Operating Room Services Department, Nisantası University, Vocational School, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Oct;27(20):9962-9967. doi: 10.26355/eurrev_202310_34175.
The aim of our study is to detect endothelial cell-specific molecule 1 (ESM-1) levels in the serum and follicular fluids (FF) of patients undergoing IVF/ICSI for PCOS. The presence of ESM-1 traffic between the serum and follicular compartment was analyzed.
A total of 50 patients, including 25 infertile patients diagnosed with PCOS according to the Revised Rotterdam criteria, and 25 patients in infertility follow-up for reasons other than PCOS, were included in the pilot study. Patients in the control group were required to have no clinical and laboratory findings of PCOS. Non-PCOS controls were selected from patients diagnosed with a male factor or unexplained infertility, and a homogeneous group was formed. Patients in PCOS and control groups were matched in terms of age and BMI. IVF/ICSI was started with antagonist protocol in both groups. Follicular fluids obtained on the day of egg collection were centrifuged, put into RNAlater, frozen, and stored until the day of analysis. Endothelial cell-specific Molecule 1 levels were measured in follicular fluid and serum samples of PCOS patients by enzyme-linked immunosorbent assay (ELISA) using the Human ESM-1 kit.
Serum ESM-1 levels of the PCOS group were significantly lower than FF-ESM1 levels (668.6±189.2 vs. 979.0±233.9 ng/L, p<0.02). FF-ESM1 levels of the control group were significantly higher than serum ESM1 levels (639.3±206.4 ng/L vs. 503.2±102.4 ng/L, p<0.01). Serum ESM1 levels of the PCOS group were significantly higher than the control group (668.6±189.2 ng/L vs. 503.2±102.4 ng/L, p<0.01). Similarly, FF-ESM1 levels of the PCOS group were significantly higher than the control group (979.0±233.9 ng/L vs. 639.3±206.4 ng/L, p<0.01). There was no significant correlation between serum and FF-ESM1 levels. A positive and significant correlation was found between FF-ESM1 and serum LH levels in PCOS (r=0.655, p<0.02). Similarly, a positive and significant correlation was found between FF-ESM1 and serum testosterone levels in PCOS (r=0.470, p<0.03). Moreover, a positive and significant correlation was detected between FF-ESM-1, AFC, MII, and total oocyte counts in PCOS.
Serum and FF-ESM-1 are regulated independently of each other in PCOS patients. ESM-1 may play a role in ovulatory dysfunction due to PCOS.
本研究旨在检测多囊卵巢综合征（PCOS）患者接受体外受精/卵胞浆内单精子注射（IVF/ICSI）时血清和卵泡液（FF）中的内皮细胞特异性分子 1（ESM-1）水平。分析了 ESM-1 在血清和卵泡腔之间的转运情况。
本研究纳入了 50 名患者，其中 25 名患有 PCOS 的不孕患者符合修订后的鹿特丹标准，25 名因非 PCOS 原因进行不孕随访的患者作为对照组。对照组患者要求无 PCOS 的临床和实验室发现。非 PCOS 对照组患者选自诊断为男性因素或不明原因不孕的患者，并形成同质组。PCOS 组和对照组患者在年龄和 BMI 方面相匹配。两组均采用拮抗剂方案进行 IVF/ICSI。在取卵日收集卵泡液后，将其离心，放入 RNAlater 中，冷冻并储存，直至分析日。采用人 ESM-1 试剂盒通过酶联免疫吸附试验（ELISA）测量 PCOS 患者卵泡液和血清中的 ESM-1 水平。
PCOS 组血清 ESM-1 水平明显低于 FF-ESM1 水平（668.6±189.2 与 979.0±233.9 ng/L，p<0.02）。对照组 FF-ESM1 水平明显高于血清 ESM1 水平（639.3±206.4 与 503.2±102.4 ng/L，p<0.01）。PCOS 组血清 ESM1 水平明显高于对照组（668.6±189.2 与 503.2±102.4 ng/L，p<0.01）。同样，PCOS 组 FF-ESM1 水平明显高于对照组（979.0±233.9 与 639.3±206.4 ng/L，p<0.01）。血清和 FF-ESM1 水平之间无显著相关性。在 PCOS 中，FF-ESM1 与血清 LH 水平呈正相关且显著（r=0.655，p<0.02）。同样，在 PCOS 中，FF-ESM1 与血清睾酮水平呈正相关且显著（r=0.470，p<0.03）。此外，在 PCOS 中，FF-ESM-1、AFC、MII 和总卵母细胞计数之间存在正相关且显著。
在 PCOS 患者中，血清和 FF-ESM-1 彼此独立调节。ESM-1 可能在 PCOS 导致的排卵功能障碍中发挥作用。
