الفهرس 
Acknowledgments
Apoptosis suppression and alteration of endometrial cell fate:Only 14 pages are availabe for public view
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Abstract
Endometriosis is a chronic inflammatory disease in women of reproductive age and can cause both pain and infertility defined by the presence of endometrial glands and stroma outside the uterine cavity. It affects 6–10% (over 176 million) women of reproductive age.There is not definite cause of endometriosis, but a large number of theories had been studied to explain it. The reference standard for diagnosing endometriosis is laparoscopy, preferably including histological verification by biopsy of suspected lesions. Time to definitive diagnosis can be delayed up to 7–11 years for several reasons, as well as high risks and costs associated with surgery. Thus developing a non invasive or minimally invasive/office-based biomarker of endometriosis and potentially disease stage would be advantageous to shorten the time to diagnosis, initiate timely therapies, and detect disease recurrence at the earliest stage. Gal-3 is a member of the large family of lectins, it is a glycoprotein related to cell embryogenesis, adhesion, differentiation and proliferation, apoptosis, mRNA splicing and regulation of the immune system response. The participation in all these processes has put Gal-3 in evidence for its study in diseases promotion and development, including endometriosis. It is now widely accepted that oxidative stress, defined as an imbalance between reactive oxygen species (ROS) and antioxidants, may be implicated in the pathophysiology of endometriosis causing a general inflammatory response in the peritoneal cavity. The present study is designed to estimate the levels of Gal-3 and oxidative stress markers in both healthy and endometriosis females to detect whether Gal-3 causes or protect against the disease to assess the effect of oxidative stress on endometriosis and to investigate the correlation between Gal-3 and oxidative stress markers in pathogenesis of endometriosis. This case-control study included 90 women, who attended the Laparscopy unit in Woman Health Hospital from July, 2017 to November, 2018. They were classified into two groups: group I included 45 patients who were found to have surgically and histopathologically confirmed endometriosis with exclusion of patients with pelvic inflammatory disease, cervical erosion, vaginal infection or coagulopathies. group II: 45 age-matched women free of endometriosis. These women had normal menstrual cycles and had not received hormonal therapy within 3 months prior to sampling. Patient medical history , Sonographic and histopathological evaluation were obtained in every patient. The endometrial biopsy (1-2 gram) will be obtained by laparoscopy in diseased group during proliferative phase (days 5-15) and also during laparoscopic operation in the healthy one and frozen at -80c till assay of Gal-3. Also, Five ml of venous blood was collected into EDTA tubes then plasma is divided into 4 ependorff tubes then stored in -20 ℃ till batch assay of plasma Galectin-3, NO, hydrogen peroxide and total antioxidants. This study demonstrates that there is a significant difference of Gal-3 levels in plasma and endometrial tissue between controls and endometriosis patients. Gal-3 levels were significantly higher in endometriosis patients than the healthy controls. As well, there is a significant difference in plasma levels of oxidative stress markers (NO, H2O2) with higher levels in patients than controls. Total antioxidants levels were lower in plasma levels of patients than controls with a significant difference. Moreover, there is a positive significant correlation between Gal-3 levels (either in plasma or endometrial tissue) and plasma levels of each of NO and H2O2 and a negative significant correlation was found between plasma levels of total antioxidants and plasma levels of each of Gal-3, NO, H2O2. Also, there was a negative significant correlation between plasma level of total antioxidants and tissue level of Gal-3. In conclusion, Gal-3 levels either in plasma or endometrial tissue are increased in endometriosis that allows a possible new biochemical marker that differentiate the endometriosis samples from normal samples, so assessment of Gal-3 level could therefore be clinically helpful in diagnosis of endometriosis and it could be a non-invasive blood based marker for follow up of endometriosis patients as it could exclude the disease if its level is less than 28.4 ng/ml. Moreover, Gal-3 levels in endometrial tissue and plasma is positively correlated with plasma levels of NO and H2O2 and negatively correlated with plasma levels of total antioxidants; this could explain one of the possible mechanisms by which Gal-3 can cause endometriosis.