اسم المؤلف:
رشا زهير جاسم
اسم المشرف:
زهير ابراهيم المشهداني | بشرى حميد علي
المستخلص:
Endometriosis , a chronic inflammatory autoimmune disease, is among one of the most challenging of the 21st century that affects women in reproductive age. Seventy five consecutive married women endometriotic patients with age range (25 - 40) year were enrolled in this study , divided into three groups , the first included twenty five newly diagnosed endometriotic patients ( without any treatment) , the second consisted of twenty five endometriotic patients who were treated with zoladex for 3 to 5 months , the third involved twenty five patients with recurrent endometriosis (post treatment of zoladex) for one to two years ago. Patients groups were compared with two matched age and sex control groups , control group included twenty five healthy women while pathological control group involved twenty five women suffering from infertility caused by gynecological disorders not linked with endometriosis. The present study highlights the role of some morphological characteristics (BMI and W/H) , immunological / inflammatory aspect (Interleukin - 36 ? , Angiopoietein - 2 , Tumor Necrosis Factor - ? , Immunoglobulin G , Immunoglobulin A , Immunoglobulin M , Sialic acid ) , oxidative aspect (Total Cholesterol , Triacylglycerol , High Density Lipoprotein cholesterol , Low Density Lipoprotein cholesterol , Very Low Density Lipoprotein cholesterol , Paraoxonase - 1 , Ceruloplasmin ) and hormonal aspect (estrogen) in the pathogenesis of endometriosis. …………… Results have revealed that endometriotic patients have approximately a normal BMI and lower than pathological control group, but it was increased in patients under treatment with zoladex. A greater W/H ratio was associated with both endometriosis and pathological control group , while W/H was approximately not affected after treatment with zoladex. The present study have reported for the first time a positive relationship between IL - 36? , Sia and endometriosis. Those parameters could be considered novel biochemical markers in endometriosis because their levels were higher in sera of endometriotic patients without treatment compared with control and pathological control groups. Moreover , Ang - 2 appears to be a good biochemical marker in endometriotic patients. Hence, Ang - 2 levels were higher in sera of endometriotic patients compared with control and pathological control groups In contrast high levels of TNF - ? are associated not only with endometriosis but with pathological control group also. IgA and IgM could be used as possible biochemical markers for endometriosis. The present study is the first dealing with zoladex action on depressing IL - 36? , Ang - 2 , Sia while TNF - ?, IgG , IgA, IgM were decreased under treatment with zoladex. The present study have also suggested that TC and LDL - could be used in diagnosis of endometriosis , HDL - c levels were lower in patients without treatment compared with control and pathological control, but elevation obsereved under treatment with zoladex. PON - 1 activity was low in sera of patients while it was increased after treatment. Furthermore , this is the second study that proves a positive relation between CP and endometriosis and the first dealing with zoladex role on decreasing CP level in endometriosis. Lastly , estrogen was higher in endometriosis compared with control and pathological control groups , while it was decreased by zoladex action
