ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМПymj-1359Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHХарактеристики соединительной ткани тазового дна при пролапсе гениталийThe Characteristics of the Connective Tissue of the Pelvic Floor at the Collapse of the GenitalsХанзадянМ. Л.KhanzadyanM. L.

Ханзадян Марина Лаертовна – к.м.н., доцент ФПК МР 

Khanzadyan Marina Laertovna ‐ MD, Associate Professor of obstetrics, gynecology and reproductive medicine department

8 Miklukho‐ Maklay Street Moscow 117198

khmala@rambler.ruДемураТ. А.DemuraT. A.

Демура Татьяна Александровна – к.м.н., доцент 

Demura Tatiana Aleksandrovna ‐ MD, Associate Professor of Strukov pathological anatomy department, Medical University 

8 Trubetskaya Street Moscow 119991

demura-t@yandex.ruПолинаМ. Л.PolinaM. L.

Полина Мирослава Леонидовна – к.м.н., ассистент кафедры ФПК МР

Polina M.L. – MD, Assistant of obstetrics, gynecology and reproductive medicine department

8 Miklukho‐Maklay Street Moscow 117198

polina.ml@mail.ruРоссийский университет дружбы народовРоссияPeoples' Friendship UniversityRussian FederationГБОУ ВПО «Первый МГМУ им. И.М.Сеченова»РоссияFirst Sechenov MGMURussian Federation201513092025041113Copyright © Ханзадян М.Л., Демура Т.А., Полина М.Л., 20252025Ханзадян М.Л., Демура Т.А., Полина М.Л.Khanzadyan M.L., Demura T.A., Polina M.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/1359

Изучены особенности иммуногистохимического распределения экспрессии маркеров ММП-1, ММП-2 и ТИМП-1 в крестцово-маточных и круглых связках матки у женщин с пролапсом гениталий (ПГ) на материале биоптатов женщин в возрасте от 42 до 65 лет, взятых в ходе влагалищной гистерэктомии. Выявлено, что снижение накопления ТИМП-1 на фоне высокой экспрессии металлопротеиназ при ПГ контрастирует с уровнем экспрессии умеренной ММП-2, низкой ММП-1 и умеренной ТИМП-1 в группе контроля, что влияет на плотность внеклеточного матрикса. Разрыхление соединительной ткани наряду с уменьшением ее эластичности, растяжимости и прочности сопровождалось деградацией волокон и повышенным распадом коллагена, определяя патобиохимию нарушений при тазовой дисфункции.

The objective of our study is to clarify the distribution of immunohistochemical marker expression of MMP‐1, MMP‐2 and TIMP‐1 in the sacrouterine and round ligaments of the uterus among women with genital prolapse.

The research was performed on the material of biopsies of sacrouterine and round ligaments of the uterus on both sides taken during vaginal hysterectomy from 15 women with genital prolapse aged 42 to 65 years old. It was found that the decrease in the accumulation of TIMP‐1 on the background of high expression of metalloproteinases in the POP contrasts with a moderate level of expression of MMP‐2, low MMP‐1 and moderate TIMP‐1 in the control group, which affects the density of the VCR. Connective tissue loosening, reducing of its elasticity and tensile strength was accompanied by degradation of fibers and increased degradation of collagen, defining pathobiochemical disorders in the pelvic dysfunction.

пролапс гениталийматриксные металлопротеиназытканевые ингибиторы матриксных протеиназgenital prolapsematrix metalloproteinasestissue inhibitors of matrix proteinasesReferencesКадурина Т.И. Дисплазия соединительной ткани / Т.И. Кадурина, В.Н. Горбунова // Руководство для врачей. – СПб.: ЭЛБИ, 2009. – 704 с.Kadurina T. I. Gorbunova V. N. Displaziya soedinitel'noj tkani [Connective tissue dysplasia] Rukovodstvo dlya vrachej. [Manual for Physicians.].SPb.: EHLBI, 2009, 704p.Радзинский В.Е. Перинеология / В.Е. Радзинский. – М., 2010. – 372 с.Radzinskij V. E. Perineologiya [Perineology]. Moskva, 2010, 372p.Смольнова Т.Ю. Клинико-патогенетические аспекты опущения и выпадения внутренних половых органов и патологии структур тазового комплекса у женщин при дисплазии соединительной ткани. Тактика ведения: дисс. … д-ра мед. наук / Т.Ю. Смольнова. – М., 2009. – 221 с.Smol'nova T. YU. Kliniko–patogeneticheskie aspekty opushheniya i vypadeniya vnutrennikh polovykh organov i patologii struktur tazovogo kompleksa u zhenshhin pri displazii soedinitel'noj tkani.Taktika vedeniya [Clinical and pathogenetic aspects of descent and prolapse of internal genital organs and structures of the pelvic complex pathology among women with connective tissue dysplasia. Management tactics]: diss. … dokt. med. nauk. M., 2009, 221 p.Chen B. Alterations in connective tissue metabolism in stress incontinence and prolapse / B. Chen, J. Yeh // J Urol. – 2011. – V. 186, №5. – P. 1768–72.Chen B. Alterations in connective tissue metabolism in stress incontinence and prolapse / B. Chen, J. Yeh// J Urol. – 2011. – V. 186. – № 5. – P. 1768–72.Difference in expression of collagen type I and matrix metalloproteinase-1 in uterosacral ligaments of women with and without pelvic organ prolapse / M. Vulic, T. Strinic, S. Tomic [et al.] // Eur J Obstet Gynecol Reprod Biol. – 2011. – V. 155, № 2. – P. 225–8.Difference in expression of collagen type I and matrix metalloproteinase‐1 in uterosacral ligaments of women with and without pelvic organ prolapse / M. Vulic, T. Strinic, S. Tomic [et al.] //Eur J ObstetGynecolReprod Biol. – 2011. – V. 155. – № 2. – P. 225–8.Ewies A.A. Changes in extracellular matrix proteins in the cardinal ligaments of postmenopausal women with or without prolapse: a computerized immunohistomorphometric analysis / A.A. Ewies, F. Al-Azzawi, J. Thompson // Hum Reprod. –2003. –V. 18, № 10. – P. 2189- 95.Ewies A. A. Changes in extracellular matrix proteins in the cardinal ligaments of post‐ menopausal women with or without prolapse: a computerized immunohistomorphometric analysis / A. A. Ewies, F. Al‐Azzawi, J. Thompson // Hum Reprod. –2003. –V. 18. – № 10. – P. 2189‐ 95.Expression of matrix metalloproteinase-1 in round ligament and uterosacral ligament tissue from women with pelvic organ prolapse / A. Usta, K. Guzin, M. Kanter [et al.] // J Mol Histol. – 2014. – V. 45, № 3. – P. 275– 81.Expression of matrix metalloproteinase‐1 in round ligament and uterosacral ligament tissue from women with pelvic organ prolapse / A. Usta, K. Guzin, M. Kanter [et al.] //J MolHistol. – 2014. – V. 45. – № 3. – P. 275– 81.Extracellular matrix remodeling is increased in vaginal tissue of premenopausal patients with pelvic organ prolapse / M. Alarab, O. Shynlova, H. Drutz // ReprodSci. – 2008. – № 15. – 311 p.Extracellular matrix remodeling is increased in vaginal tissue of premenopausal patients with pelvic organ prolapse / M. Alarab, O. Shynlova, H. Drutz // ReprodSci. – 2008. – № 15. – 311 p.Increased expression of matrix metalloproteinase 2 in uterosacral ligaments is associated with pelvic organ prolapse / B. Gabriel, D. Watermann, K. Hancke [et al.] // Int Urogynecol J Pelvic Floor Dysfunct. – 2006. – V. 17, № 5. – P. 478–482.Increased expression of matrix metalloproteinase 2 in uterosacral ligaments is associated with pelvic organ prolapse / B. Gabriel, D. Watermann, K. Hancke [et al.] // IntUrogynecol J Pelvic Floor Dysfunct. – 2006. – V. 17. – № 5. – P. 478–482.Increased expression of matrix metalloproteinase-1 in uterosacral ligament tissue from women with pelvic organ prolapse / T. Strinic, M. Vulic, S. Tomic [et al.] // Acta Obstet Gynecol Scand. – 2010. – V. 89, № 6. – P. 832 –4.Increased expression of matrix metalloproteinase‐1 in uterosacral ligament tissue from women with pelvic organ prolapse / T. Strinic, M. Vulic, S. Tomic [et al.] //ActaObstetGynecol Scand. – 2010. – V. 89. –№ 6. – P. 832 –4.Kerkhof M.H. Changes in connective tissue in patients with pelvic organ prolapse a review of the current literature / M.H. Kerkhof, L. Hendriks, H.A. Brölmann // Int Urogynecol J Pelvic Floor Dysfunct. – 2009. – V. 20, № 4. – P.461–74.Kerkhof M.H. Changes in connective tissue in patients with pelvic organ prolapse‐a review of the current literature / M.H.Kerkhof, L. Hendriks, H.A. Brölmann//IntUrogynecol J Pelvic Floor Dysfunct. – 2009. – V. 20. – № 4. – P. 461–74.Matrix metalloproteinases -1, -2 expression in uterosacral ligaments from women with pelvic organ prolapse / T. Strinic, M. Vulic, S. Tomic [et al.] // Maturitas. – 2009. – № 64. – P.132– 135.Matrix metalloproteinases ‐1, ‐2 expression in uterosacral ligaments from women with pelvic organ prolapse / T. Strinic, M. Vulic, S. Tomic [et al.] // Maturitas. – 2009. – № 64. – P. 132–135.Pelvic floor disorders: linking genetic risk factors to biochemical changes / L. Campeau, I. Gorbachinsky, G.H. Badlani [et al.] // BJU Int. – 2011. – V. 108, № 8. – P. 1240–7.Pelvic floor disorders: linking genetic risk factors to biochemical changes / L. Campeau, I. Gorbachinsky, G.H. Badlani [et al.] // BJU Int. – 2011. – V. 108. – № 8. – P. 1240–7.Petros P. The Female Pelvic Floor. Function, Dysfunction and Management According to the Integral Theory / P. Petros. – N.-Y.: Springer, 2007. – 260 p.Petros P.The Female Pelvic Floor. Function, Dysfunction and Management According to the Integral Theory / Petros P. ‐ N.‐Y.: Springer, 2007. – 260 p.Trojanek J. Matrix metalloproteinases and their tissue inhibitors / J. Trojanek // Postepy Biochem. – 2012. – V. 58, № 3. – P. 353– 62.Trojanek J. Matrix metalloproteinases and their tissue inhibitors / J. Trojanek//PostepyBiochem. – 2012. – V. 58. – № 3. – P. 353– 62.

The authors declare that there are no conflicts of interest present.