Nirmala G. Prabawati
Malang , IndonesiaTitle: Impaired Muscle Stem Cells (MuSCs) of Levator ani after Chilbirth up to Aging State as Pathogenesis of Pelvic Organ Prolapse
Abstract
Pelvic organ
prolapse (POP) is a common urogynaecological disorder that affects one in four
women across all age groups, or over 50% of postmenopausal parous women with a
history of vaginal birth. The injury of levator ani muscle as the largest
component of pelvic floor during vaginal birth might assosciate with impaired
muscle satelite stem cell (MuSCs) deterioration and the occurance of pelvic
organ prolapse in elderly state. MuSCs play a central role to repair and maintain the muscle
in which they reside by their self-renewal ability and capacity of
differentiating into distinct and specialized cells. As stem cells age, their
renewal ability declines and their capacity to maintain organ homeostasis and
regeneration is impaired. From a molecular perspective, these changes in stem
cells properties can be due to several types of cell intrinsic injury and DNA
aberrant alteration as well as changes in the tissue microenviroment might be influenced
by muscle tissue injuries during vaginal birth. It has been suggested that
aging-induced deterioration of stem cell functions may play a key role in the
pathophysiology of the various aging-associated disorders, including pelvic
organ prolapse. Aging-related
elevation in circulating levels of proinflammatory cytokines, such as
interleukin 6 (IL-6) and tumor necrosis factor ? (TNF-?), can also cause
differentiation disorders of MuSCs. The decline of MuSC regenerative
capacity is due to age-associated extrinsic/environmental changes as well as
cell-intrinsic/autonomous changes. As extrinsic factors, inflammatory
responses, extracellular components, and changes in interacting cell types
definitely affect the function in MuSCs. MuSC function is also impaired by
cell-intrinsic damages including oxidative stress, DNA damage, modified
signaling pathways, damage to proteins, and altered metabolism. Changes in these microenvironmental factors in response to
aging are believed to be responsible for the changes in stem cell function with
aging. It has been shown that potentially underlying aging-related tissue
degeneration, such as pelvic organ prolapse, could be due to impaired MuSCs by
surrounding micro-environmental pathologic factors. Degeneration of
pelvic floor muscles in aging process related to deterioration of their stem
cell functions since after birth is the key of thie review.
Biography
Nirmala Prabawati
is an obstetrician and gynecologist of Brawijaya University Hospital, one of
educational hospital In Indonesia. She also a lecturer in Medical Faculty of
Brawijaya University, Malang. Her interest is in urogynecology reconstruction
and pelvic surgery and she intended to have consultant training in
urogynecology. She worked as General Practioner for Freeport Hospital and some
rural areas in Tembagapura, Papua Indonesia for 2 years before she enrolled
ObsGyn residency in 2009-2013. She held best presentation in oral speech for
Obstetrics and Gynecology Asscociation Annual Meeting in 2013, and She won
travel award for Internasional Society of Study of Hypertension in Pregnancy in
2014.
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