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"Endometriosis adalah kelainan ginekologis yang dimanifestasikan dengan adanya kelenjar dan sel endometrium yang berkembang di luar uterus. Endometriosis merupakan penyakit multifaktorial dimana faktor genetik dan lingkungan berinteraksi menyebabkan timbulnya penyakit ini. Beberapa penelitian telah melaporkan bahwa endometriosis merupakan penyakit yang terkait dengan hormon estrogen. Mekanisme kerja estrogen ditentukan oleh kuantitas dan aktivitas reseptor estrogen. Namun demikian analisa variasi genetik, ekspresi dan aktivitas estrogen reseptor sampai saat ini belum banyak diketahui. Tujuan Penelitian ini adalah untuk menganalisa variasi genetik, ekspresi mRNA dan aktivasi ER pada jaringan endometriosis. Alel gen reseptor estrogen REα dan REβ dari 83 sampel penderita endometriosis dibandingkan dengan 76 kontrol menggunakan metoda PCR RFLP. Pengukuran ekspresi mRNA dari 18 jaringan penderita endometriosis dan 18 kontrol dilakukan dengan menggunakan metoda kuantitatif Real Time PCR (qRT-PCR). Pengukuran kadar estrogen serum (E2) dilakukan dengan metoda ELISA. Deteksi aktivasi ER dilakukan dengan uji fosforilasi reseptor estrogen β (serin 105) dengan metoda Western Blot. Hasil uji Chi-square ditemukan bahwa frekuensi alel A (normal) dan alel G (mutan) pada gen REα SNP rs9340799 dalam populasi berbeda bermakna (p=0,012) dan OR 1,772 dan kedua frekuensi alel dari hasil uji keseimbangan menurut Hardy-Weinberg berbeda bermakna (p = 0,003). Frekuensi alel (normal dan mutan) dalam populasi REα SNP rs2234693 tidak menunjukkan perbedaan bermakna dan seimbang dalam populasi. Frekuensi genotip pada SNP REβ rs4986938 pada endometriosis dibandingkan kontrol berbeda bermakna (p=0,015) dan OR 0,311 dengan populasi seimbang. Menurut keseimbangan Hardy-Weinberg dan frekuensi alel normal G dan alel mutan A juga berbeda bermakna (p=0,034) dan OR =0,438. Hasil pengukuran ekspresi mRNA menunjukkan terjadi peningkatan ekspresi ERβ 49,52 kali dibanding kontrol sedangkan REα tidak menunjukkan perbedaan dibandingkan kontrol. Kadar estradiol serum (E2) fase proliferasi tidak menunjukkan perbedaan bermakna dibanding kontrol. Hasil uji Spearman menunjukkan tidak ada korelasi kadar estradiol dengan ekspresi REα dan REβ (p>0,05). Fosforilasi ERβ pada Serin 105 menunjukkan penurunan pada kelompok endometriosis dibandingkan jaringan normal dengan perbandingan nilai intensitas pita yakni 0,1 pada endometriosis dan 4,2 pada kontrol. Sebagai kesimpulan, frekuensi alel A dan G gen REα berbeda bermakna pada SNP rs9340799 dan frekuensi alel di dalam populasi tidak seimbang. Distribusi genotip normal GG dan mutan AA serta frekuensi alel G dan alel A gen REβ berbeda bermakna pada SNP rs4986938. Ekspresi (mRNA) REβ lebih tinggi secara signifikans pada kelompok endometriosis dibandingkan kontrol. Ekspresi protein Fosforilasi ERβ pada Serin 105 menunjukkan penurunan pada endometriosis dibandingkan jaringan normal.

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Endometriosis is a gynecological disorder that is manifested by the presence of endometrium glands and cells that grow and develop outside the uterus. Endometriosis is a multifactorial with genetic and environmental factors interacting to cause this disease. Several studies have reported that endometriosis is a disease associated with the hormone estrogen. The mechanism of action of estrogen depends on the quantity and activity of estrogen receptors. However, genetic variation, expression and estrogen receptor activation in endometriois patients have not been fully characterized. The aim of this study was to analyze genetic variation, ER expression and determine ER activation in endometriosis patients. This study determined the alleles of the estrogen receptor gene REα and REβ from 83 blood samples from endometriosis patients compared with 76 controls using the RFLP PCR method. Quatitative Real time PCR was used to analyze mRNA expression of REβ genes from 18 tissues with endometriosis and 18 controls. Measurement of serum estrogen (E2) levels was carried out using the ELISA method. Furthermore, the phosphorylation test of estrogen receptor (serin 105) was carried out using the Western Immunobloting method. The results of the Chi-square test found that the frequencies of the A (normal) allele and G (mutant) allele in the REα SNP gene rs9340799 in the population were significantly different (p=0.012) and OR 1.772 and the two allele frequencies from the results of the balance test according to Hardy-Weinberg were significantly different. (p = 0.003). Allele frequencies (normal and mutant) in the REα SNP population of rs2234693 did not show significant and balanced differences in the population. The genotype frequency of SNP REβ rs4986938 in endometriosis compared to control was significantly different (p=0.015) and OR 0.311 with a balanced population. According to the Hardy-Weinberg balance, the frequencies of the normal G allele and the mutant A allele were also significantly different (p=0.034) and OR=0.438. Erβ expression showed 49,52 folds increase compared to control (p=0.00), whereas ERα did not show a significat different compared to control. There was no different in serum estradiol (E2) levels compared to controls. The results of the Spearman test showed that there was no correlation between serum estradiol levels and the expression of REβ and REβ (p>0.05). Phosphorylation Ser105 of ERβ showed a decrease in the endometriosis group compared to control with a comparison of values of 0.1 and 4 2. As a conclusion, The A and G allele frequencies of the RE gen gene were significantly different in SNP rs9340799 and the allele frequencies in the population were not balanced. The distribution of normal genotypes of GG and AA mutants and the frequency of G allele and A allele of REβ gene were significantly different at SNP rs4986938. REβ (mRNA) expression was significantly higher in the endometriosis group than the control group. Phosphorylated ERβ protein expression in Serin 105 showed a decrease in endometriosis compared to normal tissue."

"Latar belakang: Resistensi progesteron akibat gangguan ekspresi reseptor progesteron pada jaringan endometriosis telah diketahui menjadi faktor yang memperberat kondisi klinis pasien endometriosis. Tujuan penelitian ini adalah untuk menganalisis tingkat metilasi DNA pada promoter gen PR-B pada berbagai jaringan endometriosis seperti eutopik endometrium, lesi ektopik peritoneum, endometrioma dan darah menstruasi serta pengaruhnya terhadap ekspresi mRNAnya dibandingkan dengan kontrol endometrium normal; untuk mengetahui patomekanisme endometriosis pada berbagai lokasi terkait dengan resistensi progesteron.Metode: Penelitian ini menggunakan desain potong lintang yang melibatkan 20 sampel untuk masing-masing kelompok kasus dan kontrol. Tingkat metilasi DNA dari gen PR-B diukur menggunakan metode Methylated Specific PCR MSP lalu intensitas pita di dalam gel agarose dihitung dengan software ImageJ. Presentase intensitas pita pada sampel dibandingkan dengan kontrol positif disebut dengan tingkat metilasi DNA. Pengukuran ekspresi relatif mRNA PR-B menggunakan qRT-PCR dua tahap dan analisis dilakukan dengan metode Livak.Hasil: Dari penelitian ini didapatkan perbedaan bermakna antara tingkat metilasi DNA gen PR-B pada jaringan endometriosis ektopik peritoneum 72,4 termetilasi , endometrioma 85 termetilasi dan eutopik endometrium 72,21 termetilasi dibandingan dengan kontrol p

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Background: Progesterone resistance, due to alteration of progesterone receptor PR expression in endometriosis, was known as a disrupt factor in response to progesterone. The aim of this study is to analyze DNA methylation level on PR B promoter in various tissues include eutopic endometrium, ectopic peritoneal, endometrioma and menstrual blood from endometriosis patient as well as the implication on it's mRNA relatif expression compare with normal endometrium control to know the patomechanisms of endometriosis in various lession in term of progesterone resistance.

Methods: It was a cross sectional study, involved 20 sample for both patient and control. DNA isolate from each sample were converted by bisulfite conversion. DNA methylation level of PR B gene was analysis by Methylated Specific PCR MSP method, then band intensity in gel agarose was measured by ImageJ software. Percentage of band intensity in sample compared with positive control was determined as DNA methylaton level. Quantitative real time PCR was conducted to assess expression of mRNA PR B for each sample and Livak method was used to analysis it's relatif expression compare with control.

Result: There were significant different of methylation level of PR B gene in ectopic peritoneal endometriosis 72,40 methylated , endometrioma 85 methylated and eutopic endometrium 72,21 methylated compared with control p"

"Latar belakang: Sindrom ovarium polikistik (SOPK) merupakan salah satu kelainan endokrin paling umum pada 7-15% wanita usia reproduksi yang menyebabkan infertilitas anovulatori. SOPK sering ditemukan pada wanita gemuk, sekitar 50-75% tetapi sindrom ini juga dapat ditemukan pada wanita kurus sebesar 5,5%. Penyebab dan patogenesis SOPK sampai sekarang masih diperdebatkan tapi hasil penelitian memperlihatkan hiperandrogen dan resistensi insulin terlibat dalam perkembangan perjalanan penyakit dan fenotip SOPK. Efek androgen dimediasi oleh reseptor androgen (AR) sedangkan efek insulin dimediasi oleh reseptor insulin (INSR). Ekspresi dan aksi dari kedua reseptor ini terutama pada sel granulosa ovarium dapat dipengaruhi oleh mekanisme epigenetik yang diduga terlibat dalam perkembangan penyakit SOPK ini. Tujuan: Mengetahui tingkat metilasi DNA pada gen reseptor androgen (AR) dan reseptor insulin (INSR) serta ekspresi mRNAnya pada sel granulosa subjek SOPK dan nir-SPOK. Metode: Penelitian ini merupakan penelitian deskriptif analitik dengan rancangan cross sectional. Sampel berupa sel granulosa dari folikel ovarium didapatkan dari wanita yang melakukan ovum pick up (OPU) di klinik Yasmin RSUPN Ciptomangunkusumo yang kemudian dilakukan isolasi DNA dan RNA. Pada isolat DNA dilakukan konversi bisulfit, Methyl Specifik PCR (MSP), elektroforesis dan analisis ketebalan pita dengan perangkat lunak ImageJ untuk mendapatkan data tingkat metilasi DNA. Pada isolat RNA dilakukan qPCR untuk mendapatkan ekspresi relatif mRNA gen AR dan INSR. Hasil: Analisis data dari 21 subjek SOPK dan 20 subjek nir SOPK menunjukkan terdapat perbedaan bermakna (p=0,00) tingkat metilasi DNA gen AR pada pasien SOPK (45.24 %±16,84) dibandingkan nir-SOPK (84,96±15,45). Analisis gen INSR, pada subjek SOPK 100% tidak terjadi metilasi pada promotor gen INSR tetapi pada subjek nir-SOPK 1 dari 21 wanita mengalami metilasi parsial ((37,82%±8,25). Dari penelitian juga didapatkan terjadinya peningkatan ekspresi relatif mRNA AR sebesar 2,459 kali dan 1,791 kali pada mRNA INSR. Tidak terdapat korelasi antara tingkat metilasi gen AR dan INSR dengan ekspresi mRNAnya. Kesimpulan: Penurunan tingkat metilasi DNA (hipometilasi) pada gen AR dan INSR dapat meningkatkan tingkat ekspresi mRNA AR dan INSR, yang kemudian berkontribusi terhadap kejadian hiperandrogen dan resistensi insulin pada fenotip subjek SOPK.

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Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in 7-15% of women of reproductive age who cause anovulatory infertility. PCOS is often found in obese women, around 50-75% but this syndrome can also be found in thin women at 5.5%. The causes and pathogenesis of PCOS is still debated but the results of the study show hyperandrogen and insulin resistance involved in the development of the disease course and the PCOS phenotype. The androgen effect is mediated by the androgen receptor (AR) while the effect of insulin is mediated by the insulin receptor (INSR). The expression and action of these two receptors, especially in ovarian granulosa cells can be influenced by epigenetic mechanisms that are thought to be involved in the development of PCOS.

Objective: To determine the level of DNA methylation in the androgen receptor gene (AR) and insulin receptor (INSR) and its mRNA expression in the SOPK and nir-SPOK granulosa cells.

Method: This study is a descriptive analytic study with a cross sectional design. Samples in the form of granulosa cells from ovarian follicles were obtained from women who performed ovum pick up (OPU) at the Yasmin clinic Ciptomangunkusumo Hospital which was then isolated from DNA and RNA. DNA isolates were carried out bisulfite conversion, Methyl Specific PCR (MSP), electrophoresis and tape thickness analysis with ImageJ software to obtain DNA methylation level data. QPCR was performed on RNA isolates to obtain the relative expression of the AR and INSR mRNA genes.

Results: Analysis of data from 21 SOPK subjects and 20 non-PCOS subjects showed significant differences (p = 0.00) of AR gene DNA methylation rates in PCOS patients (45.24% ± 16.84) compared to non-PCOS (84.96 ± 15 , 45). INSR gene analysis, in the subject of 100% PCOS there was no methylation of the INSR gene promoter but in non-PCOS subjects 1 out of 21 women had partial methylation ((37.82% ± 8.25). AR is 3.459 times and 2.791 times in INSR mRNA. There is no correlation between the rate of methylation of the AR and INSR genes with their mRNA expression.

Conclusion: Decreasing levels of DNA methylation (hypomethylation) in AR and INSR genes can increase the level of expression of mRNA AR and INSR, which then contributes to the incidence of hyperandrogen and insulin resistance in the phenotype of the PCOS subject."

"Latar Belakang: TNF-α dan CXCL16 terlibat dalam patofisiologi endometriosis melalui regulasi respon inflamasi dan pengkode nyeri endometriosis. Peningkatan TNF-α berperan dalam jalur pensinyalan P53 untuk apoptosis. Darah menstruasi sebagai pelepasan jaringan endometrium dapat digunakan dalam mengidentifikasi biomarker untuk diagnosis penyakit endometriosis tanpa memerlukan biopsi. Metode: Sampel darah menstruasi subjek dikumpulkan dengan menggunakan pembalut kertas saring dan jaringan endometrium dikumpulkan dengan melakukan biopsi, yang kemudian diekstraksi DNA dan RNA-nya. Tingkat metilasi DNA diukur dengan menggunakan metode pyrosequencing. Tingkat ekspresi mRNA diukur dengan menggunakan metode qPCR dan dianalisis dengan metode Livak Hasil: Ekspresi mRNA gen TNF-α pada darah menstruasi pasien endometriosis meningkat signifikan 3,73 kali lipat dibandingkan ekspresi pada kontrol (p=0,005). Gen TNF-α mengalami hipermetilasi dan berbeda bermakna dalam darah menstruasi pasien endometriosis dibandingkan kontrol (p=0,008). Sedangkan ekspresi mRNA gen CXCL16 pada darah menstruasi pasien endometriosis meningkat 2,42 kali (p=0,030) dibandingkan ekspresi mRNA darah menstruasi pada kontrol. Gen CXCL16 mengalami hipometilasi (p=0,004). Pada P53 terjadi terjadi peningkatan ekspresi gen P53 1,52 kali. Ekspresi mRNA gen TNF-α dan CXCL16 pada subjek nyeri berat lebih tinggi dibandingkan subjek nyeri sedang, dan terdapat korelasi positive. Kesimpulan: Penelitian ini menunjukkan bahwa peningkatan ekspresi mRNA TNF-α dan CXCL16 dalam darah menstruasi pasien endometriosis dapat menjadi penanda langsung untuk mendiagnosis endometriosis. Namun, untuk memvalidasi lebih lanjut temuan ini dan mengeksplorasi potensi sebagai alat diagnostik, penelitian tambahan yang melibatkan kelompok pasien yang lebih besar diperlukan

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Background: TNF-α and CXCL16 are implicated in the pathophysiology of endometriosis through the regulation of inflammatory response and the coding of endometriosis pain. Elevated TNF-α is implicated in the P53 signaling pathway for apoptosis. Menstrual blood, as a discharge of endometrial tissue, presents an opportunity for identifying biomarkers for the diagnosis of endometriosis without resorting to biopsy. Method: Menstrual blood samples were collected using filter paper pads, and endometrial tissues were obtained via biopsy, from which DNA and RNA were extracted. DNA methylation levels were assessed using the pyrosequencing method after bisulfite conversion treatment. Meanwhile, mRNA expression levels were measured using the quantitative polymerase chain reaction (qPCR) method and analyzed using the Livak method. Results: The mRNA expression of the TNF-α gene in menstrual blood of endometriosis patients increased significantly by 3.73 times compared to controls (p=0.005). The TNF-α gene exhibited hypermethylation, significantly differing in menstrual blood of endometriosis patients compared to controls (p=0.008). The mRNA expression of the CXCL16 gene in menstrual blood of endometriosis patients increased by 2.42 times (p=0.030) compared to controls, although there was no significant difference in expression between menstrual blood and endometrial tissue in endometriosis patients (p=0.173). The CXCL16 gene displayed hypomethylation (p=0.004). There was an increase in P53 gene expression, which was 1.52 times higher than in control menstrual blood. The mRNA expression of TNF-α and CXCL16 genes in subjects experiencing severe pain was higher than in those with moderate pain, and there was a positive correlation. Conclusion: This study suggests that increased mRNA expression of TNF-α and CXCL16 in menstrual blood of endometriosis patients may serve as direct markers for diagnosing endometriosis. However, further validation of these findings and exploration of their potential as diagnostic tools requires additional studies involving larger patient cohorts."

"Latar Belakang: Endometriosis merupakan penyakit multifaktorial yang mempengaruhi 10% wanita usia subur. Diketahui bahwa gen EGFR dan MMP-2 mengalami peningkatan ekspresi pada endometriosis sehingga memiliki peran dalam perkembangan endometriosis, dan gen yang dapat meregulasi sitoskeleton. Tujuan dari penelitian ini adalah untuk mengevaluasi hubungan antara tingkat metilasi gen EGFR dan MMP-2 dengan ekspresi mRNA-nya pada jaringan endometriosis peritoneum.Metode Penelitian: Penelitian ini menggunakan desain cross sectional. Sampel yang digunakan sebanyak 20 wanita endometriosis dan 20 wanita bukan endometriosis yang usianya sekitar 20-45 tahun. Pada wanita endometriosis diambil jaringan endometriosis peritoneum dengan tindakan laparoskopi, sedangkan 20 wanita bukan endometriosis diambil jaringan endometrium normal dengan tindakan mikrokuretase. Tingkat metilasi DNA gen EGFR dan MMP-2 dianalisis dengan metode Methylation Specific PCR (MSP) dan Ekspresi mRNA gen EGFR dan MMP-2 dianalisis dengan metode qRT-PCR.Hasil: Tingkat metilasi DNA pada gen EGFR dan MMP-2 mengalami hipermetilasi. Pada gen EGFR, tingkat metilasi DNA antara jaringan endometriosis peritoneum dibandingkan dengan jaringan endometrium normal terdapat perbedaan yang bermakna (p=0,001), sedangkan pada gen MMP-2 tingkat metilasi DNA-nya tidak terdapat perbedaan yang bermakna (p=0,596) antara jaringan endometriosis peritoneum dibandingkan dengan jaringan endometrium normal. Nilai ekspresi relatif mRNA EGFR dan MMP-2 mengalami peningkatan ekspresi pada jaringan endometriosis peritoneum. Penelitian ini tidak menunjukkan korelasi yang bermakna antara tingkat metilasi dengan tingginya ekspresi mRNA baik gen EGFR maupun MMP-2. (gen EGFR (p=0,947 dan r=-0,016) dan gen MMP-2 (p=0.769 dan r=0.070)Kesimpulan: Tingginya ekspresi mRNA EGFR dan gen MMP-2, kemungkinan bukan hanya disebabkan karena faktor metilasi DNA, melainkan faktor lainnya.

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Background: Endometriosis is a multifactorial disease that affects 10% of women of childbearing age. It is known that the EGFR and MMP-2 genes have increased expression in endometriosis and thus have a role in the development of endometriosis, and genes that can regulate the cytoskeleton. The purpose of this study was to evaluate the relationship between the level of methylation of the EGFR and MMP-2 genes with their mRNA expression in peritoneal endometriosis tissue.

Method: The study used a cross sectional design. The sample used was 20 women with endometriosis and 20 women without endometriosis who were around 20-45 years old. In endometriosis women are taken to peritoneal endometriosis tissue by laparoscopic, while 20 women without endometriosis are taken to normal endometrial tissue by microcuretase. The levels of EGFR and MMP-2 gene methylation were analyzed by the Methylation Specific PCR (MSP) method and the mRNA expression of the EGFR and MMP-2 genes were analyzed by the qRT-PCR method.

Results: The level of DNA methylation in the EGFR and MMP-2 genes was hypermethylated. In the EGFR gene between peritoneal endometriosis tissue compared to normal endometrial tissue there were significant differences (p=0,001), whereas in the MMP-2 gene there was no significant difference (p=0.596) between peritoneal endometriosis tissue compared to normal endometrial tissue. The relative expression value of EGFR and MMP-2 mRNA has increased expression in peritoneal endometriosis tissue. This study did not show a significant correlation between the level of methylation and the high mRNA expression in both the EGFR and MMP-2 genes. (EGFR gene (p=0.947 and r=-0.016) and MMP-2 gene (p=0.769 and r=0.070)

Conclusion: The high expression of EGFR mRNA and MMP-2 gene, the possibility is not only due to hypermethylation factors, but other factors."

"Latar Belakang: Endometriosis menjadi penyakit dengan teka-teki yang memerlukan penyelesaian. Prevalensinya bervariasi dengan rentang yang luas. 0,7-44% pada populasi umum. 26,5% pada kelompok 40-44 tahun, namun 52,7% pada usia 18-29 tahun. Ilmu, tehnologi dan penelitian yang ada belum menghasilkan terapi terkini menurunkan prevalensinya. Anti inflamasi non-steroid terapi non-hormonal penghilang nyeri mempunyai efek samping pada pemakaian jangka panjang, terapi hormonal mempengaruhi siklus menstruasi dan fertilitas. Modalitas terapi perlu dikembangkan mengatasi endometriosis. Peroxisome Proliferator Activated Receptor gamma merupakan faktor transkripsi terikat pada membran nukleus sebagai anti inflamasi potensial. Aktivasi PPAR gamma oleh ligan menghambat faktor transkripsi nuclear factor-κB menurunkan ekspresi gen sitokin inflamasi, menurunkan TNF α, menginduksi sekresi IL-8 menghambat proliferasi sel. Agonis selektif PPARγ diharapkan menjadi pilihan terapi non-hormonal jangka panjang endometriosis masa mendatang. Belum ada penelitian mengevaluasi ekpresi PPARγ pada jaringan endometrium endometriosis dan tidak endometriosis. Tujuan: Penelitian ini membandingkan ekpresi mRNA PPARγ endometrium subjek endometriosis dan tidak endometriosis.Metode: Penelitian potong lintang pada Desember 2016-Oktober 2017 di Kamar Operasi RS Ciptomangunkusumo. Dua puluh lima pasien endometriosis yang menjalani laparoskopi atau laparotomi yang memenuhi syarat penelitian direkrut consecutive sampling diperiksa tampilan PPAR Gamma pada dinding endometrium endometriosis dan tidak endometriosis; jaringan endometriosis dari dinding kista endometriosis. Ekspresi PPAR Gamma diperiksa menggunakan two step real time PCR. Penelitian ini disetujui oleh Komite Etik dan Penelitian tahun 2016. Hasil: Ekspresi PPARγ endometrium subjek endometriosis dan tidak endometriosis tidak berbeda bermakna (p 0,58). Ekspresi mRNA PPARγ jaringan endometrium dan endometriosis subjek endometriosis tidak berbeda bermakna (p 0,89). Ekspresi PPARγ jaringan endometriosis dan endometrium subjek tidak endometriosis tidak berbeda bermakna (p 0,68). Kesimpulan: Penilaian ekspresi mRNA PPARγ belum dapat digunakan sebagai dasar target terapi endometriosis. Penelitian lanjutan memisahkan jaringan epitel dan stromanya dapat dilakukan untuk membuktikan peran PPARγ pada patogenesis endometriosis.

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Background: Endometriosis becomes a disease with a puzzle that requires completion. Prevalence varies with wide ranges. 0.7-44% in the general population. 26.5% in the 40 to 44 years group, but 52.7% at the age of 18-29 years. Existing science and research have not resulted in current therapy reducing its prevalence. Non-steroidal antiinflammatory non-hormonal pain relief therapy has side effects on long-term use, hormonal therapy affects the menstrual cycle and fertility. Therapeutic modalities need to be developed to overcome endometriosis. Peroxisome Proliferator Activated Receptor gamma is a transcription factor bound to the nuclear membrane as a potential anti-inflammatory. Activation of gamma PPAR by ligand inhibits nuclear factor-κB transcription factor decreases expression of inflammatory cytokine gene, decreases TNF α, inducing IL-8 secretion inhibiting cell proliferation. PPAR sel-selective agonists are expected to be the preferred long-term non-hormonal therapy of future endometriosis. Objective: This study compared PPAR expression in endometriosis and endometrial subjects of endometriosis and not endometriosis.Method: Cross-sectional study in December 2016-October 2017 at Operation Room of RS Ciptomangunkusumo. Twenty-five endometriosis patients undergoing laparoscopy or laparotomy who qualified for the study were recruited consecutive sampling examined PPAR Gamma display on the endometrial wall of endometriosis and not endometriosis; endometriosis of the cervical wall of endometriosis. The PPARγ expression was examined using two step real time PCR. The study was approved by the Ethics and Research Committee of 2016. Result: The PPAR expression of the endometrium of endometriosis and nonendometriosis did not differ significantly (p 0.58). Expression of PPAR gamma endometrial and endometriosis tissue subject of endometriosis was not significantly different (p 0.89). PPAR expression of endometriosis and endometrial tissue of the subjects not endometriosis was not significantly different (p 0.68). Conclusion: PPAR expressivity assessment has not been used as a target for endometriosis therapy. Further studies separating epithelial tissue and stroma can be performed to prove the role of PPARγ in the pathogenesis of endometriosis."

"Latar belakang: Telah dilaporkan bahwa terdapat perubahan pada ekspresi dari ribuan gen di jaringan endometrium endometriosis, termasuk diantaranya adalah gen FN1 dan RAC1. Perubahan ekspresi gen tersebut dapat disebabkan oleh mekanisme epigenetik seperti perubahan tingkat metilasi DNA pada gen.Tujuan: Mengetahui tingkat metilasi DNA pada gen FN1 dan RAC1 serta ekspresi mRNAnya pada jaringan endometrium subjek endometriosis dan nir-endometriosis.Metode: Penelitian ini merupakan cross sectional dengan jumlah sampel sebanyak 40 dari jaringan endometrium subjek endometriosis dan subjek nir-endometriosis. Sampel diambil dengan teknik mikrokuretase di RSUPN Ciptomangunkusumo dan RS Fatmawati Jakarta. Pada jaringan kemudian dilakukan isolasi DNA dan RNA. Pada isolat DNA dilakukan konversi bisulfit, MSP, elektroforesis dan analisis intensitas pita menggunakan software ImageJ untuk mendapatkan data persentase tingkat metilasi DNA. Pada isolat RNA dilakukan qRT-PCR untuk mendapatkan ekspresi relatif mRNA gen FN1 dan RAC1.Hasil: Analisis persentase tingkat metilasi DNA promotor menunjukkan terdapat perbedaan bermakna (p=0,022) pada gen FN1 pada pasien endometriosis (37,95%) dibandingkan nir-endometriosis (59,22 %), sedangkan pada gen RAC1 tidak terdapat perbedaan bermakna (p=0,63) dengan tingkat metilasi subjek endometriosis (28.45%) dan subjek nir-endometriosis (26.11%). Penelitian ini juga melaporkan terjadinya peningkatan ekspresi relatif mRNA gen FN1 dan RAC1 dibandingkan dengan subjek nir-endometriosis, namun secara statistik tidak terdapat perbedaan bermakna (p>0,05). Tidak terdapat korelasi bermakna antara tingkat metilasi gen FN1 dan RAC1 dengan ekspresi mRNAnya.Kesimpulan: Terjadi penurunan tingkat metilasi yang bermakna pada gen FN1 di jaringan endometrium endometriosis, namun tidak berkorelasi dengan peningkatan mRNA nya. Tidak terdapat perbedaan bermakna tingkat metilasi dan ekspresi mRNA pada gen RAC1 di jaringan endometrium subjek endometriosis dibandingkan dengan nir endometriosis.

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It has been reported that there was a changes in the expression of thousands of genes in endometrial endometriosis tissues, including the FN1 and RAC1 genes. Changes in gene expression can be caused by epigenetic mechanisms such as DNA methylation in genes.

Objective: To determine the level of DNA methylation in FN1 and RAC1 genes and their mRNA expression in endometrial tissue of endometriosis and non-ndometriosis.

Method: This study was designed as cross sectional with a total sample of 40 of endometrial tissues in the subject of endometriosis and non-endometriosis. Samples were taken by microcuretase at Ciptomangunkusumo and Fatmawati Hospital, Jakarta. DNA and RNA was isolated. DNA isolates were converted by bisulfite procedure, MSP conversion, electrophoresis, analyzed intensity of the band which appeared on gel electrophoresis using ImageJ software to obtain the percentage data of DNA methylation level. In RNA isolates, it was analyzed using qRT-PCR methode to obtain the relative mRNA expression level.

Results: Analysis of percentage of DNA methylation level showed significant differences (p=0.022) in the FN1 gene (37.95%) compared to non-endometriosis (59.22%), whereas in the RAC1 gene there was no significant difference (p=0,63) with methylation level of endometriosis subjects (28.45%) and non-endometriosis subjects (26.11%). For relative mRNA expression of FN1 and RAC1 genes showed no significant differences (p> 0.05). For correlation in endometrial endometriosis showed no significant between the rate of methylation of the FN1 and RAC1 genes with their mRNA expression.

Conclusion: There was a significant decrease in DNA methylation level of FN1 gene in endometrial endometriosis tissues, but it did not correlate with the increasing in its mRNA expression. There was no significant difference in DNA methylation level and mRNA expression of RAC1 gene in endometrial tissues of endometriosis subjects compared to non-endometriosis."

"Endometriosis merupakan penyakit pada sistem reproduksi wanita yang ditandai dengan tumbuhnya jaringan endometrium di luar rongga uterus. Endometriosis memengaruhi sistem reproduksi salah satunya dengan menyebabkan penurunan kualitas oosit akibat terjadinya apoptosis pada sel granulosa di dalam folikel. Apoptosis pada sel granulosa diketahui diaktivasi melalui jalur intrinsik yang dipengaruhi oleh protein BAX (pro-apoptosis) dan BCL-2 (anti-apoptosis). Penelitian ini bertujuan untuk mengetahui ekspresi mRNA bcl-2 dan bax pada sel granulosa penderita endometriosis melalui metode real-time PCR yang kemudian diuji secara statistik dengan menggunakan Uji-t. Hasil penelitian menunjukkan bahwa ekspresi mRNA bax/bcl-2 pada wanita penderita endometriosis menunjukkan perbedaan yang signifikan (p < 0,05) dibandingkan pada wanita tanpa endometriosis.

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Endometriosis is a disease in female reproductive system which marked by the present of endometrium tissue outside the uterus cavity. Endometriosis affects the reproductive system by decreasing oocyte quality as an impact of granulosa cells apoptosis in the follicle. Apoptosis in granulosa cells has been known activated through intrinsic pathway which is influenced by BAX (pro-apoptosis) and BCL-2 (anti-apoptosis) proteins. This research was conducted to know the mRNA expression of bcl-2 and bax in granulosa cells of endometriosis patients using real-time PCR and statistic tests (T-test). The result shows that there is significance difference (p < 0,05) of bax/bcl-2 expression between granulosa cells of endometriosis patients and granulosa cells in women without endometriosis."

"Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan sebuah penyakti dengan prevalensi yang tinggi dan beban kesehatan yang besar. Hingga saat ini, penyebab SOPK masih belum jelas. Penelitian sebelumnya mengenai ekspresi reseptor vitamin D (VDR) pada pasien SOPK menunjukkan hasil yang menjanjikan namun belum terbukti secara jelas. Oleh sebab itu, diduga bahwa polimorfisme VDR berperan penting dalam kejadian dan beratnya gejala SOPK.Metode: Penelitian potong lintang dilakukan pada pasien SOPK dan wanita usia reproduktif non-SOPK sebagai kontrol pada November 2019 hingga 2021. Pasien hamil, menyusui, memiliki riwayat gangguan hormon adrenal, tiroid, maupun prolaktin, atau mengonsumsi obat hormonal dalam 6 bulan terakhir dieksklusi dari penelitian. Subjek penelitian direkrut secara konsekutif. Ekspresi VDR dinilai dari ekspresi mRNA VDR yang dinilai dengan pemeriksaan PCR. Polimorfisme VDR dinilai pada tiga titik regio penyandi gen, yakni rs7975232, rs11574113, dan rs11574114.Hasil: Sebanyak 80 pasien SOPK dan 80 pasien kontrol diikutsertakan dalam penelitian. genotip A/A pada regio rs7975232 dan genotip C/C pada regio rs11574113 lebih banyak didapatkan pada pasien dengan SOPK. Di sisi lain, genotip A/C pada regio rs7975232 dan genotip C/G pada regio rs11574114 lebih banyak didapatkan pada kelompok kontrol (p < 0,05). Tidak terdapat perbedaan ekspresi VDR pada pasien dengan polimorfisme yang berbeda (p > 0,05).Kesimpulan: Didapatkan polimorfisme gen penyandi VDR yang berbeda antara pasien SOPK dan non-SOPK. Tidak didapatkan perbedaan ekspresi VDR yang bermakna antara pasien SOPK dan non-SOPK.

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Background: Polycystic ovary syndrome (SOPK) is a disease with a high prevalence and a large health burden. Until now, the cause of SOPK is still unclear. Previous studies on vitamin D receptor (VDR) expression in PCOS patients have shown promising results but have not been clearly proven. Therefore, it is suspected that the VDR polymorphism plays an important role in the incidence and severity of PCOS symptoms.

Methods: A cross-sectional study was conducted on PCOS patients and non-SOPK women of reproductive age as controls from November 2019 to 2021. Patients who were pregnant, breastfeeding, had a history of adrenal, thyroid, or prolactin hormone disorders, or had taken hormonal drugs in the last 6 months were excluded from the study. study. Research subjects were recruited consecutively. VDR expression was assessed from VDR mRNA expression assessed by PCR examination. VDR polymorphism was assessed at three points in the gene encoding region, namely rs7975232, rs11574113, and rs11574114.

Results: A total of 80 PCOS patients and 80 control patients were included in the study. A/A genotypes in the rs7975232 region and C/C genotypes in the rs11574113 region were more common in patients with PCOS. On the other hand, the A/C genotype in the rs7975232 region and the C/G genotype in the rs11574114 region were more common in the control group (p < 0.05). There was no difference in VDR expression in patients with different polymorphisms (p > 0.05).

Conclusions: Different polymorphisms of the VDR coding gene were found between PCOS and non-SOPK patients. There was no significant difference in VDR expression between PCOS and non-SOPK patients."

"Latar belakang: Peran estrogen pada patofisiologi endometriosis sudah dikenal sejak lama. Namun, belum ada studi yang menganalisis rasio estradiol, estron dan estriol antara wanita dengan dan tanpa endometriosis. Tujuan: Menganalisis kadar estron (E1), estradiol (E2) dan estriol (E3) dalam darah dan rasio E2:E1, E2:E3 dan E1:E3 antara wanita dengan dan tanpa endometriosis. Metode: Penelitian dengan desain potong lintang analitik, dengan 27 wanita dengan endometriosis dan 27 wanita tanpa endometriosis yang memenuhi kriteria inklusi. Sampel didapatkan dari RS Cipto Mangunkusumo dan rumah sakit jejaring lainnya periode Oktober 2012 - April 2013. Kadar metabolit estrogen dalam darah diperiksa dengan uji enzyme-linked immunosorbent (ELISA). Perbandingan data antara dua kelompok dianalisis dengan uji Mann-Whitney. Hasil: Kadar estron ditemukan lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol (54,66 pg/ml vs 73,52 pg/ml, p 0,229). Demikian pula, kadar estradiol dan estriol lebih rendah pada kelompok endometriosis (29 pg/ml vs 35 pg/ml, p 0,815 dan 1,11 pg/ml vs 1,67 pg/ml, p 0.095, berturut-turut). Rasio E2:E1 lebih tinggi pada kelompok endometriosis (0,51 pg/ml vs 0,38 pg/ml, p 0,164), demikian pula dengan rasio E2: E3 (26,53 pg/ml vs 21,11 pg/ml , p 0,223) dan rasio E1:E3 (58,55 pg/ml vs 50,28 pg/ml, p 0,684). Namun, semua perbedaan itu tidak bermakna secara statistik. Kesimpulan: Kadar estron, estradiol, dan estriol pada wanita dengan kelompok endometriosis lebih rendah dibandingkan pada wanita tanpa endometriosis. Rasio E2: E1, E2: E3 dan E1: E3 lebih tinggi pada kelompok endometriosis. Namun, semua perbedaan itu tidak bermakna secara statistik.

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Background: The role of estrogen in the pathophysiology of endometriosis has been well known. However, no study has observed the ratio of estradiol, estrone, and estriol between women with endometriosis and without endometriosis.

Objectives: To assess the estrone (E1), estradiol (E2) and estriol (E3) blood level and its ratio (E2:E1, E2:E3 and E1:E3) between women with and without endometriosis.

Methods: An analytical cross sectional study with 27 women with endometriosis and 27 women without endometriosis who met the inclusion criteria. The samples were recruited in Cipto Mangunkusumo hospital and other satellite hospitals from October 2012 to April 2013. The blood level of estrogen metabolites was examined by enzyme-linked immunosorbent assay (ELISA). The data comparison between two groups was analyzed by using Mann-Whitney test.

Result: The level of Estrone was found to be lower in endometriosis group compared to this in control group (54,66 pg/ml vs 73,52 pg/ml, p 0.229). Similarly, the level of estradiol and estriol were lower in endometriosis group (29 pg/ml vs 35 pg/ml, p 0.815 and 1,11 pg/ml vs 1,67 pg/ml, p 0.095, consecutively). The E2:E1 ratio was higher in endometriosis group (0,51 pg/ml vs 0,38 pg/ml, p 0.164), as well as E2:E3 ratio (26,53 pg/ml vs 21,11 pg/ml, p 0.223) and the E1:E3 ratio (58.55 vs 50.28, p 0.684). However, all those differences were not statistical significant.

Conclusion: The estrone, estradiol and estriol level in women with endometriosis group was lower compared to these in women without endometriosis group. The ratio E2:E1, E2:E3 and E1:E3 was higher in endometriosis group. However, all those differences were statistically insignificant."