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Amaç: Adneksiyel torsiyon en yaygın jinekojik acillerden biridir. Reproduktif çağda olan bir kadında ozellikle acil müdahele gerektiren bir durumdur. Bu çalışmada detorsiyon, nifedipin ve resveratrol tedavisinin AMH ve overyan histopataloji üzerindeki koruyucu etkisi değerlendirildi.Gereç ve Yöntem: 24 adet erişkin, sağlıklı gebe olmayan Sprague-Dawley cinsi dişi rat 4 gruba ayrıldı: Kontrol (Grup 1), torsiyon/detorsiyon (Grup 2), torsiyon/detorsiyon+nifedipin (Grup 3), torsiyon/detorsiyon +resveratrol (Grup 4). İlk gruba sadece laparatomi işlemi yapıldı. İkinci grubun bilateral overleri 720° döndürülerek 3 saaat boyunca abdomen yan duvarına fikse edildi, torsiyonu takiben 3 saat detorsiyon durumunda bekletildikten sonra bilateral ooferektomi işlemi yapıldı. Üçüncü Grup‘a 2.Grup‘tan farklı olarak 150 dk da 100 mg/kg, 4. Grup‘a ise 10 mg/kg resveratrol verildi. AMH düzeyi, immünohistokimyasal AMH ve VEGFR-2 tutulumu, TAS-TOS, OSI ve follikül sayımı değerlendirildi.Bulgular: Grup içi preoperative postoperatif AMH degişimi istatistiksel olarak anlamlı saptanmadı (Sırasıyla p= 0.05). Primordiyal follikül sayısı Grup 1‘ de, Grup 2‘ den58anlamlı düzeyde yüksek bulundu (pSonuç: Nifedipin ve Resveratrol tedavileri biyokimyasal AMH düzeyi ve dokuların antioksidan-oksidan sistem belirteçlerine etki etmediği; nifedipinin immünohistokimyasal AMH ekspresyonunu ve sekonder follikül sayısını koruduğu; resveratrolun dokularda VEGFR-2 ekspresyonunu azalttığı görülmüştür.Anahtar kelime: Nifedipin, resveratrol, AMH, over torsiyonu-detorsiyonu Objective: Adnexial torsion is amongst the most common gynecological emergencies which requires emergent treatment in women in reproductive age. In this study we aimed to evaluate the protective effect of detorsion, resveratrol and nifedipine treatment on AMH and ovarian histopathology.Materials and Methods: Twenty-four female, adult, healthy, nonpregnant Sprague-Dawley rats were included in this study which were separated into 4 groups: control (Group 1), torsion/detorsion (Group 2), torsion/detorsion+nifedipine (Group 3), torsion/detorsion+resveratrol (Group 4). Group 1 only received a laparotomy. 720° of bilateral ovarian torsion was performed in Group 2 and ovaries were fixed to the abdominal wall for a duration of 3 hours. Following 3 hours of ischemia, derotation was performed and rats were followed in this state for another 3 hours. At the end of 3 hours of derotation, bilateral oophorectomy was performed. In addition to the procedures performed in Group 2, Group 3 recieved 100mg/kg of nifedipine at 150 minutes and Group 4 recieved 10 mg/kg of resveratrol at 150 minutes. AMH levels, immunohistochemical expression of AMH and VEGFR-2, TAS-TOS-OSI and follicle counts were evaluated.Results: No statistically significant difference between groups in postoperative change in AMH levels were detected (p=0.058; 0.089; 0.756; 0.206, respectively). Immunohistochemical staining revealed AMH expression compared control group was similar in Group 3, significantly decreased in Group 2. Group 4 had better60expression compared to Group 2 however it was still lower than in the control group. Also, in immunohistochemical staining, VEGFR-2 staining was similar in Group 2 and Group 3 but decreased in Group 4, compared to the control group. No statistically significant difference in TAS, TOS and OSI values were detected between groups (p>0.05). Primordial follicle count in Group 1 was found to be significantly higher than in Group 2 (p=0.014). Secondary follicle count in Group 3 was found to be significantly higher than in Group 2 and Group 4 (p=0.013; 0.017, respectively).Conclusion: Nifedipine and resveratrol treatments were found not to have an effect on biochemical AMH levels and antioxidant-oxidant system parameters in rats that received ovarian torsion and subsequent detorsion. Nifedipine was demonstrated to have a protective effect on immunohistochemical AMH expression and secondary follicle count. It was also observed that resveratrol decreased the expression of VEGFR-2 in tissues.Keywords: Nifedipine, Resveratrol, AMH, ovarian torsion-detorsion |
