Otoimmun ve Vasküler Hastalıklarda Erken Dönemde Endometriyum Reseptivitesinin Değerlendirilmesi

Abstract

At each monthly cyle, endometrium undergoes structural changes and renews itself under hormonal control. A healthy endometrium is necessary for a succesful implantation and pregnancy. Implantation depends on the interaction between the blastocyst and endometrium. During this interaction many molecules such as cytokins [ Leukemia İnhibitory Factor (LIF), Colony-Stimulating Factor-1 (CSF-1), IL-1], growth factors and adhesion molecules (integrins) play important roles. These molecules are controlled by estrogen and progesterone and are synthesized by the endometrium at certain phases of the menstrual cycle and early pregnancy. During the interaction of the blastocyst with the endometrium, different types of ‘cell death’ processes are observed in endometrial epithelial cells and stromal cells. Autophagy is one of them and Beclin-1 is expressed in early autophagy. Recent studies decline the cellular sources and expression mechanisms of these factors. Patients with autoimmune diseases and MTFHR thrombophilia can have recurrent miscarriages. The aim of this study was to investigate the expression of some of the factors which may play crucial roles in implantation in the normal pregnancies, in patients with autoimmune diseases and MTHFR mutations, and try to compare them to find out the differences which may interfere in implantation in these pregnancies. Abortus material until 10th gestational-week are used in this study. Group 1; control group (unwanted unwanted induced abortions), Group 2; abortus materials from pregnancies with autoimmun diseases, Group 3; abortus material from pregnancies with hereditary thrombophilia (MTHFR). LIF, IGF-1 and Beclin-1 expressions are investigated immunohistochemically. In patients with autoimmune diseases and MTHFR thrombophilia, miscarriages are common. The explanation of the changes of these factors in autoimmune and MTHFR thrombofilia may help to contribute to understand the etiology of unsuccesfull pregnancies in these patients and may help to improve treatment protocols.