR30可能通过介导雌激素致母胎间胆酸转运失调的效应,从而导致了对胎儿的损害。
[Abstract]:Objective: to investigate the relationship between the expression of GPR30 in placenta of ICP and normal pregnant women and the levels of peripheral blood bile acid, estradiol and fetal prognosis, and the relationship between GPR30 and the development of ICP and fetal prognosis. Methods: the serum levels of estradiol in 30 pregnant women with ICP (15 cases in mild group, 15 cases in severe group) and 15 normal pregnant women (control group) were detected by enzyme linked immunosorbent assay (ELISA). Real time fluorescence quantitative (RT-PCR) and Western blot (western blot) were used to detect the relative expression of GPR30mRNA and the expression of protein in placenta of three groups of pregnant women, and the related indexes of perinatal adverse outcome were collected. The above data were analyzed statistically. Results: 1. The peripheral serum TBA levels in severe ICP group were (48.51 卤8.39) 渭 mol/L, (22.04 卤7.11) 渭 mol/L, and (3.42 卤1.31) 渭 mol/L;, respectively (P0.01). 2. The level of serum E2 in severe ICP group was (33.58 卤1.70) ng/ml, that in mild ICP group was (28.66 卤1.66) ng/ml, and that in normal pregnant women group was (23.83 卤1.16) ng/ml; (P0.01). There was a positive correlation between E _ 2 and TBA in peripheral blood of pregnant women in three groups, r = 0.862. 3. The relative expression of GPR30mRNA was (2.78 卤0.53) in severe ICP group, (1.99 卤0.27) in mild ICP group and (1.27 0.24) in normal pregnant women group (P0.01). 4. The relative gray value of GPR30 protein in placenta of severe ICP group was (0.54 卤0.09), that of mild ICP group was (0.40 卤0.55), and that of normal pregnant women was (0.32 卤0.04). 5. The relative expression of GPR30mRNA in placenta of three groups was positively correlated with the level of E _ 2 in peripheral blood, and the expression of GPR30 protein in placenta of three groups was positively correlated with the level of E _ 2 in peripheral blood, and the expression of GPR30 protein in placenta of three groups was positively correlated with the level of E _ 2 in peripheral blood. 6. The relative expression of GPR30mRNA in placenta of three groups was positively correlated with the level of TBA in peripheral blood, and the expression of GPR30 protein in placenta of three groups was positively correlated with the level of peripheral TBA (r = 0.796 7). There was a positive correlation between the relative expression of GPR30mRNA and the expression of GPR30 protein in the placenta of the three groups (r = 0.829). 8. The relative expression of GPR30mRNA in placenta of pregnant women with adverse perinatal outcome and non-perinatal adverse outcome was (2.41 卤0.531) and (1.69 卤0.71), respectively, with significant difference between the two groups (P0.01). The relative gray values of GPR30 protein expression in placenta of the two groups were (0.48 卤0.10) and (0.35 卤0.12), respectively. The difference between the two groups was statistically significant (P0.01). Conclusion: the level of E _ 2 in peripheral blood of pregnant women with 1.ICP is increased, and the degree of increase is related to the severity of the disease. 2. The expression of GPR30 was found in placental tissues of late pregnancy, and the level of GPR30 in placenta of ICP patients was higher than that of normal pregnant women, and both had positive correlation with TBA in peripheral blood, suggesting that GPR30 might be related to the development of ICP. 3. The expression of GPR30 in placental tissue was positively correlated with the level of E 2 in peripheral blood, suggesting that the increased estrogen level of pregnant women with ICP might increase the sensitivity of placenta to estrogen by promoting the expression of GPR30 in placenta. 4. The expression of GPR30 in placenta is related to fetal poor prognosis, which suggests that GPR30 may cause fetal damage by mediating the effect of estrogen on the miscarriage of cholic acid between mother and fetus.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.7

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