Santanam Nalini, Zoneraich Nathaniel, Parthasarathy Sampath
1 Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
2 Department of Pharmacology, Physiology & Toxicology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Reprod Sci. 2017 Apr;24(4):619-626. doi: 10.1177/1933719116667225. Epub 2016 Sep 27.
As infertility is intimately associated with endometriosis, the levels of myeloperoxidase (MPO), a leukocyte enzyme and an oxidative stress marker, were determined in a case-control prospective study of 68 women with and without endometriosis undergoing in vitro fertilization in the outpatient fertility center within a tertiary care academic medical center. Measured values included plasma and follicular fluid (FF) concentrations of MPO, plasma estradiol, as well as oocyte quality, fertilization, implantation, and pregnancy rates in these women. In FF (mean ± standard error of mean [SEM]), the MPO concentrations (ng/mL) for controls were 4.3 ± 0.37, mild endometriosis (stages I-II) 3.9 ± 0.17, and moderate/severe endometriosis (stages III-IV) 16.6 ± 12.5 ( P < 0.0143). In FF, among patients supplemented with vitamins E and C, the MPO levels decreased significantly only in moderate/severe endometriosis from 25.3 ± 22.0 ng/mL to 4.9 ± 1.61 ng/mL, respectively. Plasma levels of MPO between groups did not change. Outcome data revealed a trend toward decreased percentage of mature oocytes, implantation rate, and clinical pregnancy rate with severity of endometriosis and MPO levels. Myeloperoxidase may be a potential oxidative stress target for endometriosis-associated infertility.
由于不孕症与子宫内膜异位症密切相关,在一家三级医疗学术中心的门诊生育中心,对68名接受体外受精的患有和未患有子宫内膜异位症的女性进行了一项病例对照前瞻性研究,测定了白细胞酶和氧化应激标志物髓过氧化物酶(MPO)的水平。测量值包括这些女性血浆和卵泡液(FF)中MPO的浓度、血浆雌二醇水平,以及卵母细胞质量、受精率、着床率和妊娠率。在卵泡液中(均值±均值标准误[SEM]),对照组MPO浓度(ng/mL)为4.3±0.37,轻度子宫内膜异位症(I-II期)为3.9±0.17,中度/重度子宫内膜异位症(III-IV期)为16.6±12.5(P<0.0143)。在卵泡液中,补充维生素E和C的患者中,仅中度/重度子宫内膜异位症患者的MPO水平显著降低,分别从25.3±22.0 ng/mL降至4.9±1.61 ng/mL。各组间血浆MPO水平无变化。结果数据显示,随着子宫内膜异位症严重程度和MPO水平的增加,成熟卵母细胞百分比、着床率和临床妊娠率有下降趋势。髓过氧化物酶可能是子宫内膜异位症相关不孕症潜在的氧化应激靶点。