Büyük Başak, Beyazıt Fatma
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Histology and Embryology, Çanakkale, Turkey.
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Gynecology and Obstetrics, Çanakkale, Turkey.
Turk J Obstet Gynecol. 2019 Mar;16(1):7-14. doi: 10.4274/tjod.galenos.2018.21298. Epub 2019 Mar 27.
Asherman syndrome (AS) is a progressive disease involving menstrual disorders, recurrent pregnancy losses, and infertility developing as a result of partial or full blockade of the uterine cavity with adhesions. AS generally develops after trauma to the basal layer of the endometrium. In spite of a variety of methods such as adhesiolysis, inserting intrauterine devices, and administering high doses of estrogen, treatments remain insufficient. This study aimed to assess the effects of local intrauterine Ankaferd Blood Stopper (ABS) administration in inducing endometrial proliferation and building a normal endometrial layer in a rat model.
AS was induced in 30 female Wistar albino rats. The rats were randomized into three groups:Group 1: AS groupGroup 2: AS + serum physiologic (SP) groupGroup 3: AS + ABS groupAS model was induced in all animals. The uterine horns were harvested after 15 days of therapy and investigated for inflammation, fibrosis, and immunohistochemical (IHC) markers.
Compared with the other groups, fibrosis, and inflammation were significantly reduced in group 3 (chi-square, p=19.000, 0.001 and 26.365, <0.001, respectively). The IHC assessment showed that the tumor necrosis factor-α receptor levels were not different (Kruskal-Wallis H=0.091, p=0.995), but the interleukin (IL)-1β and IL-6 expression was reduced significantly in group 3 (H, p=18.706, <0.001, and 22.114, <0.001, respectively).
The therapeutic effects of local administration of ABS in rats with AS model were demonstrated histopathologically and immunohistochemically. Based on these results, ABS administration in addition to the current treatments for AS may increase the treatment success and reduce the need for advanced treatment.
阿谢曼综合征(AS)是一种进展性疾病,涉及月经紊乱、复发性流产和因宫腔部分或完全被粘连阻塞而导致的不孕。AS通常在子宫内膜基底层受到创伤后发生。尽管有诸如粘连松解术、放置宫内节育器和给予高剂量雌激素等多种方法,但治疗仍然不足。本研究旨在评估局部宫腔内给予安卡福得止血剂(ABS)对大鼠模型中诱导子宫内膜增殖和构建正常子宫内膜层的效果。
对30只雌性Wistar白化大鼠诱导建立AS模型。将大鼠随机分为三组:
第1组:AS组
第2组:AS + 生理盐水(SP)组
第3组:AS + ABS组
对所有动物诱导建立AS模型。治疗15天后采集子宫角,检查炎症、纤维化和免疫组织化学(IHC)标志物。
与其他组相比,第3组的纤维化和炎症明显减轻(卡方检验,p分别为19.000、0.001和26.365,<0.001)。免疫组织化学评估显示肿瘤坏死因子-α受体水平无差异(Kruskal-Wallis H = 0.091,p = 0.995),但第3组白细胞介素(IL)-1β和IL-6表达明显降低(H,p分别为18.706,<0.001和22.114,<0.001)。
组织病理学和免疫组织化学证明了局部给予ABS对AS模型大鼠的治疗效果。基于这些结果,在AS的当前治疗基础上给予ABS可能会提高治疗成功率并减少对进一步治疗的需求。