P-64: Innate Immune System Importance in Ectopic Pregnancy with Emphasis on TLR4 Gene

Background: In an ectopic pregnancy (EP) the egg does not reach to the uterus, but instead implants somewhere outside it, usually in fallopian tube. In most cases the exact cause of an ectopic pregnancy is unknown but it is often a result of some sort of damage to the fallopian tube. The tube may have become blocked or narrowed by previous surgery or infection. An active immune system need to react against these infections. Toll-like receptors (TLRs) are a family of innate immunity receptors that are essential for detecting pathogens. Different TLRs serve as receptors for diverse ligands, for example: TLR4 is the receptor for Gram-negative lipopolysaccharide (LPS) and it show higher expression in the Fallopian tube and endometrium compared with that in the cervix. The objective of this study is to clarify whether TLR4 expression level is involved in EP or not? Materials and Methods: In this study, our samples were divided into two groups: case and control groups. Case group were women underwent salpingectomy for EP and control group was pseudo-pregnant women with healthy tube underwent hysterectomy. For control group, Women were injected with human chorionic gonadotropin (hCG) in 14 days leading up to hysterectomy to produce a state of pseudo-pregnancy. In this investigation TLR4 expression level was detected in infundibulum, ampulla and isthmus of tubes in case and control groups and also Q-PCR was used to compare quantitative expression of TLR4 gene among case and control groups. Results: Using RT-PCR shown that TLR4 gene was expressed in all region of control group, but in case group was not expressed in infundibulum and ampulla, whiles very, very low expression in isthmus was detected. This finding was confirmed by Q-PCR for TLR4 gene. Conclusion: No expression of TLR4 in fallopian tube with EP is a strong evidence of critical role of this receptor in prevention of ectopic pregnancy.