Abstract
Objective:The aim of the present study was to evaluate the effects of progesterone (PG) against ovarian ischemia-reperfusion (I/R) injury through the evaluation of biochemical and histopathologic parameters.Material and Methods:Twenty-one female Wistar albino rats were divided into three groups. Group 1: Sham; group 2: I/R; group 3: I/R+PG (8 mg/kg). PG was administered intraperitoneally to the rats in group 3, 30 minutes before a detorsion operation. Ovarian I/R injury was evaluated in serum and tissue by using biochemical parameters including malondialdehyde (MDA), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, neutrophil gelatinase-associated lipocalin (NGAL) and immunofluorescence staining by using a terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay.Results:Serum and tissue TOS levels were significantly lower in group 3 than in group 2. Tissue TAS levels were higher in group 3 than in group 2 (p<0.001). NGAL and MDA levels were similar between the groups. Histologic score, including vascular congestion, hemorrhage, polymorphonuclear neutrophils, and interstitial edema, was higher in group 2. Pre-treatment with PG decreased the score, but this difference was not statistically significant. The number of apoptotic cells was higher in group 2 than in groups 1 and 3. The TUNEL-positive cell number decreased with PG in group 3.Conclusion:Preoperative PG treatment might exert protective effects on ovarian I/R injury through its anti-apoptotic and antioxidative properties.
Highlights
Adnexal torsion is a serious cause of gynecologic emergency surgery, with a prevalence of 2.7%
The histologic score was found to be lower in the I/R+PG group compared with the I/R group, it was not statistically significant (Graphic 1)
We demonstrated that progesterone shows a protective effect against ovarian I/R injury by reducing the number of apoptotic cells and this shows the anti-apoptotic effect of progesterone
Summary
Adnexal torsion is a serious cause of gynecologic emergency surgery, with a prevalence of 2.7%. Diagnosis and intervention are delayed because clinical findings in adnexal torsion are nonspecific. This can lead to a decrease in the patient's follicle reserve and infertility. There are increases in neutrophil infiltration and activation, production of nitric oxide and cytokines such as tumor necrosis factor, and superoxide radicals (SOR) in ovarian tissue. This condition, called ischemia-reperfusion (I/R) injury, causes more tissue damage than ischemia alone. Protective effects of progesterone on traumatized neurons, heart, and vascular tissues have been demonstrated. It has been experimentally determined that progesterone reduces SOR formation
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