Markers of the intrinsic apoptosis pathway in reproductive-age women with various intrauterine pathologies. A retrospective study

Background. In recent decades, the frequency of various intrauterine pathologies (IUPs) has increased, which is diagnosed in 38–72% of women of reproductive age. An imbalance in cell proliferation, differentiation, and death plays a crucial role in the pathogenesis of IUPs. Aim. To determine the content of proteins regulating the internal pathway of apoptosis in endometrial cells and circulating lymphocytes in patients of reproductive age with various IUPs. Materials and methods. A comprehensive clinical, instrumental, and biochemical assessment was conducted in 47 women of reproductive age (mean age was 39.5±2.74 years) with various IUPs. Clinical, ultrasound, hysteroscopic, morphological, and biochemical methods were used in all patients. Results. In patients with an endometrial polyp, the most pronounced imbalance of apoptotic factors was detected. In such patients, a statistically significant increase in the Bcl-2 anti-apoptotic protein was observed in the endometrium, as well as a considerable increase in pro-apoptotic factors, including p53 protein, cytochrome C, and cleaved PARP, compared to female subjects without IUPs. The simultaneous elevation in Bcl-2 was determined in circulating lymphocytes. Conclusion. The combination of clinical, instrumental, and biochemical methods of examination enhances the accuracy of diagnosing various IUPs. Interpretation of clinical data should be carried out taking into account the results of instrumental and biochemical research, which will optimize treatment tactics and prevent the likelihood of disease recurrence.