Polikistik over sendromu (PCOS) ve endometriozis tanili infertil bireylerden elde edilen kumulus hücreleri ve foliküler sivinin sağlikli bireylerden elde edilen örneklerle karşilaştirilmasi

Öz

Amaç: Polikistik over sendromu (PKOS), endometriozis (END) ve erkek faktör (MF) (kontrol) gruplarında bulunan hastalara ait kumulus hücrelerinde Büyüme farklılaşma faktörü-9 (GDF-9), Kemik morfogenetik protein-15 (BMP-15) belirteçleri, apoptoz seviyeleri ile foliküler sıvı inflamasyon parametreleri (interlökin-6 (IL-6), tümör nekroz faktör alfa (TNF-alfa), total oksidan (TOS)/anti-oksidan (TAS) stres seviyeleri arasındaki ilişkinin araştırılması. Gereç ve Yöntemler: Kumulus hücrelerinde büyüme farklılaşma faktörü-9 (GDF-9) ve kemik morfogenetik protein-15 (BMP-15) belirteçleri immünohistokimyasal yolla değerlendirilmiş olup; hücre ölümü TUNEL yöntemi kullanılarak araştırılmıştır. Folikül sıvısı örneklerinde toplam oksidatif stres (TOS) ve toplam anti-oksidan düzey (TAS) spektrofotometrik olarak araştırılmış, interlökin-6 (IL-6) ve tümör nekrozis faktör alfa (TNF-alfa) düzeyleri ELISA (Enzyme-Linked ImmunoSorbent Assay) yöntemi ile incelenmiştir Bulgular: GDF-9 ve BMP-15 düzeyleri sağlıklı gruba kıyasla PCOS ve END gruplarında düşük seviyede saptanırken, hücre ölümüne ilişkin veriler bu gruplarda daha yüksek gözlenmiştir. Endometriozis grubunda GDF-9, BMP-15 değerleri en düşük, hücre ölümü düzeyleri ise en yüksek olarak bulunmuştur. Sağlıklı gruba kıyasla PCOS ve endometriozis gruplarında folikül sıvısı TOS düzeyleri istatistiksel olarak anlamlı yüksek bulunmuştur. Folikül sıvısı TAS düzeyleri ise sağlıklı gruba kıyasla PCOS ve endometriozis gruplarında daha yüksek bulunmuş ancak gruplar arasındaki fark istatistiksel olarak anlamlı bulunmamıştır. Sonuç: Sonuçlarımız, GDF-9, BMP-15 belirteçleri, apotoz seviyeleri, oksidatif durum, inflamasyon seviyeleri arasındaki korelasyonun PCOS veya END tanılı hastalarda oosit olgunlaşması için uygun olmayan mikroçevre ile yorumlanabileceğini düşündürmektedir. Konu ile ilgili ileri çalışmalara ihtiyaç devam etmektedir. İleri çalışmalarda benzer verilerin elde edilmesi halinde kumulus hücre özelliklerinin, özellikle foliküler sıvı oksidatif stres düzeyleri ile birlikte değerlendirilmesinin, oosit seçimine katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

• kumulus hücresi
• folikül sıvısı
• polikistik over sendromu
• endometriozis
• oksidatif stres

Comparıson of cumulus cells and follıcular fluıd obtaıned from ınfertile ındıvıduals dıagnosed wıth polycystıc ovary syndrome (PCOS) and endomethrıosıs wıth samples obtaıned from healthy ındıvıduals

Öz

Aim: Investigating the relationship between Growth differentiation factor-9 (GDF-9), Bone morphogenetic protein-15 (BMP-15) markers, apoptosis levels in cumulus cells and total oxidant (TOS)/ anti-oxidant (TAS) stress levels, inflammation parameters (interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha)) in follicular fluid belonging to patients with polycystic ovary syndrome (PCOS), endometriosis (END) and male factor (MF) (control) groups. Material and Methods: GDF-9 and BMP-15 markers are determined by immunohistochemical methods, apoptosis levels are studied with TUNEL. TOS and TAS statuses are investigated with spectrophotometry, IL-6 and TNF – alpha levels are examined by Enzyme-Linked Immuno Sorbent Assay (ELISA). Results: According to the data obtained in the study; GDF-9 and BMP-15 levels are found to be lower in PCOS and END groups and apoptosis levels of cumulus cells were significantly higher at these groups . TOS levels were significantly higher in PCOS and END groups whereas follicular fluid TAS levels were not statistically significant for these groups. IL-6 and TNF – alpha levels of follicular fluid was significantly higher in PCOS. These parameters were also higher for END group, however the difference was not found to be significant. Conclusion: Our results imply that correlation between GDF-9, BMP-15 markers, apotosis levels, oxidative status, inflammation levels may be interpreted with improper environment for oocyte maturation for patients diagnosed with PCOS or END. The need for further studies on subject proceeds. However, if similar datas are obtained in further studies, it is thought that evaluation of cumulus cell properties together with especially follicular fluid oxidative stress levels will contribute to the selection of the best oocyte.

Anahtar Kelimeler

• cumulus cell
• follicular fluid
• polycystic ovary syndrome
• endometriosis
• oxidative stress

Kaynakça

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