Surcel M, Surcel M, Zlatescu-Marton C, Micu R, Nemeti G I, Axente D D, Mirza C, Neamtiu I
"Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Gynaecology Clinic 1, Cluj-Napoca, Romania.
"Iuliu Hatieganu" University of Medicine and Pharmacy - Mother and Child, Surgery 5, Cluj-Napoca, Romania.
Acta Endocrinol (Buchar). 2020 Jan-Mar;16(1):30-36. doi: 10.4183/aeb.2020.30.
Severe Ovarian Hyperstimulation Syndrome (OHSS) forms with very aggressive clinical evolution are still common, despite prophylactic measures. Besides the Vascular Endothelial Growth Factor (VEGF), there are other angiogenic factors, like Renin-Angiotensin-Aldosterone System (RAS), that might be associated with this disorder. Our study aims to evaluate the role of VEGF and Angiotensin II (ANG II) in the development of early severe OHSS, in high risk patients under prophylactic Cabergoline therapy.
We recruited 192 patients undergoing fertilization (IVF) procedures with high risk for OHSS development. Out of these, 106 patients with OHSS were enrolled in the study, of which 28 subjects had a severe form of disease (group I), and 78 patients had a mild/moderate form (group II). We collected blood and follicular fluid from our study participants and determined serum and follicular VEGF and ANG II levels using Enzyme-Linked Immunosorbent Assay (ELISA) technique.
Follicular VEGF, ANG II, and serum VEGF levels were significantly higher in group I group II. Serum VEGF titers were 645.97 548.62 (p = 0.0008), follicular VEGF titers were 2919.52 1093.68 (p < 0.0001), and follicular ANG II levels were 281.64 65.76 (p < 0.0001). No significant differences have been shown between the two groups for serum ANG II levels.
Our study results provide evidence of a OHSS phenotype that is more prone to undergo severe clinical forms of disease, despite treatments with VEGF receptor blockers, and show that ANG II appears to play a major role alongside VEGF, in the development of these severe forms of disease.
尽管采取了预防措施，但具有非常激进临床进展形式的严重卵巢过度刺激综合征（OHSS）仍然很常见。除血管内皮生长因子（VEGF）外，还有其他血管生成因子，如肾素 - 血管紧张素 - 醛固酮系统（RAS），可能与这种疾病有关。我们的研究旨在评估VEGF和血管紧张素II（ANG II）在接受预防性卡麦角林治疗的高危患者早期严重OHSS发生中的作用。
我们招募了192名有OHSS发生高风险的接受体外受精（IVF）程序的患者。其中，106名患有OHSS的患者被纳入研究，其中28名受试者患有严重疾病形式（I组），78名患者患有轻度/中度形式（II组）。我们从研究参与者中采集血液和卵泡液，并使用酶联免疫吸附测定（ELISA）技术测定血清和卵泡液中的VEGF和ANG II水平。
I组的卵泡VEGF、ANG II和血清VEGF水平显著高于II组。血清VEGF滴度为645.97±548.62（p = 0.0008），卵泡VEGF滴度为2919.52±1093.68（p < 0.0001），卵泡ANG II水平为281.64±65.76（p < 0.0001）。两组血清ANG II水平未显示出显著差异。
我们的研究结果提供了证据，表明尽管使用了VEGF受体阻滞剂，但仍有一种OHSS表型更容易出现严重的临床疾病形式，并表明ANG II在这些严重疾病形式的发生中似乎与VEGF一起发挥主要作用。
