en نقش مسیرهای آپوپتوز وابسته و غیر وابسته به کاسپاز در پارگی زودرس کیسه آب: یک مطالعه مورد شاهدی Pregnancy Health Original Article Original Article <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">پارگی زودرس کیسه آب (</span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) به عنوان یک مشکل زنان زایمان شناخته می&shy;شود که مکانیزم آن هنوز به روشنی شناخته نشده است. آپوپتوزیس به عنوان یک عامل کلیدی در این مکانیزم در نظر گرفته می&shy;شود که از طریق مسیرهای وابسته و غیر&shy;وابسته به کاسپاز عمل می&shy;کند. فرضیه نقش کاسپاز 3، فاکتور تحریک&shy;کننده آپوپتوز (</span></span><span dir="LTR"><span style="font-size:10.0pt;">AIF</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) و سلول&shy;های بی&shy;لنفوم 2 ضد آپوپتوزی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">Bcl-2</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) در </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">وجود دارد.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بررسی نقش مسیرهای آپوپتوز وابسته و غیر&shy;وابسته به کاسپاز در پارگی زودرس کیسه آب.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مواد و روش&shy; ها:</span></span></strong> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">این مطالعه مورد شاهدی بر روی 42 زن حامله با سن حاملگی بین 20 تا 42 هفته انجام شد. شرکت&shy;کنندگان به گروه مورد با </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">و گروه شاهد بدون </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">تقسیم شدند. غشای کیسه آب بلافاصله بعد از زایمان جمع</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">آوری شد و نمونه</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">ها از محل پارگی کیسه آب انتخاب شدند. آزمایش ایمونوهیستوشیمیایی برای تشخیص بیان کاسپاز 3، </span></span><span dir="LTR"><span style="font-size:10.0pt;">AIF</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">و </span></span><span dir="LTR"><span style="font-size:10.0pt;">Bcl-2</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> انجام شد.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بیان کاسپاز 3 و </span></span><span dir="LTR"><span style="font-size:10.0pt;">AIF</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">به طور معنی</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">داری در گروه مورد افزایش یافته بود در حالیکه بیان </span></span><span dir="LTR"><span style="font-size:10.0pt;">Bcl-2</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">به طور معنی</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">داری در این گروه کاهش یافته بود.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بیان بالای کاسپاز 3 و </span></span><span dir="LTR"><span style="font-size:10.0pt;">AIF</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">و همچنین بیان پایین </span></span><span dir="LTR"><span style="font-size:10.0pt;">Bcl-2</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> به عنوان ریسک فاکتورهای </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بودند. بنابراین واضح است که مسیرهای وابسته و غیر&shy;وابسته به کاسپاز در مکانیزم </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نقش دارند.</span></span> <strong>Background:</strong> Premature rupture of membrane (PROM) remains a problem in obstetrics, the mechanisms of PROM have not been clearly defined. Apoptosis is thought to play a key role in the mechanism, via caspase-dependent and caspase-independent pathways. Caspase-3, Apoptosis-inducing factor (AIF), and anti-apoptosis B-cell lymphoma 2 (Bcl-2) are hypothesized to be involved in PROM.<br> <strong>Objective:</strong> To determine the role of caspase-dependent and caspase-independent pathways in the mechanism of PROM.<br> <strong>Materials and Methods: </strong>This was a case-control study involving 42 pregnant women with gestational age between 20-42 wk. Participants were divided into the case group (with PROM) and control group (without PROM). Amniotic membranes were collected immediately after the delivery, and samples were taken from the site of membrane rupture. Immunohistochemical examination was done to determine the expression of Caspase-3, AIF, and Bcl-2.<br> <strong>Results: </strong>The expressions of Caspase-3 (OR = 9.75; 95% CI = 2.16-43.95; p = 0.001) and AIF (OR = 6.60; 95% CI = 1.48-29.36; p = 0.009) were significantly increased, whereas, Bcl-2 expressions (OR = 8.00; 95% CI = 1.79-35.74; p = 0.004) were significantly decreased in the case group.<br> <strong>Conclusion:</strong> High Caspase-3, AIF, and low Bcl-2 expression were the risk factors for PROM. Thus, it is evident that caspase-dependent and caspase-independent pathways are involved in the mechanism of PROM.<strong><span dir="RTL"></span></strong> نارس, غشایی, آپوپتوز, کاسپاز, بارداری. Premature, Membrane, Apoptosis, Caspase, Pregnancy. 439 448 http://ijrm.ir/browse.php?a_code=A-10-581-1&slc_lang=en&sid=1 Ketut Surya Negara tutsuryanegara@gmail.com 0000-0002-0317-7326 Yes Department of Obstetrics and Gynecology, Medical Faculty of Udayana University, Sanglah Hospital, Bali, Indonesia. Ketut Suwiyoga red606_ap@yahoo.co.id 0000-0002-8478-1670 No Department of Obstetrics and Gynecology, Medical Faculty of Udayana University, Sanglah Hospital, Bali, Indonesia. Raka Sudewi raka_sudewi2006@yahoo.com 0000-0002-4669-2668 No Department of Neurology, Medical Faculty of Udayana University, Sanglah Hospital Bali, Indonesia. Nyoman Mantik Astawa mantik_astawa@unud.ac.id 0000-0002-3348-4086 No Laboratory of Veterinary Medicine, Udayana University Bali, Indonesia. Gusti Nyoman Kamasan Arijana nyomanarijana@yahoo.com 0000-0001-5374-3340 No Biomedic Laboratory of Medical Faculty Udayana University, Bali, Indonesia. Ketut Tunas ketuttunas@yahoo.co.id 0000-0002-6932-1377 No Department of Public Health, Dhyana Pura University Bali, Indonesia. Tjokorda Gede Astawa Pemayun tjokgedeap@gmail.com 0000-0002-9936-9128 No Department of Obstetrics and Gynecology, Medical Faculty of Udayana University, Sanglah Hospital, Bali, Indonesia.