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: I Made Arya Subadiyasa : Ekspresi Fibulin-5 Pada Prolaps Organ Panggul : 082147297647 : subadiyasa@gmail.com

FIBULIN-5 EXPRESSION ON PELVIC ORGAN PROLAPSE I Made Arya Subadiyasa Obstetric dan Gynecology Department of Medical Faculty of Udayana University Pelvic organ prolapse (POP) is a bulge or protrusion of pelvic organs and related segments that related to the vagina whether it is into or through the vagina. Abnormalities in the structure of the connective tissue or in the repair mechanism is one of the predisposing factor of POP in women. Elastin is one of the components of the elastic fiber. Elastic fiber affects the ability of a tissue to recoil. Fibulin-5 is an extracellular matrix glycoprotein that is important for the formation of elastic fibers. Fibulin-5 is an important key of elastogenesis because it can interact with fibrillin, tropoelastin and LOX-like proteins. Mutations in the gene encoding fibulin-5 will cause a disruption in the formation of elastic fibers. Several studies in the role of fibulin-5 in animal POP obtained the following results: (1) fibulin-5 plays a role in the pathogenesis of POP because in addition to facilitating the formation of elastic fibers also inhibit the degradation of extracellular matrix in the tissue. (2) levels of fibulin-5 is known lower at pregnancy and will return like before pregnancy at 4 weeks after childbirth postpartum. (3) Fbln5 protein content in the vaginal wall postpartum rats increased significantly where there is synthesis of new elastic fibers in the vagina postpartum (4) Increased incidence of POP in mice with mutations in fibulin-5 gene (Fbln5-/ -) due to distension of the vagina, but not in control, explaining that vaginal distension will result in losing the proponent ability of pelvic organs if not accompanied by elastic fiber synthesis and formation. Human studies suggest that the expression of fibulin-5 on the tissue declined to advocate pelvic prolapse compared to women with no prolapse. It can be concluded that the decrease in expression of fibulin-5 on the tissue ancillary role in the pathogenesis of POP. Understanding of the causes of pelvic floor dysfunction are expected to contribute to improved therapy, and more importantly, lead to preventive strategies. Keywords: fibulin-5, pelvic organ prolapse, elastin, elastic fiber.