Anti-apoptotic activity in deep pelvic endometriosis.

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Deep pelvic endometriosis lesions in the rectosigmoid and uterosacral ligaments showed higher Bcl-2 anti-apoptotic factor expression and virtually no Bax pro-apoptotic factor expression compared to endometrial tissue.

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This cross-sectional observational study evaluated anti- and pro-apoptotic factors (Bcl-2 and Bax) in deep pelvic endometriosis by comparing immunohistochemical staining in tissues collected during surgical laparoscopy from 40 untreated women with deep endometriosis (uterosacral ligaments and rectosigmoid) versus endometrial biopsy controls. All interventions were performed by the same surgeon, and Bcl-2 and Bax expression were assessed semi-quantitatively using digital densitometric analysis (relative optical density), with endometriosis confirmation in all patients; the authors did not report additional functional outcomes beyond staining patterns. Bcl-2 was positive in essentially all specimens (97.5% in uterosacral ligaments, 100% in rectosigmoid) and showed higher staining intensity in rectosigmoid and uterosacral ligaments than in endometrium, while Bax expression was virtually absent (null in rectosigmoid and endometrium, 2.5% in uterosacral ligaments). This paper is centrally about endometriosis—specifically, anti-apoptotic Bcl-2 and pro-apoptotic Bax expression patterns in deep pelvic endometriosis tissues.

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Abstract

Since endometriosis is a proliferative disease we evaluated the presence of anti-apoptotic factor (Bcl-2) and pro-apoptotic factor (Bax) in deep pelvic endometriosis. A Cross-sectional observational study was performed at Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil. Forty women aged 26 to 46 years with deep endometriosis were selected. They had not been clinically treated for at least 3 months prior to surgery and then underwent surgical laparoscopy to treat the disease. During the surgery, tissue was collected from the uterosacral ligaments and the rectosigmoid; an endometrial biopsy was also performed as a control. All interventions were performed by the same surgeon. The specimens were sent for pathological and immunohistochemical analyses; endometriosis was confirmed in all patients. After the immunohistochemical reaction a semi-quantitative evaluation of the staining intensity (relative optical density-ROD) was conducted, applying the digital densitometric analysis system. In the uterosacral ligaments 97.5% of the specimens were positive for Bcl2 whereas in the rectosigmoid 100% were positive. In the endometrium we observed that 87.5% were positive for Bcl2. BAX expression was null in the rectosigmoid and in the endometrium. In the uterosacral ligaments 2.5% of the specimens expressed BAX. The relative optical density of Bcl2 was higher in the rectosigmoid and in the uterosacral ligament when compared to the endometrium, 0.141±0.002; 0.129±0.001, respectively (p<0.01). We concluded that the anti-apoptotic factor Bcl-2 was expressed in all studied specimens, but in a higher staining intensity in the rectosigmoid and in the uterossacral ligaments in comparison to the endometrium. The pro-apoptotic factor Bax had virtually no expression in the studied tissues.
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Anti-apoptotic activity in deep pelvic endometriosis Helizabet S. Abdalla Ribeiro1, Maria Antonieta Longo Galvão2, Tsutomu Aoki3, José Mendes Aldrighi3 and Paulo Ayroza Ribeiro1 1Gyneocologic Endoscopy and Endometriosis Clinic, Department of Gynecology and Obstetrics, 2Department of Pathlogy and 3Department of Obstetrics and Gynecology, Irmandade da Santa Casa de Misericórdia de Sao Paulo (ISCMSP), School of Medical Sciences of Santa Casa de Sao Paulo, Sao Paulo, Brazil Offprint requests to: Paulo Ayroza Ribeiro, Rua Doutor Brasilio Machado, 421-apt 07, Higienópolis - CEP 01230-010, Sao Paulo (SP), Brazil. e-mail: [email protected] Summary. Since endometriosis is a proliferative disease we evaluated the presence of anti-apoptotic factor (Bcl-2) and pro-apoptotic factor (Bax) in deep pelvic endometriosis. A Cross-sectional observational study was performed at Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil. Forty women aged 26 to 46 years with deep endometriosis were selected. They had not been clinically treated for at least 3 months prior to surgery and then underwent surgical laparoscopy to treat the disease. During the surgery, tissue was collected from the uterosacral ligaments and the rectosigmoid; an endometrial biopsy was also performed as a control. All interventions were performed by the same surgeon. The specimens were sent for pathological and immunohisto-chemical analyses; endometriosis was confirmed in all patients. After the immunohistochemical reaction a semi-quantitative evaluation of the staining intensity (relative optical density-ROD) was conducted, applying the digital densitometric analysis system. In the uterosacral ligaments 97.5% of the specimens were positive for Bcl2 whereas in the rectosigmoid 100% were positive. In the endometrium we observed that 87.5% were positive for Bcl2. BAX expression was null in the rectosigmoid and in the endometrium. In the uterosacral ligaments 2.5% of the specimens expressed BAX. The relative optical density of Bcl2 was higher in the rectosigmoid and in the uterosacral ligament when compared to the endometrium, 0.141±0.002; 0.129±0.001, respectively (p<0.01). We concluded that the anti-apoptotic factor Bcl-2 was expressed in all studied specimens, but in a higher staining intensity in the rectosigmoid and in the uterossacral ligaments in comparison to the endometrium. The pro-apoptotic factor Bax had virtually no expression in the studied tissues. Histol Histopathol 29, 1129-1133 (2014) Key words: Tissue microarray, Bcl-2, Immunohisto-chemistry, Statistic DOI: 10.14670/HH-29.1129

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Condition tags

endometriosis

MeSH descriptors

Apoptosis bcl-2-Associated X Protein Endometriosis Pelvis Proto-Oncogene Proteins c-bcl-2 Adult Apoptosis bcl-2-Associated X Protein bcl-2-Associated X Protein Cross-Sectional Studies Endometriosis Female Humans Immunohistochemistry Middle Aged Pelvis Proto-Oncogene Proteins c-bcl-2 Proto-Oncogene Proteins c-bcl-2

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