Ultrastructural aspects of the remodeling process of the Corpus albicans in the recent postmenopausal period

MEDiCAL

JOURNAL

G u s ta v o R u b in o d e A z e v e d o F o c c h i, M a n u e l d e J e s u s S im o e s , E d m u n d C h a d a B a ra c a t, G e ra ld o R o d rig u e s d e L im a , J o a q u im E v e n c io N e to

U ltrastructural

aspects of the rem odeling process of the

C o r p u s a l b i c a n s

in the recent postm enopausal period

D e p a r t m e n t o f O b s t e t r i c s a n d G y n e c o l o g y a n d D e p a r t m e n t o f M o r p h o l o g y , E s c o l a P a u l i s t a d e M e d i c i n a , U n i v e r s i d a d e F e d e r a l d e S i l o P a u l o - S i l o P a u l o , B r a z i l

T o s tu d y th e c y to p h y s io lo g y o f th e c o rp u s a lb ic a n s in th e re c e n t p o s tm e n o p a u s a l p e rio d , th e a u th o rs a n a ly z e d th e o v a ria n u ltra s tru c -tu re o f te n p a tie n ts s u b m itte d to o o p h o re c to m y d u e to n o n -m a lig n a n t g y n e c o lo g ic a l d is e a s e s . E v id e n c e o f a re m o d e lin g p ro c e s s w ith c o n n e c tiv e tis s u e s u b s titu tio n o f th e c o rp o ra a lb ic a n tia w a s o b s e rv e d . T h e re m o d e lin g p ro c e s s a p p e a rs to d e p e n d o n th e a c tiv ity o f th re e e s s e n tia l c e ll ty p e s : th e fib ro b la s ts , w h ic h p ro v id e c o lla g e n s y n th e s is ; th e m a c ro p h a g e s , w h ic h p h a g o c y tiz e th e fla k y m a te ria l; a n d th e m y o fib ro b la s ts , m a in ly lo c a te d in th e p e rip h e ra l re g io n o f th e c o rp o ra a lb ic a n tia , w h ic h m a y h a v e a re tra c tin g a c tio n o n th e re m o d e lin g s ite o f th e c o rp u s a lb ic a n s .

U N IT E R M S : C o rp u s a lb ic a n s . M e n o p a u s e . U ltra s tru c tu re . C y to p h y s io lo g y . R e m o d e lin g p ro c e s s .

IN T R O D U C T IO N

E

ignificant changes in the num ber of these structures,

or in the ovarian area they occuppied before and after

m enopause. H ow ever, the corpora albicantia show ed the

presence of sclerosis, hyalinization and lack of fibroblastic

activity after cessation of the m enstrual cycles.2

O bservations on the ultrastructural features of the corpora

albicantia w ere m ade by H A ID A R 3 w ho, after studying

A d d re s s fo r c o rre s p o n d e n c e : E d m u n d C h a d a B a ra c a t

D is c ip lin a d e G in e c o lo g ia - E s c o la P a u lis ta d e M e d ic in a U n iv e rs id a d e F e d e ra l d e S a o P a u lo

R u a B o tu c a tu , 7 4 0 - V ila C le m e n tin o S a o P a u lo /S P - B ra s il.- C E P 0 4 0 2 3 -9 0 0

the ovaries of w om en suffering from prem ature ovarian

failure, described corpora albicantia w hich consisted of a

flaky m aterial containing fibroblasts and m acrophages, the

latter m ainly located in the peripheral portion of structure.

In light of previous m icroscopy studies, it has been

observed that, w ithin the course of the postm enopausal

period, there is an increase in the frequency of corpora

albicantia containing few cells im m ersed in an eosinophilic

m ass.4 _{T hese findings m ay be related to the low er horm onal}

levels that characterize the postm enopausal period, and

m ight contribute to the decrease of the rem odeling process

of the corpora albicantia, explaining the persistence of

those m orphological entities in the ovaries of

postm enopausal w om en. S ince a survey of the literature

did not show studies on the cytophysiology of available

corpora albicantia, in the present investigation w e analyzed

the ultrastructural features of the corpus albicans during

the early postm enopausal period in order to determ ine how

its rem odeling process takes place.

F O C C H I, G .R .A .; S IM O E S , M .J .; B A R A C A T , E .C .; L IM A , G .R . & N E T O , J .E . - U ltra s tru c tu ra l a s p e c ts o f th e re m o d e llin g p ro c e s s o f th e C o rp u s a lb /c a n s in th e re c e n t p o s tm e n o p a u s a l p e rio d

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F igure 1 - E lectronm icrograph show ing the central region of a corpus albicans from a postm enopausal w om an. F ibroblasts show ing cytoplasm ic prolongations (arrow ) and interm ixed w ith a flaky m aterial (F M ) are visible. A capillary (C ) can also be seen in this figure (1 .600X ).

F igure 2 - E lectronm icrograph show ing a fibroblast located in the central region of the corpus albicans from a postm enopausal w om an. O bserve the presence of flaky m aterial (F M ) and collagen fibers (arrow ). T he cytoplasm contains clearly visible centrioles (C ) and the G olgi apparatus (G ) (20,700X ).

METHODS

W e utilized ovaries obtained from ten w om en in the early postm enopausal period (less than five years of

m enopausal tim e), w ho w ere subm itted to oophorectom y

due to non-m alignant gynecological diseases. Fragm e.nts

of the ovaries w ere fixed in 2 percent glutaraldehyde in

0.1 M phosphate buffer, pH 7.2, for 4 hours and then

postfixated in I percent osm ium tetroxyde for 1-2 hours. A fter im m ersion in 0.5 percent uranyl for 12 hours, the

m aterial w as dehydrated in graded ethanols and then

em bedded in araldyte. Sem i-thin sections w ere prepared

for orientation. Silver- to light-thin sections w ere double

stained w ith 1% uranyl acetate and lead citrate and exam ined using a Zeiss EM 9s-2 electron m icroscope.

RESULTS

Fibroblasts w ith eucrom atinic-rich nuclei and several

cytoplasm ic prolongations, w hich m aintained contact w ith

adjacent cells, w ere observed inside the corpora albicantia

(Fig. I). These cells w ere surrounded w ith collagen fibers

and w ere interm ixed w ith large am ounts of a flaky m aterial

(Fig. 2), form ing a kind of cellular w eave. M acrophages

F igure 3 - E lectronm icrograph show ing part of a m acrophage in the corpus albicans from a postm enopausal w om an. O bserve the large am ounts of electrontranslucent vesicles (arrow s) in its cytoplasm (16,OOOX).

F igure 4 - E lectronm icrograph W ith higher m agnification show ing the cytoplasm of a m acrophage present in a corpus albicans from a postm enopausal w om an. O bserve electrondense bodies attached to electrontranslucent vesicles (arrow ) (30,300X ).

F igure 5 - E lectronm icrograph show ing the peripheral region of the corpus albicans. N ote the presence of flaky m aterial (F M ) in the inner portion, and a great quantity of cells (C ) in its surroundings (1 ,700X ).

w ith irreg u lar cy to p lasm co n tain in g electro n tran slu cen t v esicles (F ig . 3 ) an d sm all electro n d en se areas (F ig . 4 ) w ere o b serv ed . T h e p erip h eral reg io n o f th e co rp o ra alb ican tia sh o w ed larg e q u an tities o f cells (F ig . 5 ), su ch as fib ro b lasts, m acro p h ag es an d so m e leu co cy tes an d p lasm o cy tes. S o m e o f th e fib ro b lasts lo cated in th e p erip h eral reg io n co n tain ed cy to p lasm ic m y o filam en ts, ch aracterizin g th e m y o fib ro b lasts (F ig . 6 ). W e also n o ted th e o u tlin e o f a cap su lar stru ctu re en v elo p in g th e co rp o ra alb ican tia, co n tain in g cells w ith p y k n o tic fu sifo rm n u clei in its in n er p o rtio n .

D IS C U S S IO N

It h as b een rep o rted th at b efo re m en o p au se th e co rp o ra alb ican tia u n d erg o es rap id rem o d elin g ch an g es an d is rep laced w ith co n n ectiv e tissu e. H o w ev er, th is rem o d elin g p ro cess m ig h t b e altered after m en o p au se, sin ce th ese stru ctu res rem ain in th e o v arian stro m a fo r m an y y ears.1 .2 .5 .6 O u r fin d in g s in d icate th e o ccu rren ce o f a rem o d elin g activ ity in th e co rp o ra alb ican tia d u rin g early m en o p au se, v erified b y th e p resen ce o f ty p ical m acro p h ag es w ith sig n s o f in ten se p h ag o cy tic activ ity in th e p erip h eral reg io n o f th ese stru ctu res. In th is reg io n , fib ro b lasts p resen tin g filam en ts in th eir cy to p lasm can also b e fo u n d . T h ese cells, called m y o fib ro b lasts, h av e a co n tractile fu n ctio n an d ap p ear at sites o f tissu e retractio n .7 -9 In sid e th e co rp o ra alb ican tia w e o b serv ed fib ro b lasts sh o w in g cellu lar ju n ctio n s. T h is featu re h as b een d escrib ed in fib ro b lasts in cu ltu re an d in th e

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F igure 6 - E lectronm icrograph of a m yofibroblast located in the peripheral region of the corpus albicans from a postm enopausal w om an (21 ,1O O X ).

en d o m etriu m , b u t h ad n o t b een rep o rted p rev io u sly in th e o v ary .3 .1 0S IL V A &G IL U L A 1 1 rep o l1 ed th at th ese ju n ctio n s are o f th e g ap ty p e, an d p lay an im p o rtan t ro le in th e tran sm issio n o f sev eral stim u li fro m o n e cell to an o th er; th e cells (fib ro b lasts) m ay b eh av e lik e a sy n cy tial stru ctu re. B y co m p arin g o u r resu lts w ith literatu re d ata, w e b eliev e th at th e co rp o ra alb ican tia m ig h t stim u late th e p ro liferatio n o f cells in th eir su rro u n d in g s fo rm in g a fib ro u s cap su le. M acro p h ag es m ay b e in v o lv ed in th e p h ag o cy to sis o f th e flak y m aterial th at arises fro m th e d eg en eratio n o f th e lu th ein ic cells, w h ile m y o fib ro b lasts m ay b e resp o n sib le fo r th e retractio n o f th e site o f th e co rp u s alb ican s. T h e m acro p h ag es m ay also fo rm ch an n els in sid e th e flak y m aterial, th ro u g h w h ich an in v asio n o f cap illaries an d cells co u ld o ccu r. T h ese cells m ain tain co n tact w ith each o th er th ro u g h g ap ju n ctio n s, an d m ay start th e sy n th esis o f co llag en fib ers. In th is m an n er, th e h y alin e m aterial m ay b e rep laced w ith co n n ectiv e tissu e.

T h e co rp o ra alb ican tia co n stitu tes a h isto lo g ical fin d in g in o v aries o f p o stm en o p au sal w o m en . T h e p resen ce o f th e co rp o ra alb ican tia co u ld b e ex p lain ed b y th e lo w er h o rm o n al lev els d u rin g th is p erio d o f a w o m an 's life,1 2 w h ich p ro b ab ly co n trib u te to th e red u ctio n o f its rem o d elin g p ro cess.

C O N C LU S IO N

O u r fin d in g s su g g est ev id en ce o f a rem o d elin g p ro cess o f th e co rp o ra alb ican tia o ccu rrin g d u rin g th e early p o stm en o p au sal p erio d , an d p ro b ab ly d ep en d u p o n a resid u al h o rm o n al actio n .

F O C C H I, G .R .A .; S IM O E S , M .J.; B A R A C A T , E .C .; LIM A , G .R . & N E T O , J.E . - U ltrastructural aspects of the rem odelling process of the Corpus alb/cans in the recent postm enopausal period

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Sao Paulo M edical Journal/R PM 114(3): 1173-1176, 1996