Extracellular matrix metalloproteinase expression in endometrial tissue after arterial embolization of myomas.

OBJECTIVES: Arterial embolization of myomas (AEM) is controversial because of the changes that occur in the extracellular matrix (ECM) of the endometrium and its effect on gestational success in infertile patients desiring reproductive capability. Therefore, we performed this study on the expression of genes in the ECM of the endometrium, such as those coding metalloproteinases (MMP), before and 6 months after embolization of the uterine arteries. METHODS: Seven women with leiomyomas were evaluated, and MMP3 and MMP10 levels were measured. The women underwent pelvic nuclear magnetic resonance (NMR), examination, and endometrial biopsy between the 20th and 24th day of the menstrual cycle, and pre- and post-AEM (after 6 months). For data analysis, the Cq comparative method, also known as the 2-ΔΔCT method, was used to calculate the relative quantities of MMP gene expression among the samples collected. RESULTS: There was a significant decrease by 9.52 times in the expression of MMP3 (p=0.007), and a non-significant change in the expression of MMP10 (p=0.22) in post-AEM-treated women than pre-AEM-treated women. CONCLUSIONS: The results suggest that ECM continues to undergo tissue remodeling 6 months after AEM, at least with regard to MMP3 expression, suggesting that AEM affects the ECM for at least 6 months after the procedure.

Extracellular matrix metalloproteinase expression in endometrial tissue after arterial embolization of myomas

OBJECTIVES: Arterial embolization of myomas (AEM) is controversial because of the changes that occur in the extracellular matrix (ECM) of the endometrium and its effect on gestational success in infertile patients desiring reproductive capability. Therefore, we performed this study on the expression of genes in the ECM of the endometrium, such as those coding metalloproteinases (MMP), before and 6 months after embolization of the uterine arteries. METHODS: Seven women with leiomyomas were evaluated, and MMP3 and MMP10 levels were measured. The women underwent pelvic nuclear magnetic resonance (NMR), examination, and endometrial biopsy between the 20th and 24th day of the menstrual cycle, and pre- and post-AEM (after 6 months). For data analysis, the Cq comparative method, also known as the 2-ΔΔCT method, was used to calculate the relative quantities of MMP gene expression among the samples collected. RESULTS: There was a significant decrease by 9.52 times in the expression of MMP3 (p=0.007), and a non-significant change in the expression of MMP10 (p=0.22) in post-AEM-treated women than pre-AEM-treated women. CONCLUSIONS: The results suggest that ECM continues to undergo tissue remodeling 6 months after AEM, at least with regard to MMP3 expression, suggesting that AEM affects the ECM for at least 6 months after the procedure.

Doença Periodontal e Prematuridade / Periodontal Disease and preterm birth

Evitar a prematuridade continua sendo grande desafio ao obstetra. Apesar de todo o avanço da medicina, as taxas de morbimortalidade neonatal devido a prematuridade permanecem estáveis em patamares elevados, muito provavelmente, devido não apenas ao conhecimento incompleto dos fatores etiológicos e da fisiopatologia do trabalho de parto pré-termo, mas pelo fato de se tratar de problema de ordem médica, educacional e social, o que o torna muito mais complexo. É imprescindível a melhora da assistência pré-natal como um todo, procurando-se identificar aqueles casos de maior risco para a prematuridade a fim de que possamos diagnosticar os estágios iniciais do trabalho de parto pré-termo e com isto, não só impedir ou postergar o nascimento, mas permitir que este ocorra em melhores condições. Dentre os fatores de risco associados à ocorrência de episódios indesejáveis durante o período gestacional, diversos estudos e evidências clínicas sustentam o importante papel que as infecções maternas exercem sobre o nascer prematuro. Neste artigo de atualização procurou-se mostrar os diversos fatores associados à prematuridade, dando ênfase a doença periodontal que tem se mostrado fator relevante, nos estudos realizados nesta última década