Tekrarlayan implantasyon başarısızlığında hücre adezyon moleküllerinin rolü

Yıl 2018, Cilt: 4 Sayı: 1, 27 - 36, 18.04.2018

Rasim Hamutoğlu Berna Özdenoğlu Kutlu Tuğba Dağdeviren Hüseyin Eray Bulut

Öz

Endometrium insan vücudundaki en dinamik ve en büyüleyici dokulardan biridir. Tek amacı, menstrual döngüde nispeten kısa bir zaman aralığında ‘’implantasyon penceresi’’ bir embriyonun implantasyonunu sağlamaktır. Blastosist implantasyonu ve gebeliğin başarılı bir şekilde gerçekleşmesi, embriyo ve maternal çevre arasında hassas etkileşimler gerektirir. Tekrarlayan implantasyon başarısızlığı (RIF), in vitro fertilizasyon (IVF) tedavi sikluslarını takiben iyi kalitedeki emrbiyoların implantasyonları başarısız olduklarında belirlenir. İmplantasyon başarısızlığı, maternal faktörler veya embriyonik nedenlerle ilişkilidir. Bu karmaşık süreçte endometrial integrinler, hücre dışı matriks molekülleri ve adezyon molekülleri gibi birçok moleküler faktör rol oynamaktadır. Hücre yüzeyinde bulunan hücresel adezyon molekülleri, hücrelerin birbirlerine ve ekstraselüler matrikse bağlanmasını sağlayan protein molekülleridir. Üreme fizyolojisinde çeşitli aşamalarda hücre adezyon moleküllerinin rolü olduğu saptanmıştır. Son yıllarda, implantasyonun endometrial integrin ve selektinleri içeren tüm adezyon molekülleri yardımıyla başladığı kabul edilmektedir. avβ3 integrini, L-selektin ve E-kadherinin tek başına veya birlikte endometrial ekspresyonundaki azalma, tekrarlayan implantasyon başarısızlığına katkıda bulunabilir ve bu moleküller infertilitenin potansiyel moleküler belirteçleri olarak değerlendirilebilir. İmplantasyonda oldukça kapsamlı rolleri olan hücre adezyon moleküllerinin biyolojik ve patolojik durumlarda daha detaylı araştırılması gerekmektedir. Bu derlemede, uterus epitelinin plazma membranında oluşan morfolojik değişiklikleri ve implantasyon sırasında erken embriyo ile endometrium arasındaki iletişimi kontrol eden moleküler mekanizmalar konusundaki güncel bilgilerimizi gözden geçirmeyi amaçlıyoruz.

Anahtar Kelimeler

Hücre adezyon molekülleri, endometrium, implantasyon, tekrarlayan implantasyon başarısızlığı

Kaynakça

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