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Tian Z, Li Q, Wang X, Sun Z. The difference in extracellular matrix metabolism in women with and without pelvic organ prolapse: A systematic review and meta-analysis. BJOG 2024; 131:1029-1041. [PMID: 38291948 DOI: 10.1111/1471-0528.17768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Studies on the changes of extracellular matrix (ECM) in pelvic organ prolapse (POP) are still controversial. OBJECTIVE To identify the changes in the ECM in POP patients. SEARCH STRATEGY Comprehensive searching in Embase, PubMed, Web of Science and the Cochrane Library was carried out until 23 February 2023. SELECTION CRITERIA Studies comparing the protein levels of ECM-related components between women with and without POP. DATA COLLECTION AND ANALYSIS Quality and risk of bias were assessed using the Agency for Healthcare Research and Quality assessment. Indicators were pooled with random or fixed effect meta-analysis based on heterogeneity and sub-grouped analysed by the biopsy site. MAIN RESULTS Thirty cross-sectional studies were included, comprising 840 POP cases and 755 controls. Overall results showed that the expression of type III collagen (COLIII) and several matrix metalloproteinases (MMP-1, -2 and -9) were increased, whereas those of type I collagen (COLI), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were decreased in patients with POP. Subgroup analysis showed that the expression of COLIII in the anterior vaginal wall (AVW) and COLIII, MMP-2 and -9 in the uterosacral ligament (USL) were consistent with the overall results. However, the expression of COLI and MMP-1 in the AVW showed no difference and the expression of COLI and MMP-1 in the USL is still controversial based on current studies. CONCLUSIONS Patients with POP have lower expression of COLI and TIMP-1 and higher expression of COLIII and MMPs compared with non-POP cases, but further studies are required to investigate in specified anatomical sites.
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Affiliation(s)
- Zhao Tian
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Centre for Obstetric & Gynaecological Diseases, Beijing, China
| | - Qiutong Li
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Centre for Obstetric & Gynaecological Diseases, Beijing, China
| | - Xiuqi Wang
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Centre for Obstetric & Gynaecological Diseases, Beijing, China
| | - Zhijing Sun
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Centre for Obstetric & Gynaecological Diseases, Beijing, China
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Quiles MT, Rodríguez-Contreras A, Guillem-Marti J, Punset M, Sánchez-Soto M, López-Cano M, Sabadell J, Velasco J, Armengol M, Manero JM, Arbós MA. Effect of Functionalization of Texturized Polypropylene Surface by Silanization and HBII-RGD Attachment on Response of Primary Abdominal and Vaginal Fibroblasts. Polymers (Basel) 2024; 16:667. [PMID: 38475352 DOI: 10.3390/polym16050667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Soft tissue defects, such as incisional hernia or pelvic organ prolapse, are prevalent pathologies characterized by a tissue microenvironment rich in fragile and dysfunctional fibroblasts. Precision medicine could improve their surgical repair, currently based on polymeric materials. Nonetheless, biomaterial-triggered interventions need first a better understanding of the cell-material interfaces that truly consider the patients' biology. Few tools are available to study the interactions between polymers and dysfunctional soft tissue cells in vitro. Here, we propose polypropylene (PP) as a matrix to create microscale surfaces w/wo functionalization with an HBII-RGD molecule, a fibronectin fragment modified to include an RGD sequence for promoting cell attachment and differentiation. Metal mold surfaces were roughened by shot blasting with aluminum oxide, and polypropylene plates were obtained by injection molding. HBII-RGD was covalently attached by silanization. As a proof of concept, primary abdominal and vaginal wall fasciae fibroblasts from control patients were grown on the new surfaces. Tissue-specific significant differences in cell morphology, early adhesion and cytoskeletal structure were observed. Roughness and biofunctionalization parameters exerted unique and combinatorial effects that need further investigation. We conclude that the proposed model is effective and provides a new framework to inform the design of smart materials for the treatment of clinically compromised tissues.
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Affiliation(s)
- Maria Teresa Quiles
- General Surgery Research Unit, Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), Josep Trueta, s/n, 08195 Sant Cugat del Vallés, Spain
| | - Alejandra Rodríguez-Contreras
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. Eduard Maristany, 16, 08019 Barcelona, Spain
- Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. D'Eduard Maristany, 16, 08019 Barcelona, Spain
- Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Jordi Guillem-Marti
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. Eduard Maristany, 16, 08019 Barcelona, Spain
- Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. D'Eduard Maristany, 16, 08019 Barcelona, Spain
- Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Miquel Punset
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. Eduard Maristany, 16, 08019 Barcelona, Spain
- Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. D'Eduard Maristany, 16, 08019 Barcelona, Spain
| | - Miguel Sánchez-Soto
- Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. D'Eduard Maristany, 16, 08019 Barcelona, Spain
| | - Manuel López-Cano
- General Surgery Research Unit, Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jordi Sabadell
- General Surgery Research Unit, Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Urogynecology and Pelvic Floor Unit, Department of Gynecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Janice Velasco
- Department of Surgery, Hospital San Rafael, Germanes Hospitalàries, Passeig de la Vall d'Hebron, 107, 08035 Barcelona, Spain
| | - Manuel Armengol
- General Surgery Research Unit, Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jose Maria Manero
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. Eduard Maristany, 16, 08019 Barcelona, Spain
- Department Materials Science and Engineering, Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Escola d'Enginyeria de Barcelona Est (EEBE), Campus Diagonal-Besòs, Av. D'Eduard Maristany, 16, 08019 Barcelona, Spain
- Networking Research Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Maria Antònia Arbós
- General Surgery Research Unit, Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), Josep Trueta, s/n, 08195 Sant Cugat del Vallés, Spain
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Zhang R, Li Y, Zhang J. Molecular mechanisms of pelvic organ prolapse influenced by FBLN5 via FOSL1/miR-222/MEIS1/COL3A1 axis. Cell Signal 2024; 114:111000. [PMID: 38056607 DOI: 10.1016/j.cellsig.2023.111000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/27/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
This study delves into the role of FBLN5 in pelvic organ prolapse (POP) and its molecular mechanisms, focusing on the FOSL1/miR-222/MEIS1/COL3A1 axis. Gene relationships linked to POP were confirmed using bioinformatics databases like GEO and StarBase. Primary human uterosacral ligament fibroblasts (hUSLF) were extracted and subjected to mechanical stretching. Cellular cytoskeletal changes were examined via phalloidin staining, intracellular ROS levels with a ROS kit, cell apoptosis through flow cytometry, and cell senescence using β-galactosidase staining. FBLN5's downstream targets were identified, and the interaction between FOSL1 and miR-222 and miR-222 and MEIS1 were validated using assays. In rat models, the role of FBLN5 in POP was assessed using bladder pressure tests. Results indicated diminished FBLN5 expression in uterine prolapse. Enhanced FBLN5 countered mechanical damage in hUSLF cells by downregulating FOSL1. FOSL1 augmented miR-222, inhibiting MEIS1, which subsequently fostered COL3A1 transcription. In rat models, the absence of FBLN5 exacerbated POP by influencing the FOSL1/miR-222/MEIS1/COL3A1 pathway. FBLN5's protective role likely involves regulating the above axis and boosting COL3A1 expression. Further research is needed to validate the effectiveness and safety of this mechanism in human patients and to propose potential new treatment options.
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Affiliation(s)
- Rui Zhang
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, PR China
| | - Ya Li
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, PR China
| | - Jin Zhang
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, PR China.
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Deng W, Zhong Z, Tong Y, Liu J, Wang X, Xu L, Li Y, Chen X, Wei Q, Rao J. 4D DIA-PRM proteomic study identifying modulated pathways and biomarkers associated with pelvic organ prolapse. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1230:123916. [PMID: 37922782 DOI: 10.1016/j.jchromb.2023.123916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
Pelvic organ prolapse (POP) is a highly disabling condition that negatively affects the quality of life of millions of women worldwide. However, the underlying mechanisms associated with the development and progression of the disease remain poorly understood. Here, an untargeted four-dimensional data-independent acquisition (4D DIA)-based proteomics approach was applied to vaginal wall tissue samples from POP (n = 19) and control (n = 8) patients to identify potential diagnostic biomarker(s) for POP and examine the molecular mechanisms underlying the disease. Of the 5713 tissue proteins that were detected, 1957 proteins were significantly changed in POP patients. Further bioinformatics analysis revealed that multiple biological processes including protein digestion & absorption, retrograde endocannabinoid signaling, tyrosine metabolism, and nucleotide metabolism were significantly enriched and associated with the pathogenesis of POP. Interestingly, 16 of these differentially expressed proteins associated with four pathways were also identified by targeted parallel reaction monitoring (PRM) proteomics analysis on the same 27 tissue samples. Changes in 94 % (15/16) of these proteins were consistent with the 4D DIA data. Furthermore, most proteins displayed good diagnostic accuracy with high area under the curve (AUC) values (AUC>0.8). Specifically, five proteins including ELN, COL6A2, ENTPD1, AOC3, and COX7A2 distinguished between POP and control patients with very high accuracy (AUC ≥ 0.95) in both 4D DIA and PRM analyses, and may therefore be potential diagnostic biomarkers for POP. In summary, the present study not only provided several potential biomarker(s) for effective POP diagnosis, but extended our knowledge of the key regulatory pathways associated with the disease.
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Affiliation(s)
- Wei Deng
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China; Jiangxi Provincial Maternal and Child Health Hospital, Nanchang 330006, Jiangxi Province, China
| | - Zhifeng Zhong
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Yuehong Tong
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Jun Liu
- Jiangxi Provincial Maternal and Child Health Hospital, Nanchang 330006, Jiangxi Province, China
| | - Xiaofen Wang
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Lili Xu
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
| | - Yufeng Li
- Department of Joint Surgery, People's Hospital of Ganxian District, Ganzhou, Jiangxi, 341100, China
| | - Xiaodan Chen
- Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Nanchang 330029, Jiangxi Province, China
| | - Qingfeng Wei
- Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Nanchang 330029, Jiangxi Province, China.
| | - Jun Rao
- Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Clinical Research Center for Cancer, Nanchang 330029, Jiangxi Province, China.
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