title: Activin A and follistatin in menstrual blood: low concentrations in women with dysfunctional uterine bleeding.
abstract: Activin A and follistatin are growth factors produced by several organs, comprising the endometrium, where they modulate cell and tissue differentiation. In this study, the authors tested whether activin A and follistatin are measurable in menstrual blood and whether their concentrations change in women with dysfunctional uterine bleeding (DUB). The authors evaluated healthy women with regular menstrual cycles (n = 15) and women with DUB (n = 12). Activin A and follistatin were measured in both menstrual and peripheral blood samples using highly sensitive enzyme immunoassays, whereas their respective mRNAs were quantified by real-time polymerase chain reaction in endometrial samples collected during the perimenstrual period. Activin A concentrations were 4-fold higher in menstrual than in peripheral serum of healthy women (mean +/- SE, 4.24 +/- 0.18 vs 1.00 +/- 0.15 ng/mL, P < .001) and were significantly lower in women with DUB compared to healthy subjects (P < .001). Follistatin concentration was 8-fold higher in menstrual than in peripheral serum of healthy women (3.94 +/- 0.49 vs 0.49 +/- 0.04 ng/mL, P < .001) and was significantly lower in the menstrual serum of women with DUB compared to controls (P < .001). There was no correlation between menstrual and peripheral serum concentrations of both proteins. The endometrial expression of activin A and follistatin mRNA was lower in women with DUB compared to controls (P < .05). Both activin A and follistatin are measurable in high concentrations 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.forename: Lívia L
authors.initials: LL
authors.lastname: Nascimento
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tsigkou
authors.forename: Márcia C
authors.initials: MC
authors.lastname: Ferreira
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D028341:Activins / Q000097:blood* / Q000235:genetics; D000328:Adult; D005260:Female; D038681:Follistatin / Q000097:blood* / Q000235:genetics; D006801:Humans; D007700:Kinetics; D008598:Menstruation / Q000502:physiology*; D016133:Polymerase Chain Reaction; D014592:Uterine Hemorrhage / Q000097:blood*; D014599:Uterus / Q000033:anatomy & histology
chemical_list: D038681:Follistatin; C422405:activin A; D028341:Activins