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Master's Dissertation
DOI
10.11606/D.5.2017.tde-22082016-154558
Document
Author
Full name
Eduardo Hideki Miyadahira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2016
Supervisor
Committee
Serafini, Paulo Cesar (President)
Bonetti, Tatiana Carvalho de Souza
Soares Júnior, José Maria
Title in Portuguese
Efeito da remoção cirúrgica das lesões de endometriose profunda na expressão dos microRNAs-21, -451 e -29c e da proteína FKBP52
Keywords in Portuguese
Endometriose
Infertilidade
microRNA
Proteínas de ligação a tacrolimo
Abstract in Portuguese
INTRODUÇÃO: O tratamento cirúrgico da endometriose profunda tem se mostrado benéfico para os resultados de Reprodução Assistida. O motivo que leva aos melhores resultados ainda é desconhecido, mas remete à etiologia multifatorial dessa doença. Observa-se, então, a oportunidade de investigar mecanismos moleculares que possam justificar este fato. Nesse contexto, os microRNAs podem desempenhar papel fundamental na medida em que alteram a expressão de diferentes genes por meio da inibição póstranscricional. OBJETIVO: Analisar o efeito da remoção cirúrgica das lesões de endometriose profunda na expressão dos microRNAs -21, -451 e -29c, além da expressão da proteína FKBP52. MÉTODOS: Trata-se de estudo clínico, prospectivo, longitudinal e comparativo no qual foram incluídas 26 pacientes que foram divididas em dois grupos, segundo o resultado da ultrassonografia transvaginal com preparo intestinal. As pacientes que não apresentaram alterações sugestivas de endometriose compuseram o grupo controle (n = 11) e foram submetidas à coleta de amostra de endométrio. As pacientes do grupo de estudo (n = 15) foram submetidas à amostragem endometrial antes e após o tratamento cirúrgico da endometriose, além de ter sido realizada a coleta de amostra da lesão profunda durante o ato operatório. Foi realizada a extração total de RNA dessas amostras e, posteriormente, PCR em tempo real para análise de expressão dos microRNAs -21, -451 e -29c, além da proteína FKBP52. RESULTADOS: A comparação da expressão relativa dos microRNAs -21 e -451 entre as amostras, de forma geral, não mostrou diferença estatisticamente significante. A expressão relativa do microRNA-29c foi maior no endométrio de pacientes com endometriose em relação ao grupo controle e ainda maior nas lesões de endometriose profunda. Após a cirurgia, a expressão do microRNA-29c no endométrio, foi equivalente à do grupo controle. A expressão da FKBP52 foi menor no endométrio das mulheres com endometriose e nas lesões da doença em comparação ao grupo controle. Após o tratamento cirúrgico houve aumento da expressão de FKBP52 nas amostras de endométrio nas pacientes com endometriose que passou a ser semelhante à do grupo controle. CONCLUSÕES: Os resultados sugerem que a presença das lesões de endometriose pode aumentar a expressão do microRNA-29c no endométrio e, por conseguinte, diminuir a expressão de um dos seus RNA mensageiros alvos que codifica a proteína FKBP52. Após o tratamento cirúrgico, com remoção das lesões de endometriose, a expressão do microRNA-29c e da FKBP52 se assemelhou à do grupo controle
Title in English
The effect of surgical removal of deeply infiltrating endometriosis (DIE) on the microRNAs -21, -451, -29c and the protein FKBP52
Keywords in English
Endometriosis
Infertility
microRNA
Tacrolimus binding proteins
Abstract in English
INTRODUCTION: Surgical treatment of deeply infiltrating endometriosis appears to yield benefits to the affected women and also to the assisted reproduction treatments. Although the mechanisms involved on the improvement of the outcomes are still unknown; yet, they are similar to the multifactorial origin of the endometriosis. Considering that the microRNAs can modify different genes expression, it was investigated their role concerning the molecular pathways leading to endometriosis and the clinical betterment of the assisted reproductive procedures after the surgical treatment. OBJECTIVE: The aim of this study was to evaluate the effect of surgical treatment in women with endometriosis focusing the microRNAs -21, -451 and -29c expression, as well as the protein FKBP52 expression. METHODS: This is a clinical, prospective, longitudinal and comparative study which included 26 patients that were divided into two groups according to the findings of the transvaginal ultrasound with bowel preparation. Eleven women without evidence of DIE composed the control group and were submitted to eutopic endometrium sampling. Fifiteen women presented with evidence for DIE detected by pelvic ultrasound were also submitted to eutopic endometrium sampling before and after surgical treatment. Surgical procedures revealed the presence of relevant DIE. Total RNA extraction of all samples was performed and followed by real time PCR to evaluate microRNAs -21, -451, -29c and protein FKBP52 expression. RESULTS: MicroRNAs -21 and -451 expression analysis did not show statistically significant difference among samples. Nonetheless, expression of microRNA-29c was elevated in eutopic endometrium of women suffering from DIE in comparison to the control group. After surgery, the microRNA- 29c expression in eutopic endometrium became equivalent to the control group. The expression for FKBP52 was lower in women having DIE than those without endometriosis. The surgical treatment increased the expression of the protein FKBP52 in eutopic endometrial samples, turning it similar to the control group. CONCLUSIONS: The results of this study suggest that the presence of DIE might increase the expression of microRNA-29c in eutopic endometrium and consequently decrease the expression of one of its target messenger RNA that codifies the protein FKBP52. After surgical removal of endometriosis lesions, the microRNA-29c and the FKBP52 expression returned to a level similar to the control group
 
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Publishing Date
2017-02-16
 
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