THE COMPARISON OF EUTOPIC PPARγ IN THE PATIENT WITH
ENDOMETRIOSIS AND NON ENDOMETRIOSIS
Muharam R, Olivia L, Fuady M, Harahap JS
Departement of Obstetrics and Gynecology Faculty of Medicine University of Indonesia
INTRODUCTION
The increase of proinflammatory cytokines in patients with endometriosis has
been reported in several studies.2,3 The activation of PPARγ can increase insulin
sensitization and increase glucose metabolism, cells differentiation,
apoptosis, and inflammation. The aim of this study is to determine the
comparison of eutopic endometrial PPARγ receptors in the patient with
endometriosis and nonendomteriosis.
METHODS
This study involved the patients of Gynecology Polyclinic and Operating
Room of RSCM and Yasmin RSCM Kencana clinic who would undergo
surgery at Obstetry and Gynecology Departement of Medical Faculty of
Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta. Sampling was
begun from December 2016 to October 2017.
The subjects of this study were taken by consecutive sampling, who are
diagnosed with endometriosis who underwent laparoscopy and confirmed by
histophathology examination at Cipto Mangunkusumo Hospital
After laparoscopy is performed in the operating room, a biopsy of endometrial
tissue is performed. Patients were diagnosed endometriosis based on direct
observational laparoscopic the endometriosis lesion are included to
endometriosis group. The samples tissue of endometriosis issent to an integrated
laboratory of FKUI/ RSCM for real time PCR examination to see the expression
mRNA PPARγ of endometrial tissue. Laboratory examination results are
included in the table and analyzed to see how the similarities, differences, how
the average difference between eutopic endometrial PPARγ mRNA expression in
endometriosis and non-endometriosis patients. The endometrial eutopic tissue
was taken from curettage with endometrial pipelle shortly after the patients were
anesthesia and then inserted intothe tube containing 500 μl later RNA. Then
stored at -80oC in an integrated laboratory of FKUI.
Dr. Cipto Mangunkusumo Hospital
Jakarta
RESULTS
Of the 50 subjects studied, 1 subject experienced endometriosis which
was not detected so that it was immediately excluded from statistical
analysis. PPARγ value of endometrial tissue has collected was not
normally distributed (Kolmogorov - Smirnov and Saphiro Wilk test
for normality), but based on the coefficient of variance. The standard
deviation divided by the average <0.2 could be concluded normal
distribution both endometriosis and control group. PPARγ levels of
endometrial tissue in all subjects had an average of 22.34 ± 2.27 ng / μL.
The mean value of PPARγ expression of endometrial tissue in the
control group was 22.52 ± 2.28 ng / μL and PPARγ expression of
endometrial tissue in the endometriosis group was 22,16 ± 2,29 ng/μL.
Table 1.The comparison of endometrial tissue expression in the
endometriosis group and control
PPARγ Mean sd
Endometrial 22,52 2,28
tissue of
nonendometriosis
Endometrial 22,16 2,29
tissue of
endometriosis
Picture 1. Boxplot comparison of PPARγ mRNA expression of endometrial
tissue between the control group and endometriosis
DISCUSSION
PPARγ concentrations of endometrial tissue in all groups had a
range that was not much different with the lowest value of
19.28 ng / μl and the highest concentration of 30.42 ng / μl, while
endometriosis tissue had the lowest value of 18.33 ng / μl and the
highest value was 28.61 ng / μl. The standard deviation was small
for eutopic 2.29 and ectopic 2.52. Each sample of endometrial tissue
and endometriosis tissue which was extracted by RNA first, each
sample had equalized weight, which was 30 mg. On the other hand,
endometrial tissue and endometriosis tissue of endometriosis patients
o r i g i n a t e f r o m t h e s a m e c e l l o r i g i n .
The concentration of eutopic control when compared with eutopic
endometriosis showed higher results for eutopic control (eutopic 22.52
± 2.28 and ectopic 22.16 ± 2.29ng / μl). A normal eutopic endometrium
has a gamma PPAR which is slightly more that can be activated by
other endogenous ligands, such as 14-prostaglandin J2, 15 deoxy
delta-12, the origin of essential fat, eicosanoid, phytanic acid,
palmitolethanolamide, nirolenoleic acid.15
CONCLUSIONS
Based on the comparison result, the eutopic concentration of control
was higher than eutopic endometriosis.
REFERENCES
1. Jacoeb TZ. Pengertian Endometriosis. In: Hadisaputra W, editor. Panduan Kinis dan Algoritme Penanganan
Endometriosis 1. 1 ed. Jakarta: CV. Sagung Seto; 2009. p. 9.
2. Oral E, Olive DL, Arici A. The peritoneal environment in endometriosis. Hum Reprod Update. 1996;2(5):385 – 398.
3. Gupta S, Agarwal A, Sekhon L, Krajcir N, Cocuzza M, Falcone T. Serum and peritoneal abnormalities in
endometriosis: potential use as diagnostic markers. Minerva Ginecol. 2006;58(6):527– 551.
4. Kiec-Wilk B, Dembinska-Kiec A, Olszanecka A, Bodzioch M, Kawecka-Jaszcz K. The selected pathophysiological
aspects of PPARs activation. J Physiol Pharmacol. 2005;56(2):149 – 162.
5. Ren P, Zhang Y, Huang Y, Yang Y, Jiang M. Functions of Peroxisome Proliferator-Activated Receptor Gamma
(PPARgamma) in Gynecologic Disorders. Clin Med
6. Dilmy et al. PPARy Expression in Eutopic and Ectopic Endometrium of Reproductive Age Women with
Endometriosis. Indones j obstet gynecol. 2015;3(4):200-205.
7. Schopfer FJ, Lin Y, Baker PR, Cui T, Garcia-Barrio M, Zhang J, et al. Nitrolinoleic acid: an endogenous
peroxisome proliferator-activated receptor gamma ligand. Proc Natl Acad Sci U S A. 2005;102(7):2340 – 2345.