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Quantification of the Biaxial Mechanics of the Female Pelvic Floor

机译：女性骨盆底双轴力学的量化

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摘要

Women's reproductive health is a severely understudied field and is associated with an abundance of clinically significant pathologies such as pelvic organ prolapse (POP) and preterm birth (PTB). While the exact etiologies of these disorders are unknown, onset is understood to be predominately due to failure of the muscles and connective tissues of the pelvic floor. These failures are attributed to the suboptimal remodeling and maladaptive constituent turnover of the soft tissue extracellular matrix (ECM) including elastic fibers, collagen fibers, glycosaminoglycans / proteoglycans (GAGs/PGs), and smooth muscle cells. Both the vagina and the uterosacral ligament (USL) act as supportive structures that maintain the healthy state of the pelvic floor. Disruption of the elastic fiber and GAG metabolism within the extracellular matrix of these tissues has been suggested to result in the mechanical failure associated with pelvic floor disorders, however, the relationship between microstructure and mechanics is relatively unknown. Histological analysis paired with the biaxial testing of these pelvic floor supporting structures is an important step in providing additional insight into the specific structure-function mechanisms of these tissues. Therefore, the overall objective of this study is to establish a basic understanding of the structure and function of the extracellular matrix constituents within vital soft tissue (vagina, USL) of the murine and human pelvic floor. To elucidate the role of specific constituents, vaginal tissue from female mice in estrus were tested using an extension-inflation biaxial testing protocol pre and post digestion of both elastin and hyaluronan, the most abundant GAG in the extracellular matrix. The digestion of elastin (supported by histological area fraction analysis) resulted in a decreased compliance and an increased dilation of the vaginal wall. Results from the digestion of hyaluronan were inconclusive, as the mechanical response varied with treatment time. Finally, human uterosacral ligaments of postmenopausal, prolapsed patients were tested on a custom built planar biaxial device. This study revealed an inverse relationship between the mechanical stiffness parameters and the ratio of elastin to collagen within the USL. The present findings provide useful information to help understand the etiology behind POP, and help in the development of computational models for the prediction and assessment of observed microstructural changes associated with soft tissue failure.
机译：妇女的生殖健康是一个严重被研究不足的领域，并且与大量临床上显着的病理相关，例如盆腔器官脱垂（POP）和早产（PTB）。虽然这些疾病的确切病因尚不清楚，但据认为主要是由于骨盆底肌肉和结缔组织的衰竭引起的。这些失败归因于软组织细胞外基质（ECM）的欠佳重塑和适应不良的成分转换，包括弹性纤维，胶原纤维，糖胺聚糖/蛋白聚糖（GAGs / PGs）和平滑肌细胞。阴道和子宫ac韧带（USL）均作为支撑结构，可保持骨盆底的健康状态。这些组织的细胞外基质内的弹性纤维和GAG代谢的破坏被认为会导致与骨盆底障碍相关的机械衰竭，但是，微观结构和力学之间的关系相对未知。组织学分析与这些骨盆底支撑结构的双轴测试相结合，是向这些组织的特定结构功能机制提供更多见解的重要步骤。因此，本研究的总体目标是建立对鼠和人骨盆底重要软组织（阴道，USL）内细胞外基质成分的结构和功能的基本了解。为了阐明特定成分的作用，在弹性蛋白和透明质酸（细胞外基质中最丰富的GAG）消化之前和之后，使用延伸-充气双轴测试方案对发情雌性小鼠的阴道组织进行了测试。弹性蛋白的消化（由组织学面积分数分析支持）导致顺应性降低和阴道壁扩张增加。透明质酸的消化结果尚无定论，因为机械反应随治疗时间而变化。最后，在定制的平面双轴装置上测试了绝经后脱垂患者的人子宫ac韧带。这项研究揭示了机械刚度参数与USL中弹性蛋白与胶原蛋白的比例之间呈反比关系。本研究结果提供有用的信息，以帮助理解POP背后的病因，并帮助开发用于预测和评估与软组织衰竭相关的观察到的微结构变化的计算模型。

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  • 作者

    Capone, Daniel J.;

  • 作者单位

    Tulane University School of Science and Engineering.;

  • 授予单位 Tulane University School of Science and Engineering.;
  • 学科 Bioengineering.;Mechanical engineering.
  • 学位 M.S.
  • 年度 2018
  • 页码 125 p.
  • 总页数 125
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 物理化学（理论化学）、化学物理学;
  • 关键词

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