Spontaneous apoptosis of endometrial tisssues in patients with endometriosis

ABSTRACT

To detect spontaneous apoptosis in eutopic and ectopic endometrial tissues obtained from patients suffering from endometriosis compared with normal eutopic endometrial tissues from healthy fertile controls, aiming to assess the possible role of apoptosis in the pathophysiology of endometriosis. A prospective study. Study group of 22 patients undergoing laparoscopy for endometriosis and a control group of 16 healthy fertile women with regular mensis and without any gynecological disorders. Spontaneous apoptosis of eutopic endometrial tissues [Obtained by Novak's curette from patients and controls] and ectopic endometrial tissues [Obtained from patients during laparoscopy by laparoscopic biopsy forsceps] was detected using ELISA - based cell death detection kit which is a highly sensitive and specific assay for apoptosis. Spontaneous apoptosis was significantly decreased [p < 0.001] in eutopic endometrium of patients with endometriosis compared with healthy controls and this decrease was not attributable to the phase of the menstrual cycle. Also, in paired samples from all patients with endometriosis, there was a significant reduction [p < 0.001] in spontaneous apoptosis in ectopic endometrium compared with the eutopic one which was not attributable to the phase of the menstrual cycle. Abnormal survival [due to lower apoptosis] of eutopic endometrial tissues results in their continuing physiologic activity after displacement into ectopic sites, giving origin to endometriosis. So, the cause and / or pathogenesis of endometriosis is at least partially because of reduced sensitivity of endometrial tissue to apoptosis