The role of -1984A> G adrenomedullin gene polymorphism in tubal ectopic pregnancy
Main Article Content
Objective: Tubal ectopic pregnancy is a health issue that can cause maternal death in first trimester and our knowledge about its pathogenesis is limited. Adrenomedullin (ADM) is responsible from regulation of ciliary motility in fallopian tubes. Its expression is known to be reduced in tubal tissue in ectopic pregnancy. In this study, it was aimed to investigate the relationship between -1984A>G functional polymorphism affecting the expression level of the ADM gene and tubal ectopic pregnancies. Material and Methods: This prospective case-control study consisted of 64 women. Peripheral blood samples were obtained from 31 women diagnosed with tubal pregnancy (the study group) and 33 fertile women without a history of ectopic pregnancy (the control group). Genomic DNA was extracted from peripheral blood. The frequency of genotypes and alleles of â"1984A>G ADM (rs3814700) gene polymorphism was examined by polymerase chain reaction and restriction fragment length polymorphism (PCR/RFLP) method. Results: For -1984A>G polymorphism the study group had an A allele frequency of 90% and a G allele frequency of 10%; the control group had an A allele frequency of 91.7% and a G allele frequency of 7.3% (p=0.75). AA genotype frequency was 80% and AG allele frequency was 20% in the study group while they were 83.3% and 16.7%, respectively, in the control group (p=0.73). There were no significant differences between the study and control groups with respect to allele and genotype frequencies. Conclusion: This study found no significant relationship between tubal ectopic pregnancy and -1984A>G ADM gene polymorphism. Further studies are needed to explore other factors that affect ADM expression.
Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2011;37(4):231-40.
Shaw JL, Dey SK, Critchley HO, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Human reproduction update. 2010;16(4):432-44.
Leke RJ, Goyaux N, Matsuda T, Thonneau PF. Ectopic pregnancy in Africa: a population-based study. Obstetrics and gynecology. 2004;103(4):692-7.
Halbert SA, Tam PY, Blandau RJ. Egg transport in the rabbit oviduct: the roles of cilia and muscle. Science. 1976;191(4231):1052-3.
Lopez J, Martinez A. Cell and molecular biology of the multifunctional peptide, adrenomedullin. International review of cytology. 2002;221:1-92.
Li HW, Liao SB, Chiu PC, Tam WW, Ho JC, Ng EH, et al. Expression of adrenomedullin in human oviduct, its regulation by the hormonal cycle and contact with spermatozoa, and its effect on ciliary beat frequency of the oviductal epithelium. The Journal of clinical endocrinology and metabolism. 2010;95(9):E18-25.
Liao SB, Li HW, Ho JC, Yeung WS, Ng EH, Cheung AN, et al. Possible role of adrenomedullin in the pathogenesis of tubal ectopic pregnancy. The Journal of clinical endocrinology and metabolism. 2012;97(6):2105-12.
Li Y, Staessen JA, Li LH, Gao PJ, Thijs L, Brand E, et al. Blood pressure and urinary sodium excretion in relation to the A-1984G adrenomedullin polymorphism in a Chinese population. Kidney international. 2006;69(7):1153-8.
Boc-Zalewska A, Seremak-Mrozikiewicz A, Barlik M, Kurzawinska G, Drews K. The possible role of adrenomedullin in the etiology of gestational hypertension and preeclampsia. Ginekologia polska. 2011;82(3):178-84.
Boc-Zalewska A, Seremak-Mrozikiewicz A, Barlik M, Kurzawinska G, Drews K. Contribution of maternal-fetal adrenomedullin polymorphism to gestational hypertension and preedlampsia--gene-gene interaction pilot study. Ginekologia polska. 2012;83(7):494-500.
Fazeli A, Affara NA, Hubank M, Holt WV. Sperm-induced modification of the oviductal gene expression profile after natural insemination in mice. Biology of reproduction. 2004;71(1):60-5.
Critoph FN, Dennis KJ. Ciliary activity in the human oviduct. British journal of obstetrics and gynaecology. 1977;84(3):216-8.
Comer MT, Leese HJ, Southgate J. Induction of a differentiated ciliated cell phenotype in primary cultures of Fallopian tube epithelium. Human reproduction. 1998;13(11):3114-20.
Paltieli Y, Eibschitz I, Ziskind G, Ohel G, Silbermann M, Weichselbaum A. High progesterone levels and ciliary dysfunction--a possible cause of ectopic pregnancy. Journal of assisted reproduction and genetics. 2000;17(2):103-6.
Kobayashi K, Kubota T, Aso T, Hirata Y, Imai T, Marumo F. Immunoreactive adrenomedullin (AM) concentration in maternal plasma during human pregnancy and AM expression in placenta. European journal of endocrinology / European Federation of Endocrine Societies. 2000;142(6):683-7.
Chiu PC, Liao S, Lam KK, Tang F, Ho JC, Ho PC, et al. Adrenomedullin regulates sperm motility and oviductal ciliary beat via cyclic adenosine 5'-monophosphate/protein kinase A and nitric oxide. Endocrinology. 2010;151(7):3336-47.
O WS, Li HW, Liao SB, Cheung AN, Ng EH, Yeung WS, et al. Decreases in adrenomedullin expression and ciliary beat frequency in the nasal epithelium in tubal pregnancy. Fertility and sterility. 2013;100(2):459-63 e1.
Cheung B, Leung R. Elevated plasma levels of human adrenomedullin in cardiovascular, respiratory, hepatic and renal disorders. Clinical science. 1997;92(1):59-62.
Cheung BM, Ong KL, Tso AW, Leung RY, Cherny SS, Sham PC, et al. Plasma adrenomedullin level is related to a single nucleotide polymorphism in the adrenomedullin gene. European journal of endocrinology / European Federation of Endocrine Societies. 2011;165(4):571-7.