Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC15310.15690/vramn.v68i8.717OBSTETRICS AND GYNECOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ АКУШЕРСТВА И ГИНЕКОЛОГИИROLE OF THE GENETIC FACTORS, DETOXICATION SYSTEMS AND OXIDATIVE STRESS IN THE PATHOGENESIS OF ENDOMETRIOSIS AND INFERTILITY (REVIEW)РОЛЬ ГЕНЕТИЧЕСКИХ ФАКТОРОВ, СИСТЕМЫ ДЕТОКСИКАЦИИ И ОКСИДАТИВНОГО СТРЕССА ПРИ ЭНДОМЕТРИОЗЕ И БЕСПЛОДИИ (ОБЗОР ЛИТЕРАТУРЫ)DubinskayaE. D.ДубинскаяЕ. Д.
Russian Federation

PhD, associate professor of the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, People's Friendship University of Russia Address: 117198, Moscow, Miklukho-Maklaya St., 8; tel.: (495) 434-10-60

eka-dubinskaya@yandex.ruGasparovA. S.ГаспаровА. С.
Russian Federation

PhD, professor, member of RANS, Head of Department of Plastic and Reconstructive Surgery and Reproductive Medicine, Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, People's Friendship University of Russia Address: 117198, Moscow, Miklukho-Maklaya St., 8; tel.: (495) 434-10-60

7767778@mail.ruFedorovaT. A.ФедороваТ. А.
Russian Federation

PhD, professor, Head of Department of Blood Gravitational Surgery of V.I. Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology. Address: 117485, Moscow, Acad. Oparin St., 4; tel.: (495) 531-44-44

tfedorova1@mail.ruLaptevaN. V.ЛаптеваН. В.
Russian Federation

assistant of the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, People's Friendship University of Russia Address: 117198, Moscow, Miklukho-Maklaya St., 8; tel.: (495) 434-10-60

nvlapteva@gmail.comPeople’s Friendship University of Russia, Moscow, Russian FederationРоссийский университет дружбы народов, Москва, Российская ФедерацияFederal State Institution «Research Center for Obstetrics, Gynecology and Perinatology» of Ministry of Healthcare and Social Development of Russian Federation, Moscow, Russian FederationНаучный центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова, Москва, Российская Федерация19082013688Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук141907082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/153

The aim of this paper is to provide a systematic review of the role of the genetic factors, detoxication systems and oxidative stress in the pathogenesis of endometriosis and infertility. Endometriosis and infertility are still both the most uncommon diseases in gynecology. Many aspects of female reproductive function are strongly influenced by genetic factors, and numerous studies have attempted to identify susceptibility genes for disorders affecting female fertility such as polycystic ovary syndrome, endometriosis, fibroids, cancer (ovarian, vulvar, cervical), premature ovarian failure, recurrent pregnancy loss and pre-eclampsia. The most solid evidence linking specific polymorphisms to endometriosis is showed by the studies investigating a phase II detoxification enzyme. No data were found concerning influences of the genetic factors on the female infertility. Contrary, a lot of studies devoted to the genetic factors of male infertility are presented. It’s known that endometriosis associated with increased systemic oxidative stress. The implication of increased systemic oxidative stress in disease progression or the association with other oxidative stress-related pathologic conditions needs to be addressed in further studies. The majority of studies suggest a reduced antioxidant capacity in infertile women with endometriosis. In the present review we discussed the role of the genetic factors in the pathogenesis of endometriosis and infertility. NAT2 polimorphism, xenobiotic methabolism and exogenous factors are somehow related with these diseases. An altered balance between pro-oxidant and antioxidant activities may have an impact on folliculogenesis and adequate embryo development.

Целью работы был обзор литературных данных, связанных с изучением роли генетических факторов, системы детоксикации и оксидативного стресса в патогенезе эндометриоза и бесплодия, которые остаются одними из самых неизученных заболеваний в гинекологии. Взаимосвязь между полиморфизмом генов и различными заболеваниями доказана уже давно. В зарубежных исследованиях подтверждены факты наличия полиморфизма генов при поликистозе яичников, эндометриозе, миоме матки, раке яичников и шейки матки, преждевременном истощении яичников, привычном невынашивании и преэклампсии. Существенным доказательством наличия специфического полиморфизма при эндометриозе с позиций доказательной медицины являются нарушения в системе генов второй фазы детоксикации. В зарубежной литературе представлены исследования, подтверждающие наличие генетических причин при формировании мужских факторов бесплодия. Генетические аспекты женского бесплодия как заболевания не изучены. Роль оксидативного стресса при эндометриозе доказана на основании изучения специфических маркеров. Оксидантный-антиоксидантный статус и активность ферментов, метаболизирующих ксенобиотики, взаимосвязаны и могут меняться в зависимости от воздействия факторов внешней среды. Анализ литературных данных демонстрирует, что развитие эндометриоза и бесплодия предопределяется генетически. Немаловажную роль при этом играют факторы внешней среды и уровень эндогенной интоксикации, определяемый в т.ч. скоростью метаболизма ксенобиотиков. Изменение баланса оксидантной-антиоксидантной системы на системном и локальном уровне приводят к нарушениям функций женской репродуктивной системы (снижение фертильности).

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