Atilgan Remzi, Pala Şehmus, Yavuzkır Şeyda, Başpınar Melike, Yılmaz Mustafa, Ilhan Nevin
a Department of Obstetrics and Gynecology , Firat University School of Medicine , Elazig , Turkey.
b Department of Emergency Medicine , Firat University School of Medicine , Elazig , Turkey.
J Obstet Gynaecol. 2019 Jul;39(5):687-694. doi: 10.1080/01443615.2018.1563774. Epub 2019 Mar 20.
This study aimed to evaluate the effects of coasting, cabergoline and clarithromycin in a rat ovarian hyperstimulation syndrome (OHSS) model. The 42 female Wistar rats were divided into seven groups: control, OHSS (was given 10 IU of pregnant mare serum gonadotropin for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS ), coasting (hCG was applied on the 27th day after gonadotropin injections and the rats were decapitated on the 28th day), Cabergoline (100 mg/kg/d) and clarithromycin (100 mg/kg/d) were given (on the 26th day) with a short-term supplementation (on the 26th day) and long-term supplementation (from the 22nd to the 26th day) groups. The rats were decapitated on the 27th day. Cabergoline and clarithromycin significantly lowered VEGF-2 levels. Clarithromycin significantly reduced IL-1b and TNF-a and significantly increased IL-10 levels. Clarithromycin may be an effective drug for the treatment of OHSS. Impact statement What is already known on this subject? Ovarian hyper-stimulation syndrome (OHSS) is a self-limited disease, in which vascular endothelial growth factor (VEGF) plays the most important role and has a large clinical spectrum related with increased capillary permeability and fluid retention. Some treatment methods that block VEGF over-expression are used in treatment of OHSS. Clarithromycin is known to suppress the production of some pro-inflammatory molecules such as VEGF, IL-8, IL-1, IL-6 and TNF-a. In our study, we compared the efficacy of coasting, short- and long-term supplementation of clarithromycin and cabergoline on correcting OHSS parameters in an experimental study. What do the results of this study add? As a result of our study, we found that OHSS parameters improved better in early prophylactic treatment regimens. We have shown that clarithromycin may be a more effective treatment agent than coasting and cabergoline. What are the implications of these findings for clinical practice and/or further research? Although our study is important in that it is the first pilot study to show that clarithromycin is effective in the treatment of OHSS, there is a need for larger clinical trials.
本研究旨在评估在大鼠卵巢过度刺激综合征(OHSS)模型中,延缓刺激、卡麦角林和克拉霉素的作用。42只雌性Wistar大鼠被分为七组:对照组、OHSS组(从第22天开始连续4天给予10 IU孕马血清促性腺激素,并在第5天给予30 IU人绒毛膜促性腺激素以诱导OHSS)、延缓刺激组(在注射促性腺激素后的第27天给予人绒毛膜促性腺激素,并在第28天处死大鼠),卡麦角林组(100 mg/kg/d)和克拉霉素组(100 mg/kg/d),分为短期补充组(第26天)和长期补充组(第22天至第26天)。大鼠在第27天被处死。卡麦角林和克拉霉素显著降低VEGF-2水平。克拉霉素显著降低IL-1β和TNF-α水平,并显著提高IL-10水平。克拉霉素可能是治疗OHSS的有效药物。影响声明关于该主题已知的信息有哪些?卵巢过度刺激综合征(OHSS)是一种自限性疾病,其中血管内皮生长因子(VEGF)起最重要作用,并且与毛细血管通透性增加和液体潴留相关的临床谱较广。一些阻断VEGF过表达的治疗方法用于OHSS的治疗。已知克拉霉素可抑制一些促炎分子如VEGF、IL-8、IL-1、IL-6和TNF-α的产生。在我们的研究中,我们在一项实验研究中比较了延缓刺激、短期和长期补充克拉霉素及卡麦角林对纠正OHSS参数的疗效。本研究的结果增加了什么?作为我们研究的结果,我们发现早期预防性治疗方案中OHSS参数改善得更好。我们已经表明,克拉霉素可能是比延缓刺激和卡麦角林更有效的治疗药物。这些发现对临床实践和/或进一步研究有何意义?尽管我们的研究很重要,因为它是第一项表明克拉霉素对OHSS治疗有效的初步研究,但仍需要更大规模的临床试验。