Detecção de ativina A e folistatina no sangue menstrual: comparação entre mulheres sadias e portadoras de sangramento uterino disfuncional

Abstract

Activin A and follistatin are growth factors produced by several organs and are both measurable in systemic circulation. Human endometrium also expresses activin A and follistatin. The purpose of the present study was to evaluate whether activin A and follistatin are measurable in the menstrual blood, and whether their concentration change in women with dysfunctional uterine bleeding (DUB). Normal cycling women requesting intrauterine contraception (n=15) and a group of women with DUB (n=12)were studied on day 2 of menstrual bleeding. Activin A and follistatin were measured in both menstrual and peripheral sera by using specific ELISA. Activin A concentration in menstrual serum was fourfold higher than in peripheral serum of healthy women (mean ± SE 4.24 ± 0.18 vs. 1.00 ± 0.15 ng/ml) and was significantly lower in women with DUB (2.70 ± 0.42 ng/ml and 0.23 ± 0.02 ng/ml in menstrual and peripheral serum, respectively; p<0.05). Follistatin concentration in menstrual serum was eightfold higher than in peripheral serum of healthy women (3.94 ± 0.49 vs. 0.49 ± 0.04 ng/ml), while was significantly lower in the menstrual serum of women with DUB (1.24 ± 0.22 ng/ml). There was no correlation between concentrations in menstrual serum and peripheral serum. In conclusion, both activin A and follistatin are measurable in high concentration in human menstrual blood and are relatively lower in women with DUB. The quantitative assessment of activin A and follistatin in menstrual serum might be a putative clinical marker of endometrial function.