Ovarian drilling down-regulates endometrial nuclear factor-KB p65 expression in women with PCOS: A prospective case-control study/Ovaryen drilling PKOS hastalarinda endometrial nukleer faktor KB p65 ekspresyonunu downregule eder: Prospektif olgu kontrol calismasi

• Published in: Turkish journal of obstetrics and gynecology Vol. 19; no. 1; p. 45
• Main Authors: Gungor, Nur Dokuzeylul, Gungor, Kagan, Yurci, Arzu, Cil, Kaan, Hatirnaz, Safak
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.03.2022
• Subjects: Care and treatment; Genetic aspects; Health aspects; Ovaries; Patient outcomes; Physiological aspects; Stein-Leventhal syndrome; Transcription factors; Turkey
• ISSN: 2149-9322
• DOI: 10.4274/tjod.galenos.2022.44845

Objective: To investigate the impact of laparoscopic ovarian drilling (LOD) on the expression of endometrial NF[kappa]B p65 (Rel A) in women with clomiphene-resistant polycystic ovary syndrome (PCOS). Materials and Methods: The study group comprised 25 normal-weight women with PCOS undergoing LOD and 14 control women without PCOS. Endometrial NF-[kappa]B p65 levels evaluated before and after LOD following immunohistochemical staining. The semiquantitative method was used to evaluate the intensity of NF-[kappa]B p65 levels. NF-[kappa]B p65 was found to higher in the endometrium of patients with PCOS compared to controls. LOD leads to significant down-regulation in endometrial NF-[kappa]B p65 expression. NF-[kappa]B p65 expression of PCOS and fertile control were similar after LOD. After LOD, H-score values decreased approximately 3-fold. The H-score of the control subjects was lower than the preoperative and postoperative H-score values of the control women with ovarian cyst. Results: Expression of endometrial NF-[kappa]B p65 did not change following ovarian cystectomy. The laterality of the ovarian cyst did not cause any change in preoperative H-score values. Conclusion: By downregulating the endometrial NF-[kappa]B p65 expression LOD improved physiological inflammation in women with PCOS. Keywords: PCOS, ovarian drilling, clomiphene, nuclear factor [kappa]B, endometrial inflammation Amac: Bu calismanin amaci laparoskopik ovaryen drilling (LOD) isleminin klomifen sitrat rezistansi olan polikistik over sendromlu (PKOS) hastalarda endometriyal NF[kappa]B p65 (Rel A) ekspresyon duzeylerini etkileyip etkilemediginin arastirilmasidir. Gerec ve Yontemler: Calisma grubu LOD yapilan 25 tane normal kiloya sahip PKOS'li hastadan olusmaktadir. Kontrol grubunda ise 7 tane PKOS olmayan saglikli fertil kadin ve 7 tane de benin kisti olan ancak endometriyomasi olmayan toplam 14 hasta mevcuttur. Endometriyal NF-[kappa]B p65 ekspresyonu LOD oncesi ve sonrasi mid-sekretuar fazda olculmustur. Endometriyal ornekler immunohistokimyasal yontemlerle boyanmistir. Endometriyal NF-[kappa]B p65 ekspresyonu H-skor metodu ile degerlendirilmistir. Bulgular: Endometriyal NF-KB p65 ekspresyonu PKOS olan hastalarda LOD oncesi fertil hastalardan daha yuksek bulunmustur. PKOS'li hastalarda LOD sonrasi NF-KB p65 ekspresyonu belirgin olarak azalmistir. LOD sonrasi PKOS grubundaki hastalar ile fertil grupta NF-KB p65 ekspresyonu benzer bulunmustur. LOD sonrasi H-skoru 3 kat azalmistir. Fertil grubun H-skoru pre-op ve post-op donemde over kistli hasta grubunun H-skorundan dusuk bulunmustur. Yapilan benin kistektomi operasyonlari sonrasi endometrial NF-KB p65 ekspresyonunda belirgin degisiklik gosterilmemistir. Ovaryen kist varligi pre-operatif H-skor degerlerini etkilememektedir. Sonuc: LOD, klomifen sitrat rezistansi olan PKOS'li hastalarda endometrial NF-KB p65 ekspresyonunu azaltarak fizyolojik enflamasyonu ve reseptiviteyi iyilestirmektedir. Anahtar Kelimeler: PKOS, ovaryen drilling, klomifen sitrat, nukleer faktor KB, endometrial enflamasyon