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The role of caspase-dependent and caspase-independent pathways of apoptosis in the premature rupture of the membranes: A case-control study
Negara, Ketut Surya; Suwiyoga, Ketut; Sudewi, Raka; Astawa, Nyoman Mantik; Kamasan Arijana, Gusti Nyoman; Tunas, Ketut & Astawa Pemayun, Tjokorda Gede
Abstract
Background: 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.
Objective: To determine the role of caspase-dependent and caspase-independent
pathways in the mechanism of PROM.
Materials and Methods: 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.
Results: 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.
Conclusion: 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.
Keywords
Premature; Membrane; Apoptosis; Caspase; Pregnancy.
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