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Correlation Between Autophagy and Collagen Deposition in Patients With Pelvic Organ Prolapse

Zeng, Chunyan, MMed*; Liu, Juan, PhD*; Wang, Hailan, MMed; Zhou, Yan, MMed*; Wu, Junwei, MMed*; Yan, Guangrong, PhD

Female Pelvic Medicine & Reconstructive Surgery: May/June 2018 - Volume 24 - Issue 3 - p 213–221
doi: 10.1097/SPV.0000000000000455
Original Articles

Objectives The aim of this study was to explore the link between autophagy and collagen metabolism in patients with pelvic organ prolapse (POP) by detecting the expressions of autophagy factors, collagen, desmin, cytokeratin, and vimentin.

Methods Histology of anterior vaginal wall and uterosacral ligament was assessed by hematoxylin-eosin staining in POP and non-POP control patients (n = 50 per group). Expressions of collagen types I and III, LC3II, beclin 1, and p62 were examined by Western blot analysis. Expressions of LC3, vimentin, desmin, and cytokeratin were detected by immunohistochemical staining. A linkage between the mean of LC3 integrated option density summation (IOD SUM) and POP clinicopathologic parameters including Pelvic Organ Prolapse Quantification (POP-Q) staging, age, body mass index, gravidity, and parity was analyzed by χ2 test, respectively.

Results Compared with the control group, the following differences were found both in the vaginal wall and in the uterosacral ligament of the POP group: hematoxylin-eosin staining showed that collagen was more fragmented and disorganized. Expressions of collagen types I and III, LC3II, and beclin 1 were diminished, whereas the p62 level was elevated in Western blotting. Immunohistochemical staining showed that expression of LC3 was down-regulated, whereas vimentin level was increased. There were no significant differences in the expressions of desmin and cytokeratin in the 2 groups (P > 0.05). Mean of LC3 IOD SUM was highly linked to the POP-Q stage in the POP group (P < 0.05), whereas there was no significant correlation between the mean of LC3 IOD SUM and POP groups in age, body mass index, gravidity, and parity, respectively(P > 0.05).

Conclusions Autophagic activity is impaired in the POP group, which may relate to collagen deposition.

Impaired autophagy was linked to the collagen deposition in the pelvic organ prolapse group.

From the *Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou; †The First People’s Hospital of Chenzhou, Chenzhou; and ‡Biomedicine Research Center and Department of Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Correspondence: Juan Liu, PhD, Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, No.63 Duobao Road, Liwan District, Guangzhou, Guangdong, China. E-mail:

The authors have declared they have no conflicts of interest.

This study was supported by a grant from the Science Technology and Information Bureau of Guangzhou (grant 201300000137), a fund from China Preventive Medicine Association (grant 20131904), and a grant from the National Natural Science Foundation of China (grant 81671440).

Authors’ contributions to the manuscript: C.Z.: project development, data collection, and manuscript writing; J.L.: project development and data analysis; H.W.: manuscript writing; Y.Z.: data collection; J.W.: data management; G.Y.: manuscript editing.

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