State of antioxidant system and lipid peroxidation in patients with external genital endometriosis

• Elvira I. Babaeva
• Mekan R. Orazov
• Armen O. Dukhin
• Dmitry G. Aryutin

Abstract

Background. Endometriosis is an estrogen-dependent disease, one of the main mechanisms of which is chronic inflammation, which ranks second in the structure of gynecological morbidity, which in turn naturally had a negative effect on the reproductive health of women. Endometriosis can rightfully be considered an epidemic of the 21st century, which has engulfed all segments of the female population.

Aim. To assess the state of the antioxidant and peroxide oxidation systems in patients with external genital endometriosis.

Material and methods. The study included 130 women of reproductive age who were undergoing treatment in the Department of Gynecology of the City Clinical Hospital # 29 named after N.E. Bauman. For the period 2017-2020 these patients underwent laparoscopic surgery for external genital endometriosis. The diagnosis of external genital endometriosis, varying degrees of prevalence and severity according to the stages of classification according to R-AFS, respectively, was confirmed by laparoscopic and morphological studies. The patients underwent enucleation of endometriomas, excision of the endometrioid infiltrate with mobilization of the anterior rectal wall, as well as coagulation of endometrioid heterotopies of various localization, adhesiolysis. All patients after surgery were divided into two groups, depending on the degree of spread of endometriosis: group I (n=71) are patients with I, II stages. The spread of EGE and group II (n=59) patients with III, IV stage. The spread of OGE. Before surgery, all the patients underwent blood sampling to determine the general antioxidant status (AOS) and lipid peroxidation (LPO). Determination of the antioxidant activity of blood plasma was carried out by the chemiluminescence method using a chemiluminescent model system of free radical oxidation of luminol induced by a mixture of hemoglobin and hydrogen peroxide (Hb-H202-LM-system). To determine the total peroxides, we used the PerOx (TOS/TOC) Kit reagent kits from Immundiagnostik (Germany).

Results. Patients with III and IV degrees of IGE distribution showed a high level of oxidative stress caused by excessive formation of free radicals and lipid peroxidation products. The differences between groups I and II turned out to be statistically significant, as in the case of the analysis of the numerical values of AOS. In the group of patients with I and II degree of EGE spread, the situation is much more favorable: normal AOS values were obtained in the majority (62%) of women. In the group of patients with III and IV degree of EGE spread, the majority of women (71%) have AOS values below normal. AOS indicators above the norm are few in both group I and group II (10 and 3%, respectively).

Conclusion. Assessment of the antioxidant status and lipid peroxidation in a comprehensive assessment with morphological and anatomical changes in the organs of the reproductive system makes it possible to form an adequate picture of the severity of the disease and the condition of women with external genital endometriosis, followed by the choice of the scope of surgery and the appointment of correct drug therapy.

Keywords:external genital endometriosis, antioxidant status, lipid peroxidation, reproductive health

References

1. Borisova A.V., Kozachenko A.V., Frankevich V.E., Chagovets V.V., Kononikhin A.S., Starodubtseva N.L., Kogan E.A., Adamyan L.V. Risk factors for recurrence of external genital endometriosis after surgery: a prospective cohort study. Meditsinskiy sovet [Medical Advice]. 2018; 7: 32-8. (in Russian)

2. Arabipoor A. Oxidative stress statues in serum and follicular fluid of women with endometriosis. Cell J. 2017; 18 (4): 582-7.

3. Brown J., Farquhar C. An overview of treatments for endometriosis. JAMA. 2015; 313 (3): 296-7.

4. Adamyan L.V., Serov V.N., Andreeva E.N., Baranov I.I., Dubrovina S.O., Kozachenko A.V., KuleshovV.M., Podzolkova N.M., Prilepskaya V.N., Radzinsky V.E., Sonova M.M., Tikhomirov A.L., Uvarova E, V., Chernukha G.E., Shikh E.V., Yarmolinskaya M.I. Resolution of the expert meeting on the topic “Possibilities of personalization of endometriosis hormone therapy using dydrogesterone. Problemy reproduktsii [Russian Journal of Human Reproduction]. 2018; 24 (5): 41-4. (in Russian)

5. Nakagawa K., Hisano M., Sugiyama R., Yamaguchi K. Measurement of oxidative stress in the follicular fluid of infertility patients with an endometrioma. Arch. Gynecol. Obstet. 2016. 293 (1): 197-202.

6. Gabitova D.M, Ryzhikova V.O., Ryzhikova M.A. Antioxidant defense system of the body. Bashkirskiy khimicheskiy zhurnal [Bashkir Chemical Journal]. 2006; 13 (2): 94-6. (in Russian)

7. Saridogan E. Adolescent endometriosis. Eur J Obstet Gynecol Reprod Biol. 2017; 209: 46-9.

8. Zakirova Ya.R., Babaeva E.I., Orazov M.R., Aryutin D.G. Comprehensive assessment of the reproductive health of patients with external genital endometriosis after surgical treatment. Human. Sport. Medicine. 2016; 16 (4): 32-42. (in Russian)

9. Denny E., Weckesser A., Jones G., Bibila S., Daniels J., Bhattacharya S.; PREEMPT team. Women’s experiences of medical treatment for endometriosis and its impact on PRE-EMPT trial participation: a qualitative study. Pilot Feasibility Stud. 2018; 4: 168.

10. Isidor B. Familial deep endometriosis: A rare monogenic disease? Eur J Ob-stet Gynecol Reprod. Biol. 2018; 221: 190-3.

11. Gasparyan S.A., Cheprasova G.P., Burgova E.H. Assessment of the antioxidant defense of the body in genital endometriosis. In: Cytomorphometry in medicine and biology: fundamental and applied aspects. Mоscow, 2009: 103. (in Russian)

12. Fu J., Song H., Zhou M., Zhu H., Wang Y., Chen H., Huang W. Progesterone receptor modulators for endometriosis. Cochrane Database Syst. Rev. 2017; 7.

13. Gibson D.A., Simitsidellis I., Collins F., Saunders P.T.K. Endometrial intracri-nology: oestrogens, androgens and endometrial disorders. Int J Mol Sci. 2018; 19 (10).

14. Hwang H., Chung Y. J., Lee S. R., Park H. T., Song J. Y., Kim H., et al. Clinical evaluation and management of endometriosis: guideline for Korean patients from Korean Society of Endometriosis. Obstet Gynecol Sci. 2018; 61 (5): 55-64.

15. Pechenikova V.A., Akopyan R.A. Evolution of views on the etiopathogenesis of internal and external genital endometriosis. Vestnik Rossiyskoy voyenno-meditsin-skoy akademii [Bulletin of the Russian Military Medical Academy]. 2018; 2: 234-9. (in Russian)

16. Lethaby A., Puscasiu L., Vollenhoven B. Preoperative medical therapy before surgery for uterine fibroids. Cochrane Database Syst. Rev. 2017; 11: CD000547.

17. Orazov M.R. Controversial issues of endometriosis. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2016; 3: 72-84. (in Russian)

18. Nasiri N., Moini A., Eftekhari-Yazdi P. et al. Oxidative stress statues in serum and follicular fluid of women with endometriosis. Cell J. 2017; 18 (4): 582-7.

19. Piepenbrink A., Failing K., Riesenbeck A., Schmid P., Hoffmann B. Downregu-lation of LH in the bitch after application of the GnRH-agonist buserelin as a slow-release implant. Tierarztl. Prax. Ausg. K Kleintiere Heimtiere. 2017; 45 (3): 147-52.

20. Zheng W., Cao L., Xu Z., Ma Y., Liang X. Anti-angiogenic alternative and complementary medicines for the treatment of endometriosis: a review of potential molecular mechanisms. Evid. Based Complement. Alternat. Med. 2018; 2018: 4128984.

21. Vercellini P., Buggio L., Berlanda N., Barbara G., Somigliana E., Bosari S. Es-trogen-progestins and progestins for the management of endometriosis. Fertil. Steril. 2016; 106 (7): 15520-71.

22. Santali P., Tran C., Gayet V., Bourdon M., Maignien C., Marcellin L., et al. Oligo-anovulation is not a rarer feature in women with documented endometriosis. Fertil. Steril. 2018; 110 (5): 941-8.

23. De Sanctis V., Matalliotakis M., Soliman A., Elsefdy H., Di Maio S., Fiscina B. A focus on the distinctions and current evidence of endometriosis in adolescents. Best Pract. Res. Clin. Obstet. Gynaecol. 2018; 15: 138-50.

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