MEKANISME PROGRESIVITAS JARINGAN ENDOMETRIOSIS DISTRESS \nMELALUI INTERAKSI MIF, HSP70, Akt, c-Myc, DAN CD44 \nPADA MESENCHYMAL STEM CELL \n(Pendekatan Psikoneuroimunologi Sel Punca Pada Mencit Model Endometriosis)

Introduction: Progression of endometriosis tissue was found in patients with \nendometriosis experiencing distress. The existence of distress has been shown to \nincrease the degree of progression of endometriosis but until now the mechanism \nof progression of endometriosis tissue due to distress can not be explained. The \nstudy aims to reveal the mechanism of endometriosis tissue progression with \ndistress through interaction of MIF, HSP70, Akt, c-Myc and CD44. \nMethods: There was experimental laboratory study using randomized separated \npretest-postest control group design. This study used female Mus musculus aged \ntwo month as endometriosis animal model. The mice were grouped into three \ngroups: Pretest (K1), posttest with distress condition (K2) and posttest with \neustress condition (K3). Stressor was provided with Porsolt forced swim test \n(PST) six minutes a day for 10 days. Examination of protein expression was \nperformed with immunohystochemistry and the size of endometriosis tissue \nmeasured by image ruster2 software. Data were processed with multivariate \nanalysis of variance (Manova) and path analysis. \nResult: There were significant increase in expression of MIF, HSP70, c-Myc and \nsize of endometriosis tissue on distress group than the eustress group. (MIF: \n9,66±2,78 vs 5,56±3,18, p=0,014, δ=4,10); (HSP70: 4,24±1,80 vs 1,48±0,99, \np=0,000, δ=2,76); (c-Myc: 1,93±0,40 vs 0,72±0,49, p=0,000, δ=1,21); (size of \nendometriosis tissue: 357,76±88,22 vs 169,80±121,96, p=0,000, δ=187,96). \nHowever, distress condition did not improve expression of Akt (p=0,052) and \nCD44 (p=0,509) significantly (p>0,05). Through path analysis showed influence \nbetween distress condition to HSP70 (b=0,665; Tstat=5,291), HSP70 to c-Myc \n(b=0,314; Tstat=2,150) and c-Myc to size of endometriosis tissue (b=0,517; \nTstat=3,893). \nConclusion: The distress condition may increase expression of MIF dan HSP70 \nto cause changes in the peritoneal microenvironment becomes more \nproinflammatory. These conditions resulted activating of c-Myc at mesenchymal \nstem cell (MSC). Activation of c-Myc cause MSC can proliferate and differentiate \nto improve the size of endometriosis tissue further