Polikistik Over Sendromunda Foliküler Atrezi ve Granüloza Hücre Apoptozu İlişkisi
Özet
Polikistik Over Sendromu (PKOS) kadın infertilitesinin en sık sebeplerinden biri olup kadınların genel hayat kalitesini kötü yönde etkileyebilen bir hastalıktır. PKOS genel olarak hiperandrojenizm, overlerde polikistik görünüm ve ovulasyon düzensizliği veya yokluğu ile karakterizedir. Bu sendromun karakteristik özelliklerinden olan overlerdeki kistik görünüm, foliküler gelişimin belirli aşamalarında foliküler atrezi görülmesi ile bağlantılıdır. Foliküler atrezi oluşum mekanizmasında ise granüloza hücrelerindeki hayatta kalım ve apoptoz arasındaki dengesizlik önemli bir yer tutmaktadır. Granüloza hücre apoptozu normal foliküler gelişimde dominant olmayan foliküllerin giderilmesinde önemli bir mekanizma olmakla birlikte, PKOS patogenezinde bu mekanizmanın düzenlenmesinin bozulması, foliküler gelişimin farklı aşamalarında overlerde kistik görünüme ve genel olarak overlerin endokrin faaliyetlerinde bozulmaya yol açmaktadır. Granüloza hücrelerinin normal over faaliyetlerindeki rolü, PKOS tablosuna sebep olan faktörler, granüloza hücre apoptozisinin normal foliküler gelişim ve PKOS patogenezindeki yerinin incelenmesi PKOS tablosunda izlenen morfolojik ve biyokimyasal değişimlerin anlaşılması ve bu hastalığın doğru tedavi edilebilmesi için gereklidir.
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