The role of immune mechanisms in the development of benign uterus pathology

2016 ◽  
pp. 30-32
Author(s):  
V.A. Benyuk ◽  
◽  
D.M. Altibaeva ◽  
V.N. Goncharenko ◽  
V.V. Kurochka ◽  
...  

The objective: to study the role of immunological mechanisms in the development of adenomyosis with endometrial hyperplasia in women of reproductive age and the phased introduction of an integrated hormonal and immunostimulating therapy. Patients and methods. The authors investigated the effect of hormone therapy on the immune system of women with adenomyosis and endometrial hyperplasia: We evaluated the influence of hormone therapy 135 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: group i - 45 women using a progestogen (6 months); II – 45 women who took agonist of gonadotropin-relesing hormone (a-GnRH) (6 months) III – 45 women who received complex therapy involving a-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course – 6 months), then in the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25день. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. NK (natural killer) activity was estimated by the method of Hamaoka modification N.T. Rekowа. Results.We studied the role of immune system in the pathogenesis of adenomyosis, endometrial hyperplasia and endometrial and combined pathology of endo- and myometrium in women of reproductive age by assessing the cytotoxic activity of NK-cells, since this component determines its oversight role in the dynamics. Identified new pathogenic mechanisms in the development of benign pathology of the uterus due to the dysfunction of the immune system, especially expressed in terms of reduction of cytotoxic index of NK-cells. Conclusion. Developed a comprehensive phased hormone therapy for women of reproductive age with combined benign uterus pathology, including immunomodulator and the estimation of influence on parameters of immune status in the dynamics of observation. Key words: NK-cells, benign uterine pathology, comprehensive hormone therapy, Progestogens, -GnRH.

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 50-54
Author(s):  
Zukhra Kh. Ebzieva ◽  
Svetlana V. Yureneva ◽  
Tatiana Yu. Ivanets

Aim. To conduct a comparative analysis of serum orexin A levels in women of different age periods with and without sleep disorder and vasomotor symptoms. To evaluate the dynamics of orexin A levels under menopausal hormone therapy. Materials and methods. The study included 50 postmenopausal women and 30 women of reproductive age with a regular menstrual cycle. Using block randomization, patients are divided into 3 groups: group 1 (main group), n=25, -STRAW+ 10 (+1b and +1c), patients with sleep disorder and vasomotor symptoms; group 2 (comparison group), n=25, STRAW+ 10 (+1b and +1c), patients with vasomotor symptoms without sleep disorder; group 3 (control group), n=30, STRAW+ 10 (-4), women of reproductive age without sleep disorder. Group 1 patients were given menopausal hormone therapy. A comparative analysis was carried out using the questionnaire for assessing menopausal symptoms severity by the Greene Scale (the Greene Climacteric Scale) and Rating Scale for subjective sleep characteristics. After 12 weeks of treatment, a control examination was performed. Results. In group 1 women, the serum orexin A levels were significantly higher compared to the women without the symptoms. The link between the orexin A levels and menopause syndrome severity was established. A significant decrease in the menopausal symptoms severity after 12 weeks of menopausal hormone therapy was shown. It was accompanied by a 1,3-fold decrease in orexin A levels. Conclusions. The obtained data indicate the possible role of orexin A and the orexin neuropeptide system in the pathogenesis of sleep disorder and vasomotor symptoms in postmenopausal women.


2020 ◽  
Vol 19 (5) ◽  
pp. 44-50
Author(s):  
I.M. Ordiyants ◽  
◽  
A.A. Kuular ◽  
A.A. Yamurzina ◽  
D.S. Novginov ◽  
...  

Objective. To analyze pathogenetic mechanisms underlying the development of endometrial hyperplasia in women of reproductive age. Patients and methods. We have examined 143 women of reproductive age with endometrial hyperplasia (EH). Study participants were divided into three groups: Group I included EH patients without atypia; Group II included patients with atypical hyperplasia of the endometrium; Group III (control group) comprised 56 women with abnormal uterine bleeding, in whom we excluded adenomyosis, uterine fibroids, endometrial hyperplasia, endometrial cancer, and iatrogenic causes of uterine bleeding. Genomic DNA was isolated using phenol-chloroform extraction. Real-time polymerase chain reaction (RT-PCR) was used to detect microRNA-210, -18a, -221, and -222. The detection of tumor pyruvate kinase M2 was performed using the ScheBo® Tumor M2-PK kit designed for quantitative assessment of this metabolic cancer marker in plasma and endometrial tissue samples. Results. Significant risk factors triggering the pathogenetic mechanism of EH development in reproductive age include extragenital disorders (obesity, thyroid diseases, diseases of the urinary system, hypertension) and gynecological diseases (pelvic inflammatory diseases, adenomyosis, benign breast dysplasia, uterine fibroids). Alterations affecting estrogen receptors lead to changes in microRNA messengers, which, in turn, affect target genes and cause changes in the adaptive abilities of the cell. Expression of pyruvate kinase M2 in this chain confirms proapoptotic changes in the cell and the risk of its atypia. Conclusion. The pathogenesis of EH is based on the following factors: polymorphism of the ERS1 and PRG genes, increased expression of miRNA-210, -18a, and -222, decreased expression of miRNA-221, and overexpression of pyruvate kinase M2. Key words: endometrial hyperplasia, miRNA, pyruvate kinase M2, progesterone receptors, estrogen receptors


2017 ◽  
pp. 115-117
Author(s):  
V.A. Benyuk ◽  
◽  
V.V. Kurochka ◽  
S.V. Benyuk ◽  
D.M. Altibaeva ◽  
...  

The objective: to study the effect of hormone therapy on menstrual function of women with adenomyosis in combination with endometrial hyperplasia. Patients and methods. We evaluated the effects of hormone therapy in 160 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: I group – 60 women used the progestogen (6 months); II – 60 women, took an agonist of gonadotropin-releasing-hormone – а-GnRH) (6 months), III – 40 women who received the complex therapy including а-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course - 6 months), then for the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25 day. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. Assessment of volume of menstrual blood loss was performed using maps of menstrual blood loss and were assessed on a special scale. The total rating for the month, which exceeded 100 points, consistent with menstrual blood loss greater than 80 ml. Results. The influence of hormonal monotherapy progestogen and а-GnRH on menstrual function of women with adenomyosis in combination with endometrial hyperplasia during the follow-up throughout the year. The assessment of indicators of volume of blood loss with the help of monitoring charts. Developed a comprehensive hormone therapy for women of reproductive age with combined benign uterus pathology and the evaluation of its impact on indicators of volume of blood loss and menstrual function of women. Conclusions. Monoterapia by the progestogen and а-GnRH for 6 months of treatment normalizes the indicators of volume of blood loss and menstrual function of women, and the 12-month follow-up in women of these groups also increased the volume of blood loss and each 3 women is marked polimenorea. Developed a comprehensive phased hormone therapy for women with adenomyosis in combination with endometrial hyperplasia normalizes on the 3rd month of treatment indicators of blood loss and has a tendency to decrease during the 12 months of observation (the volume of menstrual blood loss has decreased in 4 times from initial). Key words: complex therapy, adenomyosis, endometrial hyperplasia, gestagene, а-GnRH, menstrual function, volume of blood loss.


Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 68-72
Author(s):  
A.A. Persidskaya ◽  
◽  
R.G. Guseinova ◽  
I.M. Ordiyants ◽  
◽  
...  

Study Objective: To identify the role of estrogen (ESR1) and progesterone (PRG) receptor genes in benign mammary dysplasia (BMD) in women of reproductive age with endometrial hyperplasia (EH). Study Design: prospective controlled cohort study. Materials and Methods. We examined 105 women aged 18 to 49 years old who were divided into three groups: group I — 36 BMD patients; group II — 27 women with EH without atypia; and group III — 42 BMD patients with EH without atypia. Patients with mammary disorders were divided into subgroups of diffuse and nodal BMD. We studied polymorphism of estrogen (ESR1) and progesterone (PRG) receptor genes and the ratio of their isoforms in blood serum. ESR1 and PRG gene polymorphism was analysed using polymerase chain reaction with fluorescent genotyping detection with TaqMan probes. Study Results. In PvuII C/T polymorphism of ESR1 gene there were significant differences between women with diffuse and nodal BMD in СС allele (p = 0.014), but not between study groups. Analysis of the rate of Xbal A/G alleles of ESR1 gene revealed significant differences between group I and group III in GG allele (p = 0.015), while there were no differences between women with diffuse and nodal BMD. The rate of polymorphism in Val660Leu and +331G/A alleles of PRG gene was not statistically significant in study groups; also, there were no statistically significant differences in diffuse and nodal BMD. Conclusion. Combined hyperplastic processes in endometrium and mammary glands depend on the specificity in the polymorphism system of estrogen and progesteron receptor genes. Associations between various combinations of susceptibility genes demonstrate the presence of specificity for each clinical and pathogenic variant of BMD (diffuse or local forms). Keywords: benign mammary dysplasia; endometrium hyperplasia; estrogen receptors; progesterone receptors; ESR1, PRG gene polymorphism


2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


2016 ◽  
pp. 85-89
Author(s):  
О. Shapoval ◽  

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.


Author(s):  
A.O. Atykanov ◽  
G.U. Asymbekova ◽  
A.A. Masybaeva

The paper presents quantitative indicators of lipid peroxidation (LP) products and antioxidant support network (ASN) in blood plasma in women with various histological forms of endometrial hyperplastic processes (EHPs). The goal of the paper is to assess the state of LP processes and ASN in women of reproductive age with various forms of EHPs. Materials and Methods. The trial enrolled 137 women of reproductive age: 112 women with endometrial hyperplasia (EH) and 25 women with uterine cavity synechia without EH. Conclusion. In case if EH progresses from a simple atypical form to adenocarcinoma, an increase in lipid peroxidation intensity and ASN inhibition is observed. Keywords: women, endometrial hyperplastic processes, endometrial hyperplasia, lipid peroxidation, antioxidant support network. В работе представлены количественные показатели содержания продуктов перекисного окисления липидов (ПОЛ) и системы антиоксидантной защиты (АОЗ) в плазме крови у женщин с различными гистологическими формами гиперпластического процесса эндометрия (ГПЭ). Цель исследования. Оценить состояние процессов ПОЛ и системы АОЗ при развитии различных форм ГПЭ у женщин репродуктивного возраста. Материалы и методы. Объектом исследования явились 137 женщин репродуктивного возраста: 112 женщин с гиперплазией эндометрия (ГЭ) и 25 женщин с синехиями полости матки без ГЭ. Выводы. При прогрессировании ГЭ от простой неатипичной до аденокарциномы происходит нарастание интенсивности липопереокисления и угнетения системы АОЗ. Ключевые слова: женщины, гиперпластические процессы эндометрия, гиперплазия эндометрия, перекисное окисление липидов, система антиоксидантной защиты.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Farhan Asif ◽  
Zahid Pervaiz ◽  
Jawad Rahim Afridi ◽  
Ghulam Abid ◽  
Zohra S. Lassi

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.


Author(s):  
Luis Sánchez-del-Campo ◽  
Román Martí-Díaz ◽  
María F. Montenegro ◽  
Rebeca González-Guerrero ◽  
Trinidad Hernández-Caselles ◽  
...  

Abstract Background The application of immune-based therapies has revolutionized cancer treatment. Yet how the immune system responds to phenotypically heterogeneous populations within tumors is poorly understood. In melanoma, one of the major determinants of phenotypic identity is the lineage survival oncogene MITF that integrates diverse microenvironmental cues to coordinate melanoma survival, senescence bypass, differentiation, proliferation, invasion, metabolism and DNA damage repair. Whether MITF also controls the immune response is unknown. Methods By using several mouse melanoma models, we examine the potential role of MITF to modulate the anti-melanoma immune response. ChIP-seq data analysis, ChIP-qPCR, CRISPR-Cas9 genome editing, and luciferase reporter assays were utilized to identify ADAM10 as a direct MITF target gene. Western blotting, confocal microscopy, flow cytometry, and natural killer (NK) cytotoxicity assays were used to determine the underlying mechanisms by which MITF-driven phenotypic plasticity modulates melanoma NK cell-mediated killing. Results Here we show that MITF regulates expression of ADAM10, a key sheddase that cleaves the MICA/B family of ligands for NK cells. By controlling melanoma recognition by NK-cells MITF thereby controls the melanoma response to the innate immune system. Consequently, while melanoma MITFLow cells can be effectively suppressed by NK-mediated killing, MITF-expressing cells escape NK cell surveillance. Conclusion Our results reveal how modulation of MITF activity can impact the anti-melanoma immune response with implications for the application of anti-melanoma immunotherapies.


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