Publication: İn vitro fertilizasyon tedavisinin plazma n-terminal Pro C tip natriüretik peptit düzeyleri üzerindeki etkileri
Abstract
Östrojenler kardiyovasküler sistem üzerinde koruyucu etkileri bulunan hormonlardır. Östrojenlerin, endotelden salgılanan bazı vazoaktif maddelerin sentezinde değişikliklere neden olmasının koruyuculuk mekanizmasında önemli rol oynadığı gösterilmiştir. C-tip natriüretik peptit (CNP), vazodilatör ve antienflamatuar etkileri olan damar koruyucu kardiyovasküler bir hormondur. Son yıllarda yapılan bazı hayvan deneyleri CNP sentezinin östrojenler tarafından kontrol edilebileceğine dair ipuçları sağlamıştır. Bu çalışmada amacımız östrojen düzeylerinin çok yükseldiği in vitro fertilizasyon tedavisi (IVF) alan kadınlarda plazma östrojen ve CNP düzeylerindeki değişiklikleri, aralarındaki ilişkiyi saptamak ve östrojenlerin kardiyovasküler sistem üzerindeki etkilerinin mekanizmasında CNP’nin olası rolünü araştırmaktır. Bu amaçla IVF tedavisi gören 29 sağlıklı kadından menstruel siklusun 3. günü menstrual siklusun 5. günü ve ovulasyondan önce kan örnekleri alınmıştır. Kontrol grubu olarakta sağlıklı kadınlarda menstrual siklusun 3. günü örnekler toplanmıştır. Örneklerde NT-proCNP ve östrojen düzeyleri enzim immünölçüm yöntemiyle belirlenmiştir. Elde edilen sonuçlar plazma östrojen düzeylerinin ovulasyon öncesinde (1676±822 pg/ mL), tedavinin 3. (29.7±23 pg/ mL) ve 5. (817.3±626 pg/ mL) günlerine göre anlamlı derecede (p<0.001 ve p<0.01) arttığını göstermektedir. Plazma NT-proCNP seviyeleri en yüksek düzeyine östrojenin en yüksek olduğu ovulasyon öncesi dönemde ulaşmıştır. Ovulasyon öncesi plazma NT-proCNP düzeyleri (9.9±4.6 pmol/ L), 3. güne (7.07±3.2 pmol/ L) göre anlamlı (p<0.001) olarak yüksektir. Ayrıca NT-proCNP seviyelerinde, tedavinin 5. gününde 3. güne göre anlamlı (p<0.05) artış saptanmıştır. Üçüncü gün ve 5. gün NT-proCNP ve östradiol düzeyleri arasında kuvvetli bir korrelasyon (0.58, p<0.0023) bulundu. Sonuçlarımız IVF sürecinde yükselen östrojenin, CNP salgılanmasında rolü olabileceğini göstermektedir. Bu bulgu, östrojenlerin kardiyovasküler sistem üzerindeki olumlu etkilerinin mekanizmasında CNP sentezini artırmasının da yer alabileceğini göstermektedir. Natriüretik Peptit, Östrojen, IVF.
Effect of in vitro fertilisation treatment on plasma C Type Natriuretic Peptide levels Estrogens have protective effects on the cardiovascular system. It is demonstrated that estrogen induced changes in the synthesis and release of various vasoactive compound from the endothelium have important roles in the mechanism of protection. C type natriuretic peptide is a cardioprotective vascular hormone with its vasodilator and antiinflamatuar effects. Evidence from few animal studies indicate that CNP synthesis may be modulated by estrogens. The aim of our study was to investigate the possible role of C type natriuretic peptide in estrogen’s cardioprotective effects. With this aim, we explored the changes in plasma estradiol and C type natriuretic peptide levels and their relations in women who have high levels of estrogens due to in vitro fertilization therapy. In this study three blood samples were collected from 29 woman undergoing in vitro fertilisation treatment. The samples were collected on the third and the fifth day of menstruel cycle and just before ovulation. Also as control, blood was collected from healthy women on the 3d day of their menstrual cycle. Blood levels of NT-proCNP and estrodiol were measured by enzyme-linked immunosorbent assay. Our results demonstrate that estradiol levels of women in IVF group are significantly (p<0.001 ve p<0.01) higher before ovulation (1676±822 pg/ mL) compared to 3d (29.7±23 pg/ mL ) and the 5th day (817.3±626 pg/ mL) of the treatment. Plasma NT-proCNP levels reach highest levels just before ovulation as estradiol. Plasma NT-proCNP levels of IVF group are significantly (p<0.05) higher before ovulation (9.9±4.6 pmol/ L) compared to 3d day (7.07±3.2 pmol/ L). In this group plasma NT-proCNP levels are also significantly (p<0.05) higher in the 5th day compared to 3d. Our results indicate that elevations in estradiol may have a role in the increased CNP levels during IVF treatment. This finding also suggest that CNP may be involved in the protective effects of estrogens. Key words: C type natriuretic peptide, estrogen, IVF.
Effect of in vitro fertilisation treatment on plasma C Type Natriuretic Peptide levels Estrogens have protective effects on the cardiovascular system. It is demonstrated that estrogen induced changes in the synthesis and release of various vasoactive compound from the endothelium have important roles in the mechanism of protection. C type natriuretic peptide is a cardioprotective vascular hormone with its vasodilator and antiinflamatuar effects. Evidence from few animal studies indicate that CNP synthesis may be modulated by estrogens. The aim of our study was to investigate the possible role of C type natriuretic peptide in estrogen’s cardioprotective effects. With this aim, we explored the changes in plasma estradiol and C type natriuretic peptide levels and their relations in women who have high levels of estrogens due to in vitro fertilization therapy. In this study three blood samples were collected from 29 woman undergoing in vitro fertilisation treatment. The samples were collected on the third and the fifth day of menstruel cycle and just before ovulation. Also as control, blood was collected from healthy women on the 3d day of their menstrual cycle. Blood levels of NT-proCNP and estrodiol were measured by enzyme-linked immunosorbent assay. Our results demonstrate that estradiol levels of women in IVF group are significantly (p<0.001 ve p<0.01) higher before ovulation (1676±822 pg/ mL) compared to 3d (29.7±23 pg/ mL ) and the 5th day (817.3±626 pg/ mL) of the treatment. Plasma NT-proCNP levels reach highest levels just before ovulation as estradiol. Plasma NT-proCNP levels of IVF group are significantly (p<0.05) higher before ovulation (9.9±4.6 pmol/ L) compared to 3d day (7.07±3.2 pmol/ L). In this group plasma NT-proCNP levels are also significantly (p<0.05) higher in the 5th day compared to 3d. Our results indicate that elevations in estradiol may have a role in the increased CNP levels during IVF treatment. This finding also suggest that CNP may be involved in the protective effects of estrogens. Key words: C type natriuretic peptide, estrogen, IVF.