Open AccessPelvic floor sex steroid hormone receptors, distribution and expression in pre‐ and postmenopausal stress urinary incontinent women
Author(s) -
SÖDERBERG MARIE WESTERGREN,
JOHANSSON BENGT,
MASIRONI BRITT,
BYSTRÖM BIRGITTA,
FALCONER CHRISTIAN,
SAHLIN LENA,
EKMAN ORDEBERG GUNVOR
Publication year - 2007
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340701625446
Subject(s) - medicine , menopause , estrogen receptor , estrogen , receptor , androgen receptor , hormone , endocrinology , immunohistochemistry , androgen , progesterone receptor , pelvic floor , estrogen receptor beta , gynecology , breast cancer , cancer , gastroenterology , prostate cancer
Background . Hormonal influence on stress urinary incontinence (SUI) is under debate. Sex steroid hormonal activity is mediated by nuclear receptor proteins. The aim of this study is to identify receptor isoforms and their genetic expression in the pelvic floor extra cellular matrix (ECM), and to compare women with and without SUI before and after menopause. Methods . Sub‐mucosal para‐urethral biopsies from 4 pre‐menopausal and 8 postmenopausal patients with SUI were analysed immunohistochemically regarding estrogen receptors (ER) α and β, the progesterone receptor (PR) (A+B) and B, and the androgen receptor (AR). Six pre‐menopausal and 5 postmenopausal women served as controls. All receptors were scored manually. Additionally, ER‐α and ER‐β were quantified by image analysis. Biopsies from 7 pre‐menopausal and 7 postmenopausal women suffering from SUI were studied by real‐time RT‐PCR for expression of ER‐α, ER‐β, PR and AR. The control group consisted of 5 pre‐menopausal and 5 postmenopausal women. Results. Immunohistochemistry revealed receptor‐positive cells for all isoforms in all groups. Higher ER‐β scores were seen in the pre‐menopausal SUI group compared to controls. Lower PR‐B scores were found after menopause in both groups. The image analysis confirmed that ER‐β was significantly increased in the pre‐menopausal SUI group compared to controls ( p = 0.02). By real‐time RT‐PCR, no difference of mRNA expression regarding any receptor was detected between any SUI and control group. ER‐β mRNA levels were low or undetectable. There was a significant down‐regulation of PR among postmenopausal women ( p = 0.001). Conclusions . The para‐urethral ECM is a target for sex steroid hormones mediated by the respective receptor. The significant higher expression of ER‐β protein in the pre‐menopausal SUI‐group was not reflected by a corresponding up‐regulation of mRNA which was poorly expressed in all groups.