Alteration of Apoptosis-related Genes in Female Pelvic Supportive Tissues with Regard to Menopausal Status

Abstract

Abstract Purpose: We aimed to compare expression levels of anti-apoptotic and proapoptotic genes in parametrium, sacrouterine and round ligaments of women without and sign of pelvic organ prolapse (POP) with respect to menopausal status. We hypothesized that apoptosis related gene expressions in female pelvic tissues may be altered during menopause. Methods: The study groups consisted of women who did not have POP symptoms pre-menopausal (n=10) and menopausal (n=10). Three different types of tissue samples (Parametrium-Round Ligament-Sacrouterine Ligament) were taken from the cases and RNA was isolated from these tissues. After purifying and quantifying RNA samples, qPCR was used to determine the expression levels of anti-apoptotic and pro-apoptotic genes. Results: BCL-2 gene expression levels were significantly lower in all tissues of menopausal patients compared to all tissues of premenopausal patients. Sacrouterine ligament tissue BAD expression level was significantly high (p= 0.035), BCL-2/BAD ratio was significantly lower in menopausal patients compared to premenopausal patients (p = 0.006). Conclusions: Apoptosis-related protein levels change during menopause, pro-apoptotic gene expressions decrease and anti-apoptotic gene expressions increase. Significant alteration of BCL-2 and BAD expression in sacrouterine ligament with respect to menopausal status was observed, suggesting that sacrouterine ligament which plays a crucial role for restoring normal pelvic anatomy and support for genital organs, could be more affected from menopause rather than other pelvic tissues.