دراسة بعض المعايير الفسلجيّة والتعدد الشكلي لجين مستقبل الأستروجين ألفا ( ERα-351 XbaIوERα-397 PvuII ) لدى النّساء المصابات بتليّف الرّحم في محافظة كربلاء

Study of Some Physiological Parameters and Polymorphisms of the Estrogen Receptor alpha gene) ERα-351 XbaI and ERα-397 PvuII(Among Women Suffering From Uterine Fibroid in Karbala Governorate

The current study aimed to know some physiological and genetic variables in patients with uterine fibroids (UFs) in the Holy Governorate of Karbala. Samples were collected from the Obstetrics and Gynecology Hospital in Karbala Governorate and Al-Kafeel Teaching Hospital for the period from November 2022 to March 2023, and 120 samples were collected from women, which were divided into:
The first group of 100 blood samples included 60 samples from women with uterine fibroids, and 40 samples from healthy women who did not have the disease, which was considered a control group.
The second group included 20 samples of uterine tissue, which were divided into 15 samples of uterine tissue from women with uterine fibroids after hysterectomies, and 5 samples of uterine tissue from women who did not have the disease, as the uterus was removed as a result of emergency incidents, and an immunohistochemical study was conducted on them to detect them. About the presence of estrogen and progesterone receptors in uterine tissue.
The following parameters were measured in blood serum: measurement of sex hormones, follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E), progesterone (PRG), and a standard for oxidative stress, malondialdehyde. (MDA) and standards for the antioxidants glutathione (GSH) and superoxide dismutase (SOD) In addition to measuring the inflammatory factors interleukin 6 (IL6), transforming growth factor beta (TGF-β), and tumor necrosis factor (TNF-α), vitamin D and body mass index (BMI) were also measured and studied. Some risk factors (age, weight, number of births, age at menarche, and family history) in women with uterine fibroids. The study included molecular detection of the estrogen receptor gene ERα by studying the ERα-351Xba I and ERα-397Pvu II polymorphisms in the blood of women with uterine fibroids and women. Proteins and using RFLP-PCR technology.
The results of the current study showed a significant increase (p≤0.05) in the levels of FSH, LH, E, PRG, MDA, TNF-α, and TGF-β in the blood serum of women with uterine fibroids compared with the control group, and a significant decrease (p≤0.05) in the level of Vit. D, GSH, and SOD in the blood serum of women with uterine fibroids when compared with the control group. The results also recorded a significant increase (p≤0.05) in the body mass index of women with uterine fibroids compared to women without uterine fibroids, and an increase in the number of women with uterine fibroids aged 30-45 years, with significant differences (p≤0.05) in some risk factors (age, weight, number of births, age at menstruation, and family history) in women with uterine fibroids compared with women without the disease.
The results of the genetic study also showed that there were significant differences at the level of (P≤0.05) in the GG genotype and the G allele of the ERα-351 AA, AG and the A allele when compared with the control group. It was also observed that there were significant differences at the level of (P≤0.05) in the ERα-397Pvu II polymorphism of the estrogen receptor gene of the TT, TC, CC genotype and the T, C allele in the blood of affected women compared with women. Non-infected.
We also did not find significant differences at the (P>0.05) level when studying the effect of the ERα-351Xbal polymorphism on some risk factors (age and weight), with significant differences at the (P≤0.05) level in affected women who carry the GG genotype and have a family history. There were no significant differences (P>0.05) in the AA, AG genotypes of affected women who had a family history of the disease and the AA, AG, GG genotypes of affected women who had no family history. When studying the effect of the ERα-397Pvu II polymorphism on some risk factors, the differences were significant at the level of (p≤0.05) between age and the CC genotype for female patients aged 30-45 years and 45-60 years, with a significant increase in the genotype (p≤0.05). The TT genotype for women without uterine fibroids aged 30-45 years and 45-60 years old compared to affected women, while the TC genotype did not show any significant differences (P>0.05) at all ages.
No significant differences were observed at the P>0.05 level for the ERα-397Pvu II polymorphism and family history of women with uterine fibroids when compared with unaffected women.
Significant differences were also found at the P≤0.05 level in weight and TC genotype of the ERα-397Pvu II polymorphism in women with uterine fibroids who weighed less than 70 kg and weighed more than 70 kg compared to women without the condition. While the TT and CC genotypes did not show any significant differences (P>0.05) with weight.
The results of the histological examination also showed a strong expression of the estrogen receptor in uterine tissue (++++++) (+++) and of the progesterone receptor (+++++) (++) in women with uterine fibroids, while a weak expression was observed. (+++) (+) for the estrogen receptor and for the progesterone receptor (++) (+) in the uterine tissue of women who do not have the disease.
It is concluded from the current study that infection with uterine fibroids led to changes in physiological parameters, with an increase in some genetic patterns of the estrogen receptor gene ER-α, which was highlighted in the current study.