男性不育症患者精浆外泌体miR-202-5p水平变化及临床意义  

Changes of seminal plasma exosome miR-202-5p level in male infertility patients and its clinical significance

作　　者：卞玉莹 王成 顾万建[3] 倪吴花[4] 张春妮 BIAN Yuying;WANG Cheng;GU Wanjian;NI Wuhua;ZHANG Chunni(Medical College of Jiangsu University, Zhenjiang,Jiangsu 212013,China;Department of Clinical Laboratory,PLA General Hospital of the Eastern Theater,Nanjing,Jiangsu 210002,China;Department of Clinical Laboratory,Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 210029,China;Reproductive Medicine Center,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]江苏大学医学院,江苏镇江212013 [2]中国人民解放军东部战区总医院临床检验科,江苏南京210002 [3]江苏省中医院检验科,江苏南京210029 [4]温州医科大学附属第一医院生殖医学中心,浙江温州325000

出　　处：《国际检验医学杂志》2020年第12期1418-1421,1425,共5页International Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(81401257,81672102);江苏省“科教强卫工程”青年医学人才项目(QNRC2016893)。

摘　　要：目的探讨男性不育症患者精浆外泌体微小RNA-202-5p(miR-202-5p)水平变化及其在男性生殖中的临床意义。方法选取于解放军东部战区总医院、江苏省中医院及温州医科大学附属第一医院就诊的男性不育症患者107例为研究对象,其中无精症患者53例,弱精症患者54例;另选取同期招募的53例正常生育的健康男性为对照组。采用实时荧光定量PCR技术检测精浆外泌体miR-202-5p水平,分析其在男性不育症中的诊断价值及与精液参数的相关性,采用生物信息学分析软件预测其靶基因、相关通路及靶蛋白相互作用网络。结果与对照组比较,弱精症患者精浆外泌体miR-202-5p水平明显增加(P<0.05),无精症患者精浆外泌体miR-202-5p水平明显降低(P<0.05);无精症患者精浆外泌体miR-202-5p水平较弱精症患者明显降低(P<0.05)。受试者工作特征曲线分析结果显示,精浆外泌体miR-202-5p诊断弱精症的曲线下面积(AUC)为0.664,诊断无精症的AUC为0.785,对弱精症和无精症鉴别诊断的AUC为0.878。弱精症患者精浆外泌体miR-202-5p水平与a+b级前向运动精子比例呈负相关(r=-0.312,P<0.05),与不动精子比例呈正相关(r=0.308,P<0.05)。精浆外泌体miR-202-5p是弱精症和无精症发生的危险因素(P<0.05)。生物信息学分析发现,miR-202-5p的靶基因明显富集于生殖和精子功能密切相关的蛋白调控通路。结论男性不育症患者精浆外泌体miR-202-5p水平与正常生育的健康男性存在明显差异,且与精子活力密切相关,可能参与了男性不育症的发生、发展过程。Objective To explore the changes of seminal plasma exosome microRNA-202-5p(miR-202-5p)in male infertility patients and its clinical significance in male reproduction.Methods A total of 107 male infertility patients who treated in the PLA General Hospital of the Eastern Theater,Jiangsu Province Hospital of Traditional Chinese Medicine and The First Affiliated Hospital of Wenzhou Medical University were selected as the research subjects,including 53 azoospermia patients and 54 asthenospermia patients.In addition,53 healthy normal fertile men recruited during the same period were selected as the control group.The level of seminal plasma exosome miR-202-5p was detected by real-time fluorescence quantitative PCR,the diagnostic value of miR-202-5p in male infertility and its correlation with semen parameters were analyzed,the target genes,related pathways and target protein interaction network were predicted by bioinformatics analysis software.Results Compared with the control group,the level of seminal plasma exosome miR-202-5p was significantly increased in asthenospermia patients(P<0.05),and significantly decreased in azoospermia patients(P<0.05).The level of seminal plasma exosome miR-202-5p in azoospermia patients was significantly lower than that in patients with asthenospermia(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of seminal exosome miR-202-5p in the diagnosis of asthenospermia was 0.664,the AUC in the diagnosis of azoospermia was 0.785,the AUC in the differential diagnosis of asthenospermia and azoospermia was 0.878.The level of seminal plasma exosome miR-202-5p in patients with asthenospermia was negatively correlated with the proportion of a+b grade forward movement sperm(r=-0.312,P<0.05),and positively correlated with the proportion of immobile sperm(r=0.308,P<0.05).The seminal plasma exosome miR-202-5p was a risk factor for asthenospermia and azoospermia(P<0.05).Bioinformatics analysis found that the target genes of miR-202-5p were significantly enriched in protein regu

关 键 词：微小RNA-202-5p 男性不育症 精浆外泌体 弱精症 无精症 

分 类 号：R698.2[医药卫生—泌尿科学]