Using Raman Spectroscopy to Investigate the Molecular Level Characteristics of Endometriosis

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Using Raman Spectroscopy to Investigate the Molecular Level Characteristics of Endometriosis Sevim Akyuza, Sefa Celikb, Abdullah Taner Ustac, Aysen E. Ozelb, *, Gözde Yılmazd, and Salih Yılmazc a Physics

Department, Science and Letters Faculty, Istanbul Kultur University, Atakoy Campus, Bakirkoy, Istanbul, 34156 Turkey b Physics Department, Science Faculty, Istanbul University, Vezneciler, Istanbul, 34134 Turkey c Department of Obstetrics and Gynecology, Acıbadem University, Istanbul, 34718 Turkey d Alternative Energy Resources Program, Vocational School, Istanbul Kultur University, Incirli, Istanbul, 34158 Turkey * e-mail: [email protected] Received May 25, 2019; revised April 13, 2020; accepted April 15, 2020

Abstract—Endometriosis is a benign gynecologic disorder. It is particularly common among young women and may make pregnancy difficult. In this study molecular level characterization of endometriosis tissues were performed using Raman spectroscopy in combination with multivariate statistical analysis. Three hundred sixty six Raman spectra recorded from different points of seventy two tissue samples, taken from the cyst walls of twelve patients were examined. Principle component analysis (PCA) followed by linear discriminant analysis (LDA) were performed on the Raman data, and the samples were then classified into three groups: severe, moderate, and weak endometriosis. In the severe endometriosis group, the relative band intensities of DNA were increased. Moreover, increase in pyrrole moieties and kynurenine were seen. The results show that endometriosis severity correlates to increase in DNA concentration, and degradation of tryptophan due to increased indoleamine-pyrrole 2,3-dioxygenase (IDO) activity, and an increase in kynurenine concentration and pyrrole intermediate. It is concluded that Raman spectroscopy is capable of providing a quick diagnosis, ahead of the pathology result being reported. Keywords: endometriosis, Raman spectra, PCA-LDA analysis 10.1134/S0030400X20080044

INTRODUCTION Endometriosis is a benign and chronic disease in which endometrial tissue that lines the uterus (glands and stroma) is seen outside the uterus. The disease is most commonly seen in the pelvic peritoneum, ovaries, the Douglas pouch, uterosacral ligaments, fallopian tubes, colon, and appendix. It is also, albeit rarely, seen in the pleural cavity, kidneys, liver, bladder, and surgical scars. The disease has a multifactorial etiology including genetic and environmental factors [1]. Estrogen exposure is the main cause of the disease because most patients are aged between 20–50 yr. The incidence of endometriosis changes according to the patient cohort being investigated. The incidence of endometriosis in women within the reproductive period is 2–10, 30–50% in women with infertility, and 70–90% in women with chronic pelvic pain [2]. The most common symptoms of endometriosis are pelvic pain, dysmenorrhea, dyspareunia, and infertility. Depending on the stage of the disease, dysuria,

dyschezia, and constipation