Marcadores séricos de estresse oxidativo em mulheres inférteis com endometriose

Abstract

ResumoOBJETIVO: comparar marcadores séricos de estresse oxidativo entre pacientes inférteis com e sem endometriose e avaliar a associação destes marcadores com o estadiamento da doença. MÉTODOS: estudo prospectivo envolvendo a inclusão consecutiva de 112 pacientes inférteis, não-obesas, com idade inferior a 39 anos, divididas em dois grupos: Endometriose (n=48, sendo 26 com endometriose mínima e leve -Estádio I/II e 22 com endometriose moderada e grave -Estádio III/IV) e Controle (n=64, com fator tubário e/ou masculino de infertilidade). Durante a fase folicular precoce do ciclo menstrual, foram coletadas amostras sanguíneas para análise dos níveis séricos de malondialdeído, glutationa e níveis totais de hidroperóxidos, por espectrofotometria e vitamina E, por cromatografia líquida de alto desempenho. Os resultados obtidos foram comparados da seguinte forma: os grupos endometriose versus controle; endometriose estádio I/II e controle, endometriose estádio III/IV e controle e entre os dois subgrupos de endometriose. Em todas as análises, foi considerado o nível de significância de 5% (p<0,05). RESULTADOS: os níveis de vitamina E e glutationa foram mais baixos no soro de mulheres inférteis com endometriose moderada/grave (21,7±6,0 µMol/L e 159,6±77,2 nMol/g proteína, respectivamente) quando comparadas a mulheres com endometriose mínima e leve (28,3±14,4 µMol/L e 199,6±56,1 nMol/g proteína, respectivamente). Os níveis totais de hidroperóxidos foram significativamente mais elevados no grupo endometriose (8,9±1,8 µMol/g proteína) em relação ao Grupo Controle (8,0±2 µMol/g proteína) e nas portadoras de doença III/IV (9,7±2,3 µMol/g proteína) em relação à I/II (8,2±1,0 µMol/g proteína). Não se observou diferença significativa nos níveis séricos de malondialdeído entre os diversos grupos. CONCLUSÕES: foi evidenciada uma associação positiva entre infertilidade relacionada à endometriose, avanço do estadiamento da doença e aumento dos níveis séricos de hidroperóxidos, sugerindo aumento da produção de espécies reativas em portadoras de endometriose. Esses dados, associados à redução dos níveis séricos de vitamina E e glutationa, sugerem a ocorrência de estresse oxidativo sistêmico em portadoras de infertilidade associada à endometriose.Abstract PURPOSE: to compare serum markers of oxidative stress between infertile patients with and without endometriosis and to assess the association of these markers with disease staging. METHODS: this was a prospective study conducted on 112 consecutive infertile, non-obese patients younger than 39 years, divided into two groups: Endometriosis (n=48, 26 with minimal and mild endometriosis -Stage I/II, and 22 with moderate and severe endometriosis -Stage III/IV) and Control (n=64, with tubal and/or male factor infertility). Blood samples were collected during the early follicular phase of the menstrual cycle for the analysis of serum malondialdehyde, glutathione and total hydroxyperoxide levels by spectrophotometry and of vitamin E by high performance liquid chromatography. The results wer...

Air Pollution Exposures During Adulthood and Risk of Endometriosis in the Nurses’ Health Study II

“…Lesions then continue to infiltrate, develop a blood supply, and synthesize and secrete hormones (exact hormonal milieu depends on each lesion’s secretory profile) (Takeda et al 2004). Systemic and local inflammation and oxidative stress (Andrade et al 2010; Maybin et al 2011) and hormonal alterations (including altered response to hormones and increased lesion hormone synthesis) are proposed mechanisms for endometriosis disease progression (Burney et al 2007; Pan et al 2007). …”

There is no relationship between Paraoxonase serum level activity in women with endometriosis and the stage of the disease: an observational study

“…Despite the evidence that oxidative stress may play a role in endometriosis [4-9], there are other theories that may explain the pathophysiology of this disease. The implantation theory proposes that the retrograde menstruation may result in implantation and growth of endometrial cavity.…”

“…Some authors have also suggested the possibility of endometriosis is a disease caused or associated with oxidative stress [36-40]. In the presence of pelvic endometriosis, there was activation of macrophages in the peritoneal cavity, which could promote increased production of reactive oxygen species and nitrogen and, consequently, oxidative stress, resulting in lipid peroxidation, its degradation products and the products formed by its interaction with low-density lipoproteins and other proteins [41].…”

“…It affects 3-10% of women in their reproductive years and 20-50% of women with infertility [3]. The pathophysiologic mechanism is unknown, but some authors suggest a link with oxidative stress [4-9]. In the presence of pelvic endometriosis, peritoneal macrophages would be activated, increasing the production of reactive oxygen species (ROS) [4], one of the responsible for the inflammatory reaction observed in endometriosis [6].…”

“…The pathophysiologic mechanism is unknown, but some authors suggest a link with oxidative stress [4-9]. In the presence of pelvic endometriosis, peritoneal macrophages would be activated, increasing the production of reactive oxygen species (ROS) [4], one of the responsible for the inflammatory reaction observed in endometriosis [6]. Increased levels of lipid peroxidation markers in peritoneal fluids of women with endometriosis [10], like tumor necrosis factor (TNF) α, were found in previous published studies [9].…”