Endometriosis Clinical Trial
Official title:
Galectin-3 in Patients With Endometriosis
The exact cause of endometriosis is unknown ,so our study is to investigate the relationship between Galectin-3 and endometriosis by comparing between its level in healthy and endometriosis women. Also, we will measure the level of oxidative stress markers in endometrium of both healthy and endometriosis women and investigate the correlaton between them and galectin-in endometriosis women.
Endometriosis is a benign gynaecological disorder with malignant biological characteristics
and is defined by the presence of endometrial glands and stroma outside the uterine cavity.
Ectopic endometrial cells can spread to pelvic organs such as rectum, bladder, and ovaries.
The pathophysiology of endometriosis is likely to be multifactorial and to involve an
interplay between several factors. (Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M,
2011)
The endometrial cycle and implantation are complex processes. Alterations in levels of some
regulatory molecules on the cell surface occur during the cycle tightly controlled
proliferation and differentiation. Most of these regulatory molecules and mechanisms have not
yet been investigated, However, Galectins , a sub family of lectins are delineated to
regulate vital cell functions. (Leffler H. et al Introduction to galectins. Glycoconj j,2004)
It has been shown that Gal-3 is expressed in many cell types, including endometrial cells and
trophoblast cells (Riss D, Naude S 2003) . Previous studies have reported that Gal-3 is
specifically expressed in endometrial cells in the secretory phase, in placental tissue
during early pregnancy, and in decidua surrounding the site of implantation. Another study
verified that Gal-3 plays an important role in the process of embryonic implantation (Liu YK,
Hum Reprod.2009). Intracellular Gal-3 promoted proliferation and adhesion in endometrial
cells(Yang H, TaylorHS,2011) .
Female reproductive system is vulnerable to the harmful effects of reactive oxygen species
(ROS) that damage proteins, lipids, and DNA structure. Oxidative stress is a key factor for
progression of endometriosis. Many theories have been elaborated so far to clarify
endometriosis pathogenesis and oxidative stress, a result of increased production of free
radicals or depletion of the body's endogenous antioxidant defense, has been implicated in
its pathogenesis.
Our study is a case-control study that will be made in woman health hospital and medical
biochemistry department -assiut university. We will estimate the tissue level of galectin-3
in endometrium of both healthy and endometriosis women and detect wether galectin-3 leads to
or protect against endometriosis. Also, we will measure the level of oxidative stress markers
in endometrium of both healthy and endometriosis women and investigate the correlaton between
them and galectin-in endometriosis women.
The sample size is calculated by Epi Info 2000 software computer program. Based on the
expected proportion of Galectin-3 deficiency among controls will be 20% and its increase in
cases by four folds (Odd Ratio = 4) with 80% power and a confidence level 95%, the calculated
sample size is 45cases and 45 controls (totally 90 women).
The data collected will include age, parity, menstrual history , present history (including
symptoms of pain, bleeding and infertility), drug history , history of previous diseases and
any investigations were done. The aim of the study will be explained to each participant
before filling study sheet. A written consent will be obtained from those who welcome to
participate in the study, then women will be divided into 2 groups.
Group1:
45women who were found to have surgically and histolopathologically -confirmed endometriosis.
Endometrial samples(1-2 gram) will be taken by laparoscopy which is the gold standard for
definitive diagnosis of endometriosis.
Group2:
45 women free of endometriosis. These women had normal menstrual cycles and had not received
hormonal therapy within 3 months prior to sampling. Endometrial samples(1-2 gram) will be
taken from them through Punch biopsy after IUD insertion.
Galectin-3 will be estimated by ELISA kit. Endometrial samples(1-2 gram) will be separated
from each women during proliferative phase(days 5-15) and washed several times with 0.9%
sterile saline solution to remove any blood from the tissues. The tissue samples will
homogenized by tissue homogenizer at 40,000rpm. The supernatant extracts will be collected in
Ependorf tubes and frozen at -80°C till analysis by ELISA.
The tissue levels of NO and TBARS (oxidative stress markers) were determined by chemical
methods according to the methods descriped by Van Bezooijen et al, (1998), and Buege and Aust
(1978) respectively. Also the tissue levels of catalase (CAT), glutathione (GSH) and
superoxide dismutase (SOD) activity (anti oxidants) were determined by chemical methods
according to the methods descriped by Clairborne ( 1985), Beutler et al. (1963) and Marklund
(1985).
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