Novel Technique of Vaginoplasty Developing Normal Vagina, Role of Stemness Markers and Translational Genes

Aims and Objectives: To study development of neo-vagina by metaplastic conversion of peritoneum, To identify translational Stemness markers using NANOG/OCT4/SOX2 from serial neo-vaginal mRNA, cDNA and to study role of WNT and HOXA genes in patients undergoing vaginoplasty. Material and Methods: 75 M...

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Published in:Journal of human reproductive sciences Vol. 13; no. 4; pp. 303 - 309
Main Authors: Mhatre, Pravin, Dighe, Vikas, Das, Dhanjit, Pawar, Amol
Format: Journal Article
Language:English
Published: India Wolters Kluwer India Pvt. Ltd 01.10.2020
Medknow Publications and Media Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects:
absent vagina
Biopsy
Gene regulation
Genes
Genetic analysis
Genetic aspects
Genetic research
genetics
Laparoscopy
mayer–rokitansky–kustner–hauser
Methods
mRNA
Muellerian duct
Oct-4 protein
Original
Patient compliance
Peritoneum
progenitor cell
RNA
Translation
Vagina
vaginoplasty
Wnt protein
Mayer-Rokitansky-Kustner-Hauser
Absent vagina
vaginoplasty
genetics
progenitor cell
Mayer–Rokitansky–Kustner–Hauser
ISSN:0974-1208, 1998-4766
Online Access:Get full text
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Summary:Aims and Objectives: To study development of neo-vagina by metaplastic conversion of peritoneum, To identify translational Stemness markers using NANOG/OCT4/SOX2 from serial neo-vaginal mRNA, cDNA and to study role of WNT and HOXA genes in patients undergoing vaginoplasty. Material and Methods: 75 MRKH Syndrome women underwent laparoscopic peritoneal vaginoplasty (LPV). Two patients underwent serial neo-vaginal biopsies on day 0, 7-9, 12-14, 21 and 33. Fifteen MRKHS and twelve controls were subjected for neo-vaginal biopsy to detect genes upregulation. Remaining patients were evaluated anatomically and functionally. Results: The translational stemness markers NANOG, OCT4 and SOX2 responsible for neo-vaginal formation were identified. Their appearance, concentration at different stages of conversion were demonstrated. The neo-vagina has shown up-regulation of these translational stemness markers. The study demonstrates expression of the specific genes (WNT4, WNT5A and WNT7A) and their role in formation of the neo-vagina. In the subjects stemness markers (NANOG, OCT4 and SOX2) appeared from day 9 to 14 of the neo-vaginal biopsies and after achieving the peak declined later. Genetic analysis showed low values in HOXA 9,10,11,13 and up-regulation of WNT 4A,5A,7 genes in neo-vagina. Conclusions: Study shows peritoneal metaplastic conversion to normal vagina, identified the translational stemness markers and genes responsible. The neo-vagina has shown up-regulation of these genes. The study demonstrates expression of the specific genes (WNT4, WNT5A and WNT7A) and their role in formation of the neo-vagina. Furthering this research, activating these genes may lead to treatment of developmental defects of Mullerian duct, obviating the need of transplant.
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ISSN:0974-1208
1998-4766
DOI:10.4103/jhrs.JHRS_68_20