JP4438865B2 - 妊娠可能性検査方法及び検査キット - Google Patents
妊娠可能性検査方法及び検査キット Download PDFInfo
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- JP4438865B2 JP4438865B2 JP2007504862A JP2007504862A JP4438865B2 JP 4438865 B2 JP4438865 B2 JP 4438865B2 JP 2007504862 A JP2007504862 A JP 2007504862A JP 2007504862 A JP2007504862 A JP 2007504862A JP 4438865 B2 JP4438865 B2 JP 4438865B2
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Description
研究対象
東国大学校(Dongguk University)の病院女性人工授精(IVF)プログラムに従って、多様な不妊の問題を有する54名の患者が本研究に動員された。不妊の原因別に卵管要因(n=15)、子宮内膜症(n=11)、排卵停止(n=9)そして、原因不明の不妊(n=19)である。患者らの年は21〜33歳であった(平均31.3歳)。一方、男性不妊要因、即ち、無精子症、稀少精子症等が同伴された場合は本研究対象から除外された。
1.卵母細胞の準備
排卵誘導は、ゴナドトロピン分泌ホルモン作用薬(gonadotropin releasing hormone agonist)(GnRH−a)によって実施された。黄体期中期から、900ブゼレリン(buserelin)(Hoechst, Germany)を鼻腔噴霧投与して脳下垂体を抑制させ、卵胞期3〜5日目から、ヒト更年期ゴナドトロピン(human menopausal gonadotropin)(hMG,Pergonal,Serono又はIVF―M,LG.韓国)を投与した。窒息超音波を使用した卵胞の反応に従って、hMGの投与量を調節して、卵胞の粒径が17mm以上であるものが2個以上である時、10,000IUのヒト絨毛膜ゴナドトロピン(human chorionic gonadortopin)(hCG,IVF−C,LG,韓国)を投与して胚卵を誘導した。hCG注射の36時間後に窒息超音波を使用して卵胞を吸入、卵母細胞を採取した。採取した卵母細胞は、37℃、5%CO2条件に調節された操作機(IVF chamber,米国)内で解剖顕微鏡(SMZ−10,ニコン,日本)を使用して卵球細胞の特徴と細胞質内のGVの有無を基準に卵母細胞の成熟程度を確認した。その後、10%SSSを添加したP1培地が入っている培養皿(3037,Falcon,米国)に移して受精時期までCO2培養器で培養した。受精に使用する卵母細胞は培養皿当り、5個以下になるように調節した。
卵母細胞を採取後、マスターベーションにより試料容器(specimen container)(Baxter,米国)に精液を回収した。精子の濃度と運動性は、WHOの基準に従って測定した。精液は、液状化を誘導するため、室温で10〜20分間放置された。液状化された精液は15mlコニカルチューブ(cornical tube)(2099,Falcon,米国)に移した後、10%SSSが添付されたHam’s F−10にて1,500rpmで、2回(5分、3分)遠心分離された。遠心分離後、ペレット(pellet)を除いた上層液は除去され、ペレットが散らないように1mlの10%SSSが添加されたHam's F−10を注意して添加して、30分間培養器内で精子を浮遊した。浮遊された精子は5ml容チューブ(2003,falcon,米国)に保管しながら受精に使用した。受精に使用する精子は1×105/ml匹になるように受精時期の卵母細胞が入っている培養液内に注入した。翌日の朝、37℃、5%CO2条件に調節された操作機内にある解剖顕微鏡下で注射針(syringe needle)(320310,BD,米国)を用いて卵球細胞を除去し、受精したかどうかを調べた。雌性前核と雄性前核が形成されており、2個の極体があるのを受精がなったものと確認した。
正常的に受精が行われた胚だけを選別してP1培養液で48時間を培養した後、8−細胞期以上の胚を2−5個選別して移植した。移植には、殆どの場合、Tomcat catheter(8890−793021,Sherwoo,米国)を使用した。
胚芽移植後、毎日、100mgの黄体ホルモン(progeterone in oil, Progest,Samil,韓国)が患者に対して筋肉注射された。移植後の10日頃に、血中β−hCGの濃度が10mIU/ml以上であることをもって生化学的妊娠として定義した。また、少なくとも妊娠期間中に窒息超音波検査で胎児の心臓活性が確認されることをもって臨床的妊娠として定義した。
卵胞液は、IVF体外受精施術を行って周期が高揚している女性の粒径17mm以上の卵胞から超音波吸入(ultrasound−guided aspiration)方法で回収した。回収した卵母細胞及び卵胞液は、超音波吸入に供され、卵胞液については血液が殆ど混じっていないものだけを回収して使用した。回収された卵胞液は遠心分離(3,500rpm)を30分間実施して血球細胞と顆粒球細胞等を除去した後、上層液だけを回収した。上層液は、0.2μmの濾過器で除菌し、−20℃の冷蔵庫で保管した。卵胞液は使用に際して溶解された。
卵胞液におけるMMP−2とMMP−9の発現は、Rawdanowicz et al.(1994)の記載に、Riley et al. (1999)の内容を修正したザイモグラフイを使用して検出した。卵胞液は1mg/mlのゼラチンが含まれたSDS−PAGE(7.5%(w/v gels; Minigel apparatus; Bio−Red, Hemel Hempsead)を用いて分離した。ゲルは、2.5%(v/v)Triton X−100で2回洗浄され、消化緩衝液(digestion buffer; 200mM NaCl, 50mM Tris−HCl, 2.5 mM CaCl2, 1mM ZnCl2, pH7.6; all chemicals from Sigma Chemical Co, St Louis, MO)に入れて37℃、18時間保管した。ゲルは、染色溶液(0.5%(w/v) Coomassie blue R250 (Bio Red, Richmond, CA) in 30%(v/v) methanol 10%(v/v)glacial acetic acid in H2O)で室温で染色した。
ゼラチナーゼ(Gelatinase)活性は、ゲルをスキャニングした後、帯(band)層の強さと表面を測定するGel Documentation semi−automated image analysis(Core−Bio System, Seoul,韓国)を使用して定量された。
結果は、少なくとも3反復の平均により行われた。平均に対する有意性はStudents t−testで評価した。P<0.05である場合、統計学的に有意性のあるものと判定した。
卵胞液において、92kDaに表れるゼラチナーゼ活性は、ザイモグラフイによって立証されたように、MMP−9活性と一致した(図1)。妊娠群のMMP−9活性の総量は、非妊娠群に比べて有意的に高かった(P<0.01)。
2.Hibbs MS,Hasty, KA, Seyer JM, Kang AH, Mainardi CL (1985) Biochemical and immunological characterization of the secreted forms of human neutrophil gelatinase. J Biol Chem 260:2493-2500.
3.Murphy G, Cockett MI, Ward RV and Docherty AJ. Matrix metalloproteinase degradation of elastin, type IV collagen and proteoglycan. A quantitative comparison of the activities of 95 kDa and 72 kDa gelatinases, stromelysins-1 and -2 and punctuated metalloproteinase (PUMP). Biochem J. 1991. 277 : 277-279.
4.Sato H, Seiki M(1993) Regulatory mechanism of 92 kDa type IV collagenase gene expression which associated with invasiveness of tumor cells. Oncogene 8:395-405.
5.Shimonovitz S, Hurwitz A, Dushnik M, Anteby E, Geva-Eidar T, Yagel S. Developmental regulation of the expression of 72 and 92 kd type IV collagenases in human trophoblasts: A possible mechanism for control of trophoblast invasion. Am J Obstet Gynecol 1994: 171:832-838.
6.Huang HY, Wen Y, Irwin JC, Kruessel JS, Soong YK, Polan ML.Cytokine-mediated regulation of 92-kilodalton type IV collagenase, tissue inhibitor of metalloproteinase-1(TIMP-1) and TIMP-3 messenger ribonucleic acid expression in human endometrial stromal cells. J. Clin. Endocrinol. Metab. 1998:83:1721-1729.
7.Jeziorska, M. Nagase H. Salamonsen, L.A and Wolley. D.E (1996) Immunolocalization of the matrix metalloproteinases gelatiase B and stromelysin 1 in human endometrium throughout the menstrual cycle. J. Repro. Fertil. 107, 43-51.
8.Librach CL, Werb Z, Fitzgerld ML, Chiu K, Corwin NM, Esteves RA, Grobelny D, Galardy R, Damsky CH and Fisher SJ(1991) 92kDa type IV collagenase mediates invasion of human cytotrophoblasts Jounal of Cell Biology113 437-449.
9.Vadillo-Ortega, F.Gonzalez-Azila, G,Furth, E.E. et al. (1995) 92-kd type IV collagenase (matrix metalloproteinase-9) activity in human amniochorin increases with labor. Am.J.Pathol.146, 148-156.
10.Wewer UM, Damjanov A, Weiss J, Liotta LA, Damjanov I (1986) : Mouse endometrial stromal cells produce basement-membrane components. Differentiation 32 : 49-58.
11.Aplin JD, Charlton, A.K., Ayad, S.(1988) : An immunohistochemical study of human endometrial extracellular matrix during the menstrual cycle and first trimester of pregnancy. Cell Tissue Res 253 : 2312-40.
12.Behrendtsen O, Alexander CM, Werb Z (1992) : Metalloproteinases mediate extracellular matrix degadation by cells from mouse blastocyst outgrowths. Development 114 : 447-456.
13.Cross JC, Werb Z, Fisher SJ (1994) : Implantation and the placenta : Key pieces of the development puzzle. Science 226 : 1508 - 1518.
14.Lefebvre O, Regnier C , Chenard M-P, Wendling C, Chambon P, Bassett P, Rio M.C. (1995): Developmental expression of mouse stromelysin-3 mRNA. Development 121 : 947-955.
15.Harvey MB, Leco Kj, Arcellana-Panlilio MY, Zhang X, Edwards DR, Schultz GA (1995) Proteinase expression in early mouse embryos is regulated by leukaemia inhibitory factor and epidermal growth factor. Development 121: 1005-1014.
16.Leco KJ, Edwards DR, Schultz GA (1996) : Tissue inhibitor of metalloproteinases-3 is the major metalloproteinases inhibitor in the decidualizing murine uterus. Mol Reprod Dev 45 : 458-465.
17.Alexander CM, Hansell EJ, Behrendtsen O, Flannery ML, Kishnani NS, Hawkes SP, Werb Z (1996) Expression and function of matrix metalloproteinases and their inhibitrors at the maternal embryonic boundary during mouse embryo implantation. Development 122 : 1723-1736.
18.Espey LL(1994) Current status of the hypothesis that mammalian ovulation is comparable to an inflammatory reaction. Biol. Reprod. 50 : 233-238.
19.Luck MR and Zhao Y (1995) Structural remodelling of reproductive tissues. J. Endocrinol. 146, 191-195.
20.Reponen P, Leivo I, Sahberg C, Apte SS, Olsen BR, Thesleff I, Tryggvason K. 92-kDa type IV collagenase and TIMP-3 but not 72kDa type IV collagenase or TIMP-1 or TIMP-2, are highly expressed during mouse embryo implantation. Develop Dynam 1995; 202:388-396.
21.Fisher SJ, Leitch MS, Kantor MS (1985) Degradation of extracellular matrix by the trophoblastic cells of first trimester human placentas. J. Cell Biochm 27 : 31-40.
22.Librach CL, Werb Z, Fitzgeld ML, Corwin NM, Esteves RA, Grobelny D, Galardy R, Damsky CH and Fisher SJ 92kDa type IV collagenase mediates invasion of human cytotrophoblasts. J.Cell Biol 1991; 113: 437-449
23.Hulboy DL, Rudolph LA, Matrisian LM. Matrix metalloproteinases as mediators of reproductive function. Mol Hum Reprod 1997 Jan 3(1) ; 27-45
24.Bryant-Greenwood GD and Yamamoto SY (1995) : Control of peripartal collagenolysis in the human choriodecidua. Am. J. Obstet. Gynecol., 172 : 63-70.
25.Draper D, McGregor J, Hall J (1995) Elevated protease activities in human amnion and chorion correlate with pretrem premature rupture of membrance. Am. J. Obstet. Gynecol. 173 : 1506-1512.
26.Lei H, Vadillo-Ortega F, Paavola LG and Strauss JF (1995) 92 kDa gelatinase (matrix metalloproteinase-9) is induced in rat amnion immediately prior to parturition. Biol. Reprod 53: 339-344.
Claims (4)
- 成熟な卵母細胞を有する卵胞の卵胞液に含まれたMMP−9の活性を測定し、前記MMP−9の活性をゼラチン基質ザイモグラフィ技術において密度測定機器を使用して数値化した値が50,000ユニット以上であることを確認することにより妊娠可能性を検査することを特徴とする妊娠可能性検査方法。
- 前記卵胞は、粒径17mm以上のものが選択されることを特徴とする請求項1に記載の妊娠可能性検査方法。
- MMP−9によって分解される蛋白質基質を含むポリアクリルアミドゲルを使用して卵胞液内に含まれるMMP−9の活性を測定し、前記MMP−9の活性をゼラチン基質ザイモグラフィ技術において密度測定機器を使用して数値化した値が50,000ユニット以上であることを確認することを特徴とする妊娠可能性検査キット。
- 前記蛋白質基質は、コラーゲンIV、コラーゲンV、コラーゲンXI、エラスチン、プロテオグリカン及びゼラチンの中から選択されたものであることを特徴とする請求項3に記載の妊娠可能性検査キット。
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PCT/KR2004/000688 WO2005093408A1 (en) | 2004-03-26 | 2004-03-26 | Method of diagnosing the chances of pregnancy and the diagnostic kit for the same |
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TR201806889T4 (tr) * | 2011-08-12 | 2018-06-21 | Artpred B V | İn vitro fertilizasyonun tahmin başarısına yönelik yeni yöntem ve kit. |
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US5641636A (en) * | 1994-05-20 | 1997-06-24 | University Of Pennsylvania | Method of predicting fetal membrane rupture based on matrix metalloproteinase-9 activity |
WO1998040747A1 (en) * | 1997-03-07 | 1998-09-17 | Mount Sinai Hospital Corporation | Methods to diagnose a required regulation of trophoblast invasion |
KR100570501B1 (ko) * | 2003-03-20 | 2006-04-12 | 김철호 | 임신 가능성 측정킷트 및 예측방법 |
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