| Sažetak | U Klinici za ženske bolesti i porode Kliničke bolnice Merkur u razdoblju od 1. siječnja 2013. do 31. prosinca 2018. godine provedeno je prospektivno istraživanje o utjecaju duhanskoga dima na smanjenje kvalitete cervikalne sluzi žena reproduktivne dobi i s time povezane veće učestalosti neplodnosti. Cilj je istraživanja bio utvrditi koncentracije pojedinih parametara u uzorcima sluzi iz cervikalnoga kanala žena koje boluju od primarne idiopatske neplodnosti te imaju naviku pušenja cigareta i istražiti u kojoj mjeri pušenje pridonosi povećanju učestalosti primarne idiopatske neplodnosti. U uzorcima cervikalne sluzi dobivenima iz cervikalnoga kanala izmjerene su ukupne količine proteina, koncentracije askorbinske kiseline, tiocijanata, citokroma P-450, aktivnosti enzima citokrom-oksidaze i rodanaze, lipidne peroksidacije, koncentracije superoksida, reduciranoga glutationa i dodatne peroksidacije proteina te je izračunan ukupan antioksidacijski kapacitet. U istraživanju je sudjelovalo 140 ispitanica podijeljenih u dvije skupine s obzirom na plodnost (90 zdravih i 60 ispitanica s primarnom idiopatskom neplodnosti) te s obzirom na naviku pušenja i količinu cigareta konzumiranih tijekom dana. U ispitanica pušačica nađene su više koncentracije tiocijanata (pušačice > 10 cig. = 25,70 nm/mL; pušačice < 10 cig. = 16,87 nm/mL; nepušačice = 7,26 nm/mL) i citokroma P-450 (pušačice > 10 cig. = 1,04 nm/mg proteina; pušačice < 10 cig. = 0,24 nm/mg proteina; nepušačice = 0,09 nm/mg proteina) u homogenatu površinskih stanica vrata maternice u odnosu na nepušačice te je potvrđena niža koncentracija citokroma P-450 u mitohondrijskoj frakciji površinskih stanica vrata maternice (pušačice > 10 cig. = 0,14 nM/mg proteina; pušačice < 10 cig. = 1,37 nM/mg proteina; nepušačice = 14,34 nM/mg proteina). Ta se razlika povećavala s većim brojem cigareta konzumiranih tijekom dana. Obrnute vrijednosti potvrđene su za koncentraciju askorbinske kiseline koje je znatno najmanje bilo u skupini ispitanica koje su konzumirale deset i više cigareta na dan (pušačice > 10 cig. = 10,16 μ/mL; pušačice < 10 cig. = 16,73 μ/mL; nepušačice = 42,08μ/mL). Aktivnost enzima rodanaze i lipidna peroksidacija u cervikalnoj sluzi nisu pokazale bitnu razliku među skupinama ispitanica, no lipidna peroksidacija u homogenatu epitelnih stanica vrata maternice bila je veća u ispitanica pušačica, osobito u onih koje su konzumirale deset i više cigareta na dan (pušačice > 10 cig. = 55,82 nm malondialdehida/mg proteina; pušačice < 10 cig. = 42,56 nm malondialdehida/mg proteina; nepušačice = 36,23 nm malondialdehida/mg proteina). U ispitanica s navikom pušenja koje k tomu boluju od primarne idiopatske neplodnosti potvrđene su znatno više koncentracije superoksida O2 (pušačice > 10 cig. =13,22 μM/min/mL; pušačice < 10 cig. = 10,12 μM/min/mL; nepušačice = 4,26 μM/min/mL) i reduciranoga glutationa (pušačice > 10 cig. = 82,73 μM/mL; pušačice < 10 cig. = 54,41 μM/mL; nepušačice = 24,85 μM/mL). Štoviše, najvišu koncentraciju imale su neplodne ispitanice s navikom pušenja deset i više cigareta. Dodatna oksidacija proteina (pušačice > 10 cig. = 18,00 μM/L; pušačice < 10 cig. = 29,53 μM/L; nepušačice = 37,75 μM/L) i ukupan antioksidacijski kapacitet (pušačice > 10 cig. = 247,60 μMFESO4/L; pušačice < 10 cig. = 284,20 μMFESO4/L; nepušačice = 396,05 μMFESO4/L) bili su najnižih vrijednosti u skupini ispitanica koje su bile neplodne i pušile deset i više cigareta na dan. Ovim smo istraživanjem utvrdili da dim cigareta utječe na kvalitetu sluzi iz cervikalnoga kanala povećavajući udio tvari koje štetno djeluju na njezinu kvalitetu i smanjuju antioksidacijski kapacitet, što rezultira slabijom kvalitetom cervikalne sluzi. |
| Sažetak (engleski) | A prospective study on the effect of tobacco smoke on reducing the quality of cervical mucus of the women of reproductive age and consequently a higher incidence of infertility, was performed at Department of gynecology and obstetrics Merkur Clinical Hospital from January 1st, 2013 till December 31st, 2018. The aim of the study was to determine the concentrations of individual parameters from mucus samples from the cervical canal in women suffering from primary idiopathic sterility and who have a habit of smoking tobacco, and to investigate the extent to which smoking contributes to the incidence of primary idiopathic infertility. In the cervical mucus samples obtained from the cervical canal total protein content, concentrations of ascorbic acid, thiocyanate, cytochrome P-450, cytochrome c oxidase and rhodanese enzyme activity, lipid peroxidation, superoxide concentration, reduced glutathione, additional protein peroxidation were measured and total antioxidative capacity calculated. The study involved 140 subjects, divided into two groups with respect to fertility (90 healthy and 60 subjects with primary idiopathic infertility), and smoking habits and daily cigarettes consumption. In subjects with smoking habits higher concentrations of thiocyanate (smoking >10 cig. = 25,70 nm/mL; smoking <10 cig. = 16,87 nm/mL; non-smoking = 7,26 nm/mL) and cytochrome P-450 (smoking >10 cig. = 1,04 nM/mg protein; smoking <10 cig. = 0,24 nM/mg protein; non-smoking = 0,09 nM/mg protein) were found in the superfical cervical cell homogenate when compared to to non-smokers, as well as a lower concentration of cytochrome P-450 in the mitochondrial fraction of superficial cervical cells (smoking >10 cig. = 0,14 nM/mg protein; smoking <10 cig. = 1,37 nM/mg protein; non-smoking = 14,34 nM/mg protein). This difference was greater with the higher number of cigarettes consumed per day. Reverse values were found for the concentration of ascorbic acid which was significantly lower in the group of subjects who consumed ten or more cigarettes daily (smoking >10 cig. = 10,16 μ/mL; smoking <10 cig. = 16,73 μ/mL; non-smoking = 42,08 μ/mL). The rhodanese enzyme activity and lipid peroxidation in the cervical mucus showed no significant difference between the groups, but the lipid peroxidation in the cervical epithelial cell homogenate was higher in subjects with smoking habits, especially in those who consumed ten or more cigarettes daily (smoking >10 cig. = 55,82 nm malondialdehid/mg protein; smoking <10 cig. = 42,56 nm malondialdehid/mg protein; non-smoking = 36,23 nm malondialdehid/mg protein). Significantly higher concentrations of superoxide O2 (smoking >10 cig. =13,22 μM/min/mL; smoking <10 cig. = 10,12 μM/min/mL; non-smoking = 4,26 μM/min/mL) and reduced glutathione (smoking >10 cig. = 82,73 μM/mL; smoking <10 cig. = 54,41 μM/mL; non-smoking = 24,85 μM/mL) were found in smoking subjects as well as subjects suffering from primary idiopathic sterility. Moreover, infertile subjects with the habit of smoking ten or more cigarettes a day had the highest concentration. Advanced protein oxidation (smoking >10 cig. = 18,00 μM/L; smoking < 10 cig. = 29,53 μM/L; non-smoking = 37,75 μM/L) and total antioxidant capacity (smoking >10 cig. = 247,60 μMFESO4/L; smoking <10 cig. = 284,20 μMFESO4/L; non-smoking = 396,05 μMFESO4/L) had the lowest values in the group of subjects who were infertile and smoked ten or more cigarettes a day. This study showed that cigarette smoke affects the quality of mucus from the cervical canal by increasing the proportion of substances that have a detrimental effect on its quality and that reduce the antioxidant capacity resulting in lower quality cervical mucus. |
