Cyclooxygenase -2 Expression And Apoptosis Of Endometrial Cell In Endometriosis

Endometriosis(En) is a common gynecological disorder, affecting at least 10% of reproductive-aged women, and it is characterized by the growth of endometrial tissue outside the uterine cavity. Although there are many theories regarding the pathogenesis of endometriosis, the most widely supported model is implantation of endometrial cells shed into the peritoneal cavity at the time of menses. It is assumed that spontaneous apoptosis of endometrial cells, infiltration and angiogenesis are involved in the pathogenesis of endometriosis. Cyclooxygenase-2 is highly inducible enzyme, which converts arachidonic acid to prostaglandins. More recently, several in vitro and preclinical studies showed that COX-2 overexpression is associated in human cancer cells with proliferative activity, apoptosis inhibition, increased metastatic potential, and neoangiogenesis. It is well known that human endometrium produces PGE2 and PGF2. other studies have also found that a significant amount of prostaglandins are produced from the endometrium and endometriotic tissues. Survival of endometrial cells misplaced in ectopic locations may depend in part on the inherent ability of cells to undergo apoptosis. Just like the tumor, the onset of endometriosis needs the decreased apoptosis of endometrial cells. Accordingly, COX-2 expression may be abnormal in endometriosis, and its overexpression may be involved in apoptosis of endometrial cells. The relationship between COX-2 expression and apoptosis is worth further study.OBJECTIVES1. To investigate the expression of COX-2, Bcl-2 and Bax, and to evaluate spontaneous apoptosis in eutopic along with ectopic endometrium from women with and without endometriosis. 2. To detect the concentrations of PGE-2 and Bcl-2 in sera and peritoneal fluid of women with and without endometriosis. 3. To determine the effects of ovarian steroid hormones, selective COX-2 inhibitor NS-398, PGE2, GnRH-a and mifepristoene on the expression of COX-2, release of PGE2 and Bcl-2 , and apoptosis in cultured endometrial cellsMETHODS AND RESULTS 1.Expression of COX-2, Bcl-2 and Bax, and spontaneous apoptosis in EndometriosisThe study group included 39 patients with endometriosis, in which 39 specimens of ovarian endometrioma (ovarian chocolate cysts, OCC) , 9 red peritoneal endometriotic lesions (RPL) , 7 uterosacral ligament nodules (ULN) , and 33 matched eutopic endometrium (Eu) were biopsied. The...