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Li LP, Luo Y, Huang C, Wang XR, Huang TT, Zou YY, Huang SH, Liu YQ, Yang BC. In Vitro Inhibitory Effects of Maqian Essential Oil against Ectopic Endometrial Stromal Cells and LPS-Induced Endometrial Epithelial Cells. Chem Biodivers 2022; 19:e202200756. [PMID: 36377549 DOI: 10.1002/cbdv.202200756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022]
Abstract
Previous studies revealed that MQEO (Maqian fruits essential oil), which is extracted from the fruit of Maqian (Zanthoxylum myriacanthum var. Pubescens), had a good anti-inflammatory effect, but the effect on endometriosis in vitro remains unknown. In the present study, the inhibitory effects of MQEO against the EESCs (ectopic endometrial stromal cells) were investigated. Cells were treated with a concentration gradient (from 0.025 % to 0.15 %) of MQEO for 24 h and cell viability was detected by CCK-8. In addition, apoptotic rates were investigated using flow cytometry. The effect of MQEO on cell migration was determined by wound-healing and transwell assay. The expression of apoptosis-associated and cell adhesion-related proteins was assessed by western blotting. The transcriptional levels of IL-1, IL-6 and TNF-α were determined by Real-time qPCR. RNA-seq was used to identify the DEGs (differentially expressed genes) in MQEO-pretreated EESCs. We found that the MQEO condition dosage-dependently reduced the cell viability of EESCs. Based on flow cytometry results, the number of apoptotic cells increased significantly with dosage. The wound-healing and transwell results showed that MQEO group exhibited a significantly decreased cell motility and migration ability in comparison with the normal group. Western blotting results showed that MQEO down-regulated the expression of Bcl-2, ICAM-1 (intercellular adhesion molecule 1) and CD44, but up-regulated the cleaved caspase-3 expression in EESCs. What's more, MQEO also inhibited the LPS-induced inflammation in human EECs (endometrial epithelial cells). RNA-seq revealed that 221 DEGs were up-regulated genes and 284 DEGs were down-regulated in MQEO-pretreated EESCs. Our data uncovered the beneficial effects of MQEO in endometriosis and provided new insights into the mechanism of the effect of MQEO on EESCs, suggesting MQEO could be a promising new therapeutic agent for endometriosis.
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Affiliation(s)
- Li-Ping Li
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Yong Luo
- Key Laboratory of Women's Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Cheng Huang
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Xin-Rong Wang
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Ting-Ting Huang
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Yong-Yi Zou
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Shu-Hui Huang
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Yan-Qiu Liu
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Bi-Cheng Yang
- Medical Genetics Center, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.,Jiangxi Provincial Key Laboratory of Birth Defect for Prevention and Control, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
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Jiang H, Zhang X, Wu Y, Zhang B, Wei J, Li J, Huang Y, Chen L, He X. Bioinformatics identification and validation of biomarkers and infiltrating immune cells in endometriosis. Front Immunol 2022; 13:944683. [PMID: 36524127 PMCID: PMC9745028 DOI: 10.3389/fimmu.2022.944683] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Endometriosis (EM) is a common gynecological disorder that often leads to irregular menstruation and infertility. The pathogenesis of EM remains unclear and delays in diagnosis are common. Thus, it is urgent to explore potential biomarkers and underlying molecular mechanisms for EM diagnosis and therapies. Methods Three EM-related datasets (GSE11691, GSE25628, and GSE86534) were downloaded from the Gene Expression Omnibus (GEO) which were integrated into a combined dataset after removing batch effect. Differentially expressed immune cell-related genes were obtained by CIBERSORT, WGCNA, and the identification of differentially expressed genes. Random forest model (RF), support vector machine model (SVM), and generalized linear model (GLM) were then constructed and the biomarkers for EM were determined. A nomogram evaluating the risk of disease was constructed and the validity was assessed by the calibration curve, DCA curve, and clinical impact curve. Single-gene Gene Set Enrichment Analysis (GSEA)was performed to explore the molecular mechanisms of biomarkers. The ceRNA regulatory network of biomarkers was created by Cytoscape and potential target drugs were obtained in the DGIdb database (Drug-Gene Interaction database).The expression levels of biomarkers from clinical samples was quantified by RT-qPCR. Results The ratio of eight immune cells was significantly different between the eutopic and ectopic endometrium samples. A total of eight differentially expressed immune cell-related genes were investigated. The SVM model was a relatively suitable model for the prediction of EM and five genes (CXCL12, PDGFRL, AGTR1, PTGER3, and S1PR1) were selected from the model as biomarkers. The calibration curve, DCA curve, and clinical impact curve indicated that the nomogram based on the five biomarkers had a robust ability to predict disease. Single gene GSEA result suggested that all five biomarkers were involved in labyrinthine layer morphogenesis and transmembrane transport-related biological processes in EM. A ceRNA regulatory network containing 184 nodes and 251 edges was constructed. Seven drugs targeting CXCL12, 49 drugs targeting AGTR1, 16 drugs targeting PTGER3, and 21 drugs targeting S1PR1 were extracted as potential drugs for EM therapy. Finally, the expression of PDGFRL and S1PR1 in clinical samples was validated by RT-qPCR, which was consistent with the result of public database. Conclusions In summary, we identified five biomarkers (CXCL12, PDGFRL, AGTR1, PTGER3, and S1PR1) and constructed diagnostic model, furthermore predicted the potential therapeutic drugs for EM. Collectively, these findings provide new insights into EM diagnosis and treatment.
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Affiliation(s)
- Hong Jiang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xia Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yalan Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Baozhu Zhang
- Department of Obstetrics and Gynecology, Fu’an Hospital, Fuan, Fujian, China
| | - Juanbing Wei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jianhua Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yuxiu Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Lihong Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xinqin He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China,*Correspondence: Xinqin He,
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Chen Y, Ma Y, Zhai Y, Yang H, Zhang C, Lu Y, Wei W, Cai Q, Ding X, Lu S, Fang Z. Persistent dysregulation of genes in the development of endometriosis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1175. [PMID: 36467354 PMCID: PMC9708481 DOI: 10.21037/atm-22-4806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/07/2022] [Indexed: 09/29/2023]
Abstract
BACKGROUND Endometriosis is a chronic condition that affects women of child-bearing age. Since the etiology and pathogenesis of endometriosis have not been fully elucidated, it is important to investigate the mechanisms that lead to the deterioration of endometriosis. METHODS In this study, the transcriptome data of patients with normal, mild, and severe endometriosis were examined using the GSE51981 dataset obtained from the Gene Expression Omnibus database. Short Time Series Expression Miner (STEM) was used to screen the genes with continuous expression disorder in the development process, and the core genes were identified by constructing a protein-protein interaction network. The molecular mechanisms of endometriosis were examined using enrichment analysis. Finally, the transcription factors that regulate the core genes were predicted and the comprehensive mechanisms involved in the development of endometriosis were examined. RESULTS A total of 3,472 differentially expressed genes were identified from the normal, mild, and severe endometriosis samples. These were allocated into 12 modules and HRAS, HSP90AA1, TGFB1, TP53, and UBC were selected as the core genes. Enrichment analysis showed that the genes in modules 6, 7, and 9 were significantly related to oxygen levels, metallic processes, and hormone levels, respectively. Transcription factor prediction analysis showed that TP53 regulates HRAS to participate in immune related signaling pathways. Drug prediction analysis identified 792 drugs that interact with the targeted core genes. CONCLUSIONS This study explored the molecular mechanisms involved in the development of endometriosis and identified potential biomarkers of endometriosis. This data may provide novel targets and research directions for the diagnosis and treatment of endometriosis.
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Affiliation(s)
- Yanli Chen
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yanqun Ma
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yanzhi Zhai
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Haiyan Yang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Chunlan Zhang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yingxin Lu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Wei Wei
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Qing Cai
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Xuewen Ding
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Shan Lu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Ziyu Fang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
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Association between RNAm-Based COVID-19 Vaccines and Permanency of Menstrual Cycle Alterations in Spanish Women: A Cross-Sectional Study. BIOLOGY 2022; 11:biology11111579. [PMID: 36358280 PMCID: PMC9687584 DOI: 10.3390/biology11111579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Introduction: The purpose of this study was to delve more deeply into the medium and long-term relation between mRNA-based vaccines and changes in menstrual pain, cycle length, and amount of bleeding in Spanish women. Material and Methods: A total of 746 women (63% between 18−30 and 37% between 31−45 years old) participated in the study. A numerical rating scale was used for recording pain intensity, a pictorial chart for menstrual bleeding, and data from menstrual cycle duration, type of vaccine, number of doses and time from vaccination. Results: Sixty-five per cent of the women perceived changes in their menstrual cycle after receiving the vaccines, irrespective of type of vaccine or number of doses; all p values were >0.05. Most of them (n = 316 out of 484) reported more than one alteration in their menstrual cycle. Almost half of the participants had been vaccinated over 5 months (45%), 3−4 months (15%) 2−3 months (26%), and one month or less (13%) before. The percentage of women that reported alterations remained strongly constant across time, p > 0.05, ranging from 64 to 65%. Conclusions: Reported alterations in Spanish women after COVID vaccination remained more than 5 months after the last dose.
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55
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Huang Y, Li R, Hu R, Yao J, Yang Y. PEG2-Induced Pyroptosis Regulates the Expression of HMGB1 and Promotes hEM15A Migration in Endometriosis. Int J Mol Sci 2022; 23:ijms231911707. [PMID: 36233009 PMCID: PMC9570047 DOI: 10.3390/ijms231911707] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022] Open
Abstract
Endometriosis (EMS) is a common gynecological disease. Prostaglandin E2 (PGE2), which induces chronic pelvic inflammation and cell pyroptosis, a form of programmed cell death based on inflammasome activation, are involved in EMS, but the extent of their involvement and roles remain unclear. The present study aimed to evaluate PGE2-induced pyroptosis in EMS and the influence of PGE2 in EMS progression. Using western blotting, it was found that the expressions of PGE2 and pyroptosis-related proteins (NLRP3, cleaved caspase-1, interleukin (IL)-1β and IL-18) were higher in EMS tissues than in normal endometrial tissues. The levels of PGE2, IL-1β, and IL-18 in the serum of patients with EMS and cell culture fluids were also detected. Using the transwell assay, we verified that PGE2 promoted hEM15A migration via the NLRP3/caspase-1 pyroptotic pathway, and PGE2-induced pyroptosis upregulated the expressions of high mobility group box 1 (HMGB1), E-cadherin, and vimentin. Immunohistochemistry analysis confirmed that PGE2-induced pyroptosis contributed to EMS invasion. These results suggest that PGE2-induced pyroptosis affects the progression of EMS by changing the migration ability of pyroptotic cells and upregulating the expression of HMGB1, E-cadherin, and vimentin. Our findings provide crucial evidence for new treatment pathways and use of anti-inflammatory drugs in EMS.
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Affiliation(s)
- Yi Huang
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
| | - Ruiyun Li
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
| | - Rui Hu
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
| | - Jia Yao
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, China
| | - Yuan Yang
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- Reproductive Medicine Center, The First Hospital of Lanzhou University, Lanzhou 730000, China
- Correspondence:
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Jarollahi S, Chaichian S, Jarollahi A, Hajmohammadi R, Mashayekhi R, Shahmohammadi F, Eslamivaghar M, Ghasemi Z. The Diagnostic Accuracy of Galectin-9 for Diagnosis of Endometriosis in Comparison with Laparoscopy. J Reprod Infertil 2022; 23:271-278. [PMID: 36452187 PMCID: PMC9674464 DOI: 10.18502/jri.v23i4.10812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Endometriosis is a common devastating gynecological disease with severe complications. Researches on noninvasive diagnostic tests with acceptable accuracy are still ongoing. The purpose of the present study was to evaluate the diagnostic value of serum Galectin-9 (Gal-9) level in comparison with laparoscopic results in endometriosis patients. Methods Sixty-one patients, referred to Booali, Rasool-e-Akram, and Pars Hospitals affiliated to Islamic Azad University of Medical Sciences, were recruited. Patients laparoscopically diagnosed with endometriosis were assigned to the case (n=32) and who diagnosed with other diseases were assigned to the control group (n=29). In general, 56 patients (30 in case and 26 in control group) completed the study. The serum level of Galectin-9 was measured using ELISA method before laparoscopy and was compared between the groups. Next, categorical variables were compared using Chi square and quantitative variables using independent samples t- test or Mann-Whitney U test. The Gal-9 cut-off was calculated using the Youden's index and ROC curve; then, sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of Gal-9 were reported. The p<0.05 were considered statistically significant. Results Mean serum level of Galectin-9 was 669.3±416.50 pg/ml in the case group and 265.42±492.30 pg/ml in the control group (p=0.001). Considering a cut-off value of 138 pg/ml, Galectin-9 had a sensitivity of 100% and specificity of 88.46% for diagnosis of endometriosis (p<0.001). Conclusion Galectin-9 measurement is helpful in diagnosis of endometriosis. Future studies are recommended for investigating the generalizability of these results.
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Affiliation(s)
| | - Shahla Chaichian
- Islamic Azad University of Medical Sciences, Tehran, Iran
- Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Jarollahi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Hajmohammadi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mashayekhi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Ziba Ghasemi
- Islamic Azad University of Medical Sciences, Tehran, Iran
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Schaduangrat N, Anuwongcharoen N, Moni MA, Lio' P, Charoenkwan P, Shoombuatong W. StackPR is a new computational approach for large-scale identification of progesterone receptor antagonists using the stacking strategy. Sci Rep 2022; 12:16435. [PMID: 36180453 PMCID: PMC9525257 DOI: 10.1038/s41598-022-20143-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/09/2022] [Indexed: 11/24/2022] Open
Abstract
Progesterone receptors (PRs) are implicated in various cancers since their presence/absence can determine clinical outcomes. The overstimulation of progesterone can facilitate oncogenesis and thus, its modulation through PR inhibition is urgently needed. To address this issue, a novel stacked ensemble learning approach (termed StackPR) is presented for fast, accurate, and large-scale identification of PR antagonists using only SMILES notation without the need for 3D structural information. We employed six popular machine learning (ML) algorithms (i.e., logistic regression, partial least squares, k-nearest neighbor, support vector machine, extremely randomized trees, and random forest) coupled with twelve conventional molecular descriptors to create 72 baseline models. Then, a genetic algorithm in conjunction with the self-assessment-report approach was utilized to determine m out of the 72 baseline models as means of developing the final meta-predictor using the stacking strategy and tenfold cross-validation test. Experimental results on the independent test dataset show that StackPR achieved impressive predictive performance with an accuracy of 0.966 and Matthew's coefficient correlation of 0.925. In addition, analysis based on the SHapley Additive exPlanation algorithm and molecular docking indicates that aliphatic hydrocarbons and nitrogen-containing substructures were the most important features for having PR antagonist activity. Finally, we implemented an online webserver using StackPR, which is freely accessible at http://pmlabstack.pythonanywhere.com/StackPR . StackPR is anticipated to be a powerful computational tool for the large-scale identification of unknown PR antagonist candidates for follow-up experimental validation.
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Affiliation(s)
- Nalini Schaduangrat
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, 10700, Thailand
| | - Nuttapat Anuwongcharoen
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, 10700, Thailand
| | - Mohammad Ali Moni
- Artificial Intelligence & Digital Health Data Science, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Pietro Lio'
- Department of Computer Science and Technology, University of Cambridge, Cambridge, CB3 0FD, UK
| | - Phasit Charoenkwan
- Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Watshara Shoombuatong
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, 10700, Thailand.
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Kim TH, Bae N, Kim T, Hsu AL, Hunter MI, Shin JH, Jeong JW. Leptin Stimulates Endometriosis Development in Mouse Models. Biomedicines 2022; 10:biomedicines10092160. [PMID: 36140261 PMCID: PMC9496281 DOI: 10.3390/biomedicines10092160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Endometriosis is a chronic inflammatory condition in women, and obesity leads to an inflammatory condition that is directly involved in the etiology of endometriosis. However, observational studies have shown an inverse correlation between endometriosis and a low body mass index (BMI). Obesity does not protect against endometriosis, and on the contrary, an increased BMI may lead to more severe forms of the disease. To determine the effect of obesity on endometriosis, diet-induced and genetically engineered obese mouse models were integrated with endometriosis mouse models with fluorescence-tagged ectopic lesions. High-fat diet-induced obese mice revealed a significant increase in endometriosis development compared with regular-diet control mice. However, obese recipient mice with leptin deficiency and leptin receptor deficiency showed suppressed endometriosis development compared with control mice. Furthermore, donor uterine tissues with leptin deficiency and leptin receptor deficiency suppressed endometriosis development compared with control donor in control recipient mice. Importantly, we revealed that aberrant high levels of leptin concentration significantly increased endometriosis development compared with vehicle treatment group in control mice with normal body weight. Our results suggest that leptin and its receptor are critical for endometriosis development.
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Affiliation(s)
- Tae Hoon Kim
- Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI 49534, USA
| | - Nayoung Bae
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Guro Hospital, Korea University Medical Center, Seoul 02841, Korea
| | - Taeho Kim
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Albert L. Hsu
- Reproductive Medicine and Fertility Center, Department of Obstetrics, Gynecology & Women’s Health, University of Missouri School of Medicine, Columbia, MO 65202, USA
| | - Mark I. Hunter
- Department of Obstetrics, Gynecology & Women’s Health, University of Missouri School of Medicine, Columbia, MO 65202, USA
| | - Jung-Ho Shin
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Guro Hospital, Korea University Medical Center, Seoul 02841, Korea
- Correspondence: (J.-H.S.); (J.-W.J.)
| | - Jae-Wook Jeong
- Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI 49534, USA
- Correspondence: (J.-H.S.); (J.-W.J.)
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Oxidative-Stress Related Gene Polymorphism in Endometriosis-Associated Infertility. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081105. [PMID: 36013572 PMCID: PMC9414462 DOI: 10.3390/medicina58081105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Endometriosis is a benign inflammatory disease associated with infertility and chronic pelvic pain, estimated to affect 7−10% of reproductive-age women, with the possibility of malignant transformation. Recent studies focus on oxidative stress and genetic mutations as risk factors in the pathophysiology of endometriosis-associated infertility. Materials and Methods: This case-control study is the first in Eastern European women that aimed to investigate four genes’ genetic polymorphisms that encode antioxidant enzymes involved in oxidative stress (glutathione peroxidase 1, GPX1 198Pro > Leu, catalase CAT-262C > T, glutathione S-transferase M1, and T1 null genotype) and their association with endometriosis-related infertility. We compared 103 patients with endometriosis-associated infertility with 102 post-partum women as the control group. Results: The endometriosis group had a mean age of 34.5 +/− 6.12 years, while the control group’s mean age was 35.03 +/− 5.95 years. For CAT-262C > T polymorphism, the variant genotypes were significantly more frequent in the endometriosis group. Moreover, for the GPX1 198Pro > Leu, the endometriosis group had significantly more frequent CT and TT genotypes. The null genotype of GSTM1 was detected significantly higher in the endometriosis group. No significant differences were found in the frequency of GSTT1 between the two groups. This study suggests that GPX1 198Pro > Leu, CAT-262C > T, and GSTM1 polymorphisms may be risk factors and that the association between the GSTM1-GSTT1 null genotype may play a significant role in endometriosis-associated infertility. Moreover, this study suggests that the GSTT1 null genotype does not influence the disease. Visual identification of endometriotic lesions with microscopic confirmation is the accepted gold standard for diagnosing endometriosis, but general anesthesia and laparoscopy are required. Conclusions: In this regard, a panel of genetic or laboratory markers is needed for the early diagnostics of this prevalent disease, especially in the case of young patients with future pregnancy intention.
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Salman BI, Hassan AI, Hassan YF, Saraya RE. Ultra-sensitive and selective fluorescence approach for estimation of elagolix in real human plasma and content uniformity using boron-doped carbon quantum dots. BMC Chem 2022; 16:58. [PMID: 35922841 PMCID: PMC9351230 DOI: 10.1186/s13065-022-00849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
Elagolix (ELX) is an orally administered non-peptidic GnRH antagonist that has been approved by the Food and Drug Administration in 2018 for the treatment of endometriosis pain. A sensitive and selective method for estimating elagolix (ELX) in human plasma and content uniformity was developed and validated. The spectrofluorimetric technique was used to investigate ELX utilizing boron-doped carbon quantum dots (B@CQDs). After gradually adding ELX, the quantum dots fluorescence was enhanced with LOQ of 1.74 ng mL−1, the calibration curve between ELX and corresponding fluorescence intensity was found over a range of 4–100 ng mL−1. The method was successfully applied in real human plasma with pharmacokinetic study and content uniformity test. The pharmacokinetic parameters as Cmax were found to be 570 ± 5.32 ng. mL−1 after 1 h, t1/2 was found to be 6.50 h, and AUC was found to be 1290 ± 30.33 ng. h. mL−1. B@CQDs were characterized using variety of instruments. The strategy is simple to implement in clinical labs and therapeutic drug monitoring systems.
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Affiliation(s)
- Baher I Salman
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt.
| | - Ahmed I Hassan
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt
| | - Yasser F Hassan
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt
| | - Roshdy E Saraya
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Port Said University, Port Said, 42511, Egypt
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Armour M, Sinclair J, Cheng J, Davis P, Hameed A, Meegahapola H, Rajashekar K, Suresh S, Proudfoot A, Leonardi M. Endometriosis and Cannabis Consumption During the COVID-19 Pandemic: An International Cross-Sectional Survey. Cannabis Cannabinoid Res 2022; 7:473-481. [PMID: 35089093 PMCID: PMC9418353 DOI: 10.1089/can.2021.0162] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction: Endometriosis affects 1 in 10 women worldwide, with most experiencing difficulties achieving adequate symptom control. These difficulties have been compounded by the onset of the COVID-19 pandemic due to worldwide shifts in health care resource allocation. As cannabis is a relatively common form of self-management in endometriosis, this study aims to explore the impact of the COVID-19 pandemic on cannabis consumption in those with endometriosis. Methods: An anonymous, cross-sectional online international survey was developed and promoted by endometriosis advocacy/support organizations worldwide. Respondents needed to have a diagnosis of endometriosis and be aged between 18 and 55. Results: A total of 1634 responses were received from 46 different countries. The average age of respondents was 30, with a mean diagnosis age of 25. Eight hundred forty-six respondents (51%) reported consuming cannabis in the past 3 months, with 55% of these reporting use for symptom management only. One in five respondents (20%) reported having consumed cannabis previously, the most common reason for discontinuation (65%) was access difficulties during COVID. Those who had legal access were more likely to consume cannabis than those without (p<0.0001) and were more likely to disclose usage to health care professionals (p<0.0001). The most common reasons for consuming cannabis during COVID was increased stress/anxiety (59%) and lack of access to normal medical care (48%). Pre-pandemic, cannabis was mostly consumed at least once a day (61%) and in inhaled forms (51.6%). Consumption increased for most people (57%) during the pandemic. During the pandemic just under a quarter (23%) of respondents changed their mode of consumption, with a reduction in inhaled forms (39.5%) and an increase in consumption of edibles (40%) or oil (25.2%). Conclusions: Cannabis consumption, especially for symptom relief, was relatively common among those with endometriosis, with some people starting their consumption of cannabis due to health care restrictions that occurred due to the COVID-19 pandemic. Difficulties accessing cannabis and unpleasant/unwanted side effects were the most common reasons for lack of current cannabis consumption in those who had previously consumed it. Cannabis consumption may form an important part of endometriosis management especially when access to routine medical care is restricted.
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Affiliation(s)
- Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia
| | - Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Junipearl Cheng
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Preston Davis
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Aaish Hameed
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Harini Meegahapola
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Krithika Rajashekar
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Sunethra Suresh
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Mathew Leonardi
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Xie C, Yin Z, Liu Y. Analysis of characteristic genes and ceRNA regulation mechanism of endometriosis based on full transcriptional sequencing. Front Genet 2022; 13:902329. [PMID: 35938015 PMCID: PMC9353714 DOI: 10.3389/fgene.2022.902329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Endometriosis is a common gynecological disorder that usually causes infertility, pelvic pain, and ovarian masses. This study aimed to mine the characteristic genes of endometriosis, and explore the regulatory mechanism and potential therapeutic drugs based on whole transcriptome sequencing data and resources from public databases, providing a theoretical basis for the diagnosis and treatment of endometriosis. Methods: The transcriptome data of the five eutopic (EU) and ectopic (EC) endometrium samples were obtained from Beijing Obstetrics and Gynecology Hospital, Beijing, China, and dinified as the own data set. The expression and clinical data of EC and EU samples in GSE25628 and GSE7305 datasets were obtained from the GEO database (https://www.ncbi.nlm.nih.gov/gds). Differential gene expression analysis and weighted gene co-expression network analysis (WGCNA) were used to identify the endometriosis-related differentially expressed genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted by the “clusterProfiler” R package. Then, characteristic genes for endometriosis were identified by the least absolute shrinkage and selection operator (LASSO) and support vector machine recursive feature elimination (SVM-RFE) algorithm. The expression of characteristic genes was verified by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western-blot. The receiver operating characteristic (ROC) curve was used to evaluate the discriminatory ability of characteristic genes. We assessed the abundance of infiltrating immune cells in each sample using MCP-counter and ImmuCellAI algorithms. The competitive endogenous RNA (ceRNA) regulatory network of characteristic genes was created by Cytoscape and potential targeting drugs were obtained in the CTD database. Results: 44 endometriosis-related differentially expressed genes were obtained from GSE25628 and the own dataset. Subsequently, LASSO and SVM-RFE algorithms identified four characteristic genes, namely ACLY, PTGFR, ADH1B, and MYOM1. The results of RT-PCR and western-blot were consistent with those of sequencing. The result of ROC curves indicated that the characteristic genes had powerful abilities in distinguishing EC samples from EU samples. Infiltrating immune cells analysis suggested that there was a certain difference in immune microenvironment between EC and EU samples. The characteristic genes were significantly correlated with specific differential immune cells between EC and EU samples. Then, a ceRNA regulatory network of characteristic genes was constructed and showed a total of 7, 11, 11, and 1 miRNA associated with ACLY, ADH1B, PTGFR, and MYOM1, respectively. Finally, we constructed a gene-compound network and mined 30 drugs targeting ACLY, 33 drugs targeting ADH1B, 13 drugs targeting MYOM1, and 12 drugs targeting PTGFR. Conclusion: Comprehensive bioinformatic analysis was used to identify characteristic genes, and explore ceRNA regulatory network and potential therapeutic agents for endometriosis. Altogether, these findings provide new insights into the diagnosis and treatment of endometriosis.
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Affiliation(s)
| | | | - Yong Liu
- *Correspondence: Chengmao Xie, ; Yong Liu,
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Chen M, Zhang Y, Xu M, Liu D, Yang Y, Yao S. Primary high-grade serous cancer arising from uterosacral ligament endometriosis: two case reports. J Int Med Res 2022; 50:3000605221109373. [PMID: 35836383 PMCID: PMC9290122 DOI: 10.1177/03000605221109373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Although high-grade serous cancer (HGSC) accounts for >70% of ovarian epithelial cancers, it is rarely associated with endometriosis. No previous study has reported an association between the malignant transformation of uterine ligament endometriosis and HGSC. Here, we reported two cases of Chinese female patients with HGSC arising from endometriosis in the uterosacral ligament. They had a long-term history of endometriosis and dysmenorrhea. Both were diagnosed with HGSC at stage IIB. They underwent operations and six cycles of chemotherapy with paclitaxel and carboplatin and have remained disease-free to date. Genomic analysis showed no known/suspected pathogenic variations or somatic homologous recombination deficiency in the two cases. In conclusion, these rare cases of HGSC from endometriosis might indicate a new origin of ovarian type II carcinoma. Patients with a long-term history of endometriosis and sudden aggravation of dysmenorrhea or vaginal bleeding should be aware of the possibility of endometriotic malignant transformation.
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Affiliation(s)
- Ming Chen
- Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuedi Zhang
- School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Manman Xu
- Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Duo Liu
- Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yang Yang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shuzhong Yao
- Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Diagnosis and Nursing Intervention of Gynecological Ovarian Endometriosis with Magnetic Resonance Imaging under Artificial Intelligence Algorithm. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3123310. [PMID: 35726287 PMCID: PMC9206576 DOI: 10.1155/2022/3123310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022]
Abstract
This research was aimed to study the application value of the magnetic resonance imaging (MRI) diagnosis under artificial intelligence algorithms and the effect of nursing intervention on patients with gynecological ovarian endometriosis. 116 patients with ovarian endometriosis were randomly divided into a control group (routine nursing) and an experimental group (comprehensive nursing), with 58 cases in each group. The artificial intelligence fuzzy C-means (FCM) clustering algorithm was proposed and used in the MRI diagnosis of ovarian endometriosis. The application value of the FCM algorithm was evaluated through the accuracy, Dice, sensitivity, and specificity of the imaging diagnosis, and the nursing satisfaction and the incidence of adverse reactions were used to evaluate the effect of nursing intervention. The results showed that, compared with the traditional hard C-means (HCM) algorithm, the artificial intelligence FCM algorithm gave a significantly higher partition coefficient, and its partition entropy and running time were significantly reduced, with significant differences (P < 0.05). The average values of Dice, sensitivity, and specificity of patients' MRI images were 0.77, 0.73, and 0.72, respectively, which were processed by the traditional HCM algorithm, while those values obtained by the improved artificial intelligence FCM algorithm were 0.92, 0.90, and 0.93, respectively; all the values were significantly improved (P < 0.05). In addition, the accuracy of MRI diagnosis based on the artificial intelligence FCM algorithm was 94.32 ± 3.05%, which was significantly higher than the 81.39 ± 3.11% under the HCM algorithm (P < 0.05). The overall nursing satisfaction of the experimental group was 96.5%, which was significantly better than the 87.9% of the control group (P < 0.05). The incidence of postoperative adverse reactions in the experimental group (7.9%) was markedly lower than that in the control group (24.1%), with a significant difference (P < 0.05). In short, MRI images under the artificial intelligence FCM algorithm could greatly improve the clinical diagnosis of ovarian endometriosis, and the comprehensive nursing intervention would also improve the prognosis and recovery of patients.
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Endometriosis: A Disease with Few Direct Treatment Options. Molecules 2022; 27:molecules27134034. [PMID: 35807280 PMCID: PMC9268675 DOI: 10.3390/molecules27134034] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 12/07/2022] Open
Abstract
Endometriosis is a gynecological condition characterized by the growth of endometrium-like tissues inside and outside the pelvic cavity. The evolution of the disease can lead to infertility in addition to high treatment costs. Currently, available medications are only effective in treating endometriosis-related pain; however, it is not a targeted treatment. The objective of this work is to review the characteristics of the disease, the diagnostic means and treatments available, as well as to discuss new therapeutic options.
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Wu Y, Li X, Dai Y, Shi J, Gu Z, Zhang J, Zhang C, Yan H, Leng J. Does Dysmenorrhea Affect Clinical Features and Long-Term Surgical Outcomes of Patients With Ovarian Endometriosis? A 12-Year Retrospective Observational Cohort Study. Front Med (Lausanne) 2022; 9:905688. [PMID: 35783615 PMCID: PMC9243552 DOI: 10.3389/fmed.2022.905688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background To examine and compare the differences in clinical characteristics and long-term postoperative outcomes of ovarian endometriomas (OMA) patients with and without dysmenorrhea, including data from at least 8 years of postoperative follow-up examinations. Methods Retrospective analysis of 334 OMA patients, including their demographic and clinical data. Long-term follow-up record was also collected. All laparoscopic cystectomy procedures were performed by the same surgeon at Peking Union Medical College Hospital between January 2009 and April 2013. Patients were divided into the dysmenorrhea and non-dysmenorrhea groups to perform the analysis of their preoperative characteristics, relevant surgical findings, and postoperative outcomes at the follow-up. Results Out of 334 OMA patients, 257 (76.9%) patients were allocated to the dysmenorrhea group, while the rest 77 (23.1%) patients were included in the non-dysmenorrhea group. Compared with the dysmenorrhea group, the non-dysmenorrhea group exhibited a reduced proportion of chronic pelvic pain (CPP) (P = 0.003), dyspareunia (P < 0.001), tenesmus (P < 0.001), concurrency of deep infiltrating endometriosis (DIE) (P < 0.001), and adenomyosis (P = 0.032). Preoperative infertility was significantly higher in the dysmenorrhea group (P = 0.001). The mean operating time in the dysmenorrhea vs. the non-dysmenorrhea group was 68.0 vs. 56.0 min (P < 0.001). According to the revised American Fertility Society (rAFS) scoring system, the mean scores of the two groups were 52.1 vs. 44.6 (P = 0.033). During follow-up, the dysmenorrhea group showed a higher rate of disease relapse (P < 0.001). A minimum postoperative follow-up period of 8 years was required to evaluate the pregnancy outcomes. Successful pregnancies were identified in 97/257 (37.7%) cases in the dysmenorrhea group and 36/77(46.8%) cases in the non-dysmenorrhea group (P = 0.157), respectively. Though the dysmenorrhea group had a higher rate of postoperative infertility, differences were not significant between the two groups. Conclusions Compared with the dysmenorrhea group, OMA patients without dysmenorrhea exhibited lower proportions of CPP, dyspareunia, tenesmus, lower concurrency of DIE and adenomyosis, shorter mean operating time, lower mean rAFS scores, and lower infertility rates. During the long-term follow-up, a lower recurrence rate was observed in the non-dysmenorrhea group. Regarding fertility outcomes, non-dysmenorrhea patients had a higher likelihood of successful pregnancy after surgery. Postoperative management needs to be evaluated separately according to dysmenorrhea pathology.
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Ellis K, Munro D, Clarke J. Endometriosis Is Undervalued: A Call to Action. Front Glob Womens Health 2022; 3:902371. [PMID: 35620300 PMCID: PMC9127440 DOI: 10.3389/fgwh.2022.902371] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/19/2022] [Indexed: 01/19/2023] Open
Abstract
Endometriosis is an inflammatory chronic pain condition caused by uterine tissue growing outside of the uterus that afflicts at least 11% of women (and people assigned female at birth) worldwide. This condition results in a substantial burden to these women, and society at large. Although endometriosis was first identified over 160 years ago, substantial knowledge gaps remain, including confirmation of the disease's etiology. Research funding for endometriosis is limited, with funding from bodies like the National Institutes of Health (NIH) constituting only 0.038% of the 2022 health budget—for a condition that affects 6.5 million women in the US alone and over 190 million worldwide. A major issue is that diagnosis of endometriosis is frequently delayed because surgery is required to histologically confirm the diagnosis. This delay increases symptom intensity, the risk of central and peripheral sensitization and the costs of the disease for the patient and their nation. Current conservative treatments of presumed endometriosis are pain management and birth control. Both of these methods are flawed and can be entirely ineffective for the reduction of patient suffering or improving ability to work, and neither addresses the severe infertility issues or higher risk of certain cancers. Endometriosis research deserves the funding and attention that befits a disease with its substantial prevalence, effects, and economic costs. This funding could improve patient outcomes by introducing less invasive and more timely methods for diagnosis and treatment, including options such as novel biomarkers, nanomedicine, and microbiome alterations.
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Affiliation(s)
- Katherine Ellis
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Deborah Munro
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
- *Correspondence: Deborah Munro
| | - Jennifer Clarke
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
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Yuan D, Zhu D, Yin B, Ge H, Zhao Y, Huang A, Wang X, Cao X, Xia N, Qian H. Expression of lncRNA NEAT1 in endometriosis and its biological functions in ectopic endometrial cells as mediated via miR-124-3p. Genes Genomics 2022; 44:527-537. [PMID: 35094286 DOI: 10.1007/s13258-021-01184-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/27/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Endometriosis (EM) is a gynecological disease that poses severe health risks to women, although its pathogenesis has yet to be fully elucidated. It has been shown that long non-coding RNAs (lncRNAs) are closely associated with EM initiation and have a role in the development of this disease. Previous studies exploring the expression of the lncRNA nuclear paraspeckle assembly transcript 1 (NEAT1) have shown that this lncRNA functions as a tumor promoter in endometrial cancer. However, its exact mechanism of action in EM remains unclear. OBJECTIVE This report was designed to illustrate the potential molecular mechanisms of lncRNA NEAT1 on EM. METHODS Endometrial tissues were extracted from EM model rats and patients with EM. Hematoxylin and eosin staining was applied to detect the morphological changes that occurred in rats after construction of the model. Endometrial stromal cells (ESCs) were extracted from either ectopic endometrium (EC) or eutopic endometrium (EU) tissues from patients with EM. LncRNA NEAT1 and miR-124-3p expression in EM tissues and cells were subsequently evaluated by reverse transcription-quantitative (RT-q)PCR analysis. MTT assay, flow cytometric analysis, western blot assay and Transwell assay were then employed to examine the effect of NEAT1 and miR-124-3p on EC-ESC proliferation, apoptosis, migration and invasion, respectively. The targeted relationship between lncRNA NEAT1 and miR-124-3p was subsequently confirmed by dual-luciferase and co-transfection assays. RESULTS MiR-124-3p was identified as a target of NEAT1, and could be negatively regulated by NEAT1 in EC-ESCs. The expression level of NEAT1 was evidently increased, whereas that of miR-124-3p was decreased, in the EM in vivo model, EM tissues and EC-ESCs from patients with EM. The loss-of-function assays further established that silencing of NEAT1 could inhibit EC-ESC proliferation, migration, and invasion, but it led to the promotion of apoptosis via targeting miR-124-3p. CONCLUSIONS NEAT1 is significantly upregulated in EM, promoting malignant behavior in EM through targeting miR-124-3p expression.
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Affiliation(s)
- Donglan Yuan
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Dandan Zhu
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Boyu Yin
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Hongshan Ge
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Yinling Zhao
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Aihua Huang
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Xiaosu Wang
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Xiuhong Cao
- Department of Operation, Taizhou People's Hospital Affiliated to Nantong University, Taizhou, 225300, China
| | - Nan Xia
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China
| | - Hua Qian
- Department of Obstetrics and Gynecology, Taizhou People's Hospital Affiliated to Nantong University, 399 Hailing Road, Taizhou, 225300, People's Republic of China.
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Yu L, Sun Y, Fang Q. Efficacy of Laparoscopic Surgery Combined With Leuprorelin in the Treatment of Endometriosis Associated With Infertility and Analysis of Influencing Factors for Recurrence. Front Surg 2022; 9:873698. [PMID: 35521431 PMCID: PMC9062646 DOI: 10.3389/fsurg.2022.873698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo explore the curative effect of laparoscopic surgery combined with leuprorelin in the treatment of endometriosis with infertility and the related factors of recurrence after treatment.MethodsA total of 158 patients with endometriosis and infertility were selected in our hospital from January 2019 to June 2020. Patients were randomly divided into the control group and the observation group, with 79 patients in each group. Patients in the control group was treated by laparoscopy surgery combined with dydrogesterone, while those in the observation group was treated with laparoscopic surgery combined with leuprorelin. The hormone levels, recurrence rate, pregnancy rate and adverse reaction of the two groups were compared. Combined with clinical and pathological information, the related factors of postoperative recurrence were analyzed.ResultsAfter treatment, the levels of luteinizing hormone, follicle-stimulating hormone and estradiol in the observation group were lower than those in the control group (P < 0.05). The recurrence rate at 12 months after operation in the observation group was lower than that in the control group, and the pregnancy rate was higher than that in the control group (P < 0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Preoperative dysmenorrhea was an independent risk factor for postoperative recurrence in patients with endometriosis, and postoperative pregnancy was a protective factor for postoperative recurrence in patients with endometriosis (P < 0.05).ConclusionLaparoscopy combined with leuprorelin in the treatment of endometriosis with infertility can improve hormone levels, increase the pregnancy rate and reduce the recurrence rate. Preoperative dysmenorrhea is an independent risk factor for postoperative recurrence, which should be quantified and included in the recurrence risk prediction model. Postoperative pregnancy can reduce the recurrence rate after operation, and patients with fertility requirements should be encouraged to make activ preparations for postoperative pregnancy.
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Affiliation(s)
- Lu Yu
- Department of Pharmacy, Zhoushan Women and Children Hospital, Zhoushan, China
| | - Yunming Sun
- Department of Gynaecology, Zhoushan Women and Children Hospital, Zhoushan, China
| | - Qiongyan Fang
- Department of Pharmacy, Zhoushan Hospital of Zhejiang Province, Zhoushan, China
- *Correspondence: Qiongyan Fang
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Endometrium as Control of Endometriosis in Experimental Research: Assessment of Sample Suitability. Diagnostics (Basel) 2022; 12:diagnostics12040970. [PMID: 35454018 PMCID: PMC9032605 DOI: 10.3390/diagnostics12040970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Endometriosis is a chronic gynecological disease that causes numerous severe symptoms in affected women. Revealing alterations of the molecular processes in ectopic endometrial tissue is the current policy for understanding the pathomechanisms and discovering potential novel therapeutic targets. Examining molecular processes of eutopic endometrium is likely to be a convenient method to compare it with the molecular alterations observed in ectopic tissues. The aim of the present study was to determine what proportion of the surgically resected eutopic endometrial samples is suitable for further experiments so that these can be comparable with endometriosis. Final hospital reports and histopathology reports of a 3-year-long period (1162 cases) were analysed. The application of a retrospective screening method promoted the categorization of these cases, and quantification of the categorized cases was accomplished. In addition, results obtained from cultured endometrium samples were also detailed. Only a small number of the harvested endometrial samples was suitable for further molecular analysis, while preoperative screening protocol could enlarge this fraction. Applying clinical and histopathological selection and exclusion criteria for tissue screening and histopathological examination of samples could ensure the comparability of healthy endometrium with endometriosis. The present study could be useful for researchers who intend to perform molecular experiments to compare endometriosis with the physiological processes of the endometrium.
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Sverrisdóttir UÁ, Hansen S, Rudnicki M. Impact of diet on pain perception in women with endometriosis: A systematic review. Eur J Obstet Gynecol Reprod Biol 2022; 271:245-249. [PMID: 35245715 DOI: 10.1016/j.ejogrb.2022.02.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 01/17/2022] [Accepted: 02/23/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Endometriosis is a painful, chronic inflammatory disorder that is difficult to treat. Studies have suggested that diet may have a therapeutic effect on chronic inflammation. However, only limited information is available regarding the impact of diet on pain perception in relation to endometriosis. As such, the aim of this review was to evaluate if diet has any impact on pain perception in women suffering from endometriosis. MATERIALS AND METHODS A systematic review was conducted by searching Medline and Embase to identify randomized controlled trials and observational studies adhering to the PRISMA and SWiM guidelines. A table summarizing the findings was developed using the GRADE approach. Inclusion criteria were: women of reproductive age; laparoscopically confirmed diagnosis of endometriosis; and intervention including any type of dietary change. This review was registered with PROSPERO on 14 November 2020 (CRD42020212314). RESULTS In total, the database search identified 2185 studies; of these, six studies fulfilled the inclusion criteria. The Newcastle-Ottawa scale and the Cochrane tool were used to assess the studies, which were concluded to be of high quality and to have low risk of bias. All studies had a positive impact on pain perception, with all except one study reporting a significant reduction in pain perception, indicating that high intake of polyunsaturated fatty acids, a gluten-free diet and a low nickel diet may improve painful endometriosis. It was not possible to conduct a meta-analysis due to considerable heterogeneity amongst the included studies due to differences in dietary adherence, dietary therapies, outcome measurements, populations, durations and study designs. CONCLUSION All studies found that diet had a positive impact on pain perception among women with endometriosis. However, the majority of available evidence on dietary interventions in relation to endometriosis-associated pain was derived from non-randomized controlled trials, which have multiple sources of bias. Therefore, further studies are needed to investigate diet and its effect on pain perception in women with endometriosis.
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Affiliation(s)
- Una Áslaug Sverrisdóttir
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
| | - Sara Hansen
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
| | - Martin Rudnicki
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.
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Wu Y, Zhang J, Wang T, Lou K. Clinical efficacy of turtle shell decocted pills for endometriosis and their influence on cellular immunity. Am J Transl Res 2022; 14:1901-1908. [PMID: 35422950 PMCID: PMC8991112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the therapeutic efficacy of the levonorgestrel-releasing intrauterine system combined with turtle shell decocted pills for endometriosis and their effect on cellular immune function. METHODS Clinical data of 118 patients with endometriosis admitted to Taizhou First People's Hospital from January 2019 to January 2020 were retrospectively analyzed. The patients were assigned into a single-drug group (n=68) and a combined traditional Chinese medicine group (n=50) according to treatment methods. The single-drug group was treated with the levonorgestrel-releasing intrauterine system, and the combined traditional Chinese medicine group was treated with additional turtle shell decocted pills for three cycles for a total of 12 weeks. Enzyme-linked immunosorbent assay was adopted to measure the concentration of Th1 cytokines (tumor necrosis factor (TNF)-α and interferon (IFN)-γ) and Th2 cytokines (interleukin (IL)-6 and IL-10), and the protein level of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1). The levels of serum luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (E2) were compared between the two groups. The response rate of treatment, the control rate of blood pressure and the incidence of adverse reactions were recorded in both groups. RESULTS The response rate of treatment in the combined traditional Chinese medicine group was higher than that in the single-drug group (P<0.05). Compared to before treatment, the TNF-α and IFN-γ increased in both groups after treatment, and the expressions were higher in the combined traditional Chinese medicine group than in the single-drug group (all P<0.05). After treatment, the levels of IL-6, IL-10, PD-1, and PD-L1 decreased, and the decreases in the combined traditional Chinese medicine group were greater than those in the single-drug group (all P<0.05). Serum LH, FSH and E2 levels before and after the treatment in the two groups were not statistically different (all P>0.05). The incidence of treatment-related adverse reactions between the two groups of patients was also not statistically different (P>0.05). CONCLUSION Turtle shell decocted pills can increase the clinical efficacy of levonorgestrel-releasing intrauterine system in the treatment of endometriosis, reduce levels of PD-1, and PD-L1 and improve cellular immune function. The pills do not affect the secretion of ovarian hormones or increase adverse reactions.
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Affiliation(s)
- Yunfang Wu
- Department of Gynecology, Shandong Provincial Hospital, Shandong UniversityJinan 250021, Shandong Province, China
- Department of Gynecology, Zibo Hospital of Traditional Chinese MedicineZibo 255200, Shandong Province, China
| | - Jichen Zhang
- Department of Cardiothoracic Surgery, Taizhou First People’s HospitalTaizhou 318020, Zhejiang Province, China
| | - Ting Wang
- Department of Clinical Laboratory, Zibo Hospital of Traditional Chinese MedicineZibo 255200, Shandong Province, China
| | - Kai Lou
- Department of Emergency, Taizhou First People’s HospitalTaizhou 318020, Zhejiang Province, China
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Li N, Yi K, Li X, Wang Y, Jing J, Hu J, Wang Z. MiR-143-3p facilitates motility and invasiveness of endometriotic stromal cells by targeting VASH1/TGF-β signaling. Reprod Biol 2022; 22:100592. [PMID: 34995817 DOI: 10.1016/j.repbio.2021.100592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/11/2021] [Accepted: 11/27/2021] [Indexed: 12/22/2022]
Abstract
Endometriosis is a benign gynecological disease. Accumulating evidence has revealed the participation of dysregulated miRNAs in the progression of endometriosis. Here, the function and molecular mechanism of miR-143-3p in endometriosis were investigated. The levels of vasohibin 1 (VASH1) and miR-143-3p in endometrial tissues and endometriotic stromal cells (ESCs) were detected by RT-qPCR. Migrative and invasive phenotypes of ESCs were tested by Transwell assays. The protein expression of VASH1, TGF-β signaling markers, and epithelial to mesenchymal transition (EMT) markers was examined by western blotting. The targeted relationship between miR-143-3p and VASH1 was confirmed by bioinformatics analysis and luciferase reporter assay. We found that miR-143-3p expression was significantly upregulated in ectopic endometrial tissues compared to that in eutopic and normal endometrial tissues. MiR-143-3p knockdown restrained EMT process, invasive and migrative behaviors of ESCs. Mechanically, miR-143-3p targeted VASH1 and negatively regulated VASH1. VASH1 downregulation reserved the effects of miR-143-3p knockdown in ESCs. MiR-143-3p activated TGF-β signaling via targeting VASH1. Furthermore, activation of TGF-β signaling counteracted the miR-143-3p knockdown-caused suppression of migration, invasion and EMT process in ESCs. Overall, miR-143-3p activates TGF-β signaling by targeting VASH1 to facilitate migration and invasion of ESCs.
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Affiliation(s)
- Na Li
- Department of Gynecology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, 450003, Henan, China
| | - Keyun Yi
- Department of Gynecology, Zhou kou Central Hospital, Zhoukou 466000, Henan, China
| | - Xia Li
- Department of Gynecology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, 450003, Henan, China
| | - Yue Wang
- Department of Gynecology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, 450003, Henan, China
| | - Jiayu Jing
- Department of Gynecology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, 450003, Henan, China
| | - Jiaxuan Hu
- Department of Obstetrics and Gynecology, Zhoukou Maternal and Child Health Care, Zhoukou, 466000, Henan, China
| | - Zhenhua Wang
- Department of Gynecology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, 450003, Henan, China.
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Hudson N. The missed disease? Endometriosis as an example of 'undone science'. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:20-27. [PMID: 34693042 PMCID: PMC8517707 DOI: 10.1016/j.rbms.2021.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 06/09/2021] [Accepted: 07/12/2021] [Indexed: 05/13/2023]
Abstract
Endometriosis is a chronic gynaecological condition which has been referred to as the 'missed disease' due to its unclear aetiology and inconsistencies in its diagnosis and management. Unlike other long-term conditions such as diabetes and asthma, endometriosis has remained largely ignored in government policy and research funding globally. Drawing on scholarship from the growing field of 'ignorance studies', this paper considers how ambiguity around endometriosis is part of a wider constellation of discursive, material and political factors which enrol certain forms of knowledge whilst silencing, ignoring or marginalizing other forms of knowledge. It uses concepts of 'undone science' and 'wilful ignorance' to explore how an absence of knowledge on endometriosis is a result of structural, cultural and political processes and forces which privilege certain voices and communities. This paper suggests that the association of endometriosis with historically specific constructions of menstruation and women's pain has informed contemporary imaginaries around the condition, including ideas about women being somehow accountable for their own illnesses. Applying an ignorance lens demonstrates how the legacy of invisibility of endometriosis shapes its place in the present political and social arena, and is reflective of a process of undone science. The paper concludes by arguing that the social and political significance of endometriosis as a chronic, life-limiting condition which affects millions of women globally continues to need attention, illumination and critique.
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Affiliation(s)
- Nicky Hudson
- Centre for Reproduction Research, De Montfort University, Leicester, UK
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75
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Luo J, Song Z, Zhang T, Chu K, Li J, Zhou J, Lin J. Upregulation of h-TERT and Ki-67 in ectopic endometrium is associated with recurrence of endometriosis. J Zhejiang Univ Sci B 2022; 23:158-163. [PMID: 35187889 DOI: 10.1631/jzus.b2100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
At present, endometriosis remains a worldwide health burden, with the main symptoms of dysmenorrhea, chronic pelvic pain, and infertility, markedly reducing the quality of life (de Ziegler et al., 2010). Although there is no proof that the disease is associated with high mortality, this disorder can significantly contribute to the deterioration of women's general well-being (McPeak et al., 2018). The main current treatment for endometriosis is surgery to remove endometriotic lesions; however, the recurrence rate following surgical treatment is as high as 21.5% at two years and 40.0%-50.0% at five years post-surgery (Koga et al., 2015). To prevent recurrence, adjuvant treatment with drugs after surgery is recommended to prolong relapse-free intervals. However, it is inconvenient for patients to continuously use such medications in terms of adverse effects and cost (Turk, 2002).
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Affiliation(s)
- Jie Luo
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.,Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Zhimin Song
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Tao Zhang
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Ketan Chu
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Jingyi Li
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Jianhong Zhou
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China. .,Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China. .,Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Jun Lin
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China. .,Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China. .,Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
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Michele Mongelli, Cormio G, Giudice G, Legge F, Resta L, Lambo M, Leone L, Marinaccio M, Loizzi V, Arezzo F, Cicinelli E, Cataldo V. Whose surgery is this? Endometriosis of the round ligament. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 92:e2021375. [PMID: 35045065 PMCID: PMC10523040 DOI: 10.23750/abm.v92is1.11738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 06/14/2023]
Abstract
We report two cases of endometriosis of the round ligament in a 37 and 26 - years old women, with a lump in their right groin and catamenial pain referred to plastic surgery department. MRI showed in both cases nodular lesion in the right inguinal region. The patological examination of the surgical specimen revealed endometriosis of the round ligament. The presence of a groin mass with pain increasing during the menstrual period must raise the suspicion of inguinal endometriosis and a gynecological evaluation is essential to provide a correct management of this rare condition.
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Affiliation(s)
- Michele Mongelli
- a:1:{s:5:"en_US";s:41:"Università degli studi di Bari Aldo Moro";}.
| | | | | | | | | | | | | | | | - Vera Loizzi
- University of Bari "Aldo Moro", Interdisciplinar Department of Medicine, Obstetrics and Gynecology Unit, Bari, Italy.
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Guleken Z, Bulut H, Depciuch J, Tarhan N. Diagnosis of endometriosis using endometrioma volume and vibrational spectroscopy with multivariate methods as a noninvasive method. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2022; 264:120246. [PMID: 34371315 DOI: 10.1016/j.saa.2021.120246] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
Endometriomas are typically an advanced form of endometriosis that leads to the formation of scar tissue, adhesions, and an inflammatory reaction. There is no certain serum marker for the diagnosis of endometriosis. This study aims to research the correlation between the amount of peaks corresponding to proteins and lipids with the volume of endometrioma and determine the chemical structure of blood serum collected from women suffering from endometriosis patients with endometrioma and healthy subjects using Fourier Transform Infrared (FTIR) spectroscopy. FTIR spectroscopy is used as a non-invasive diagnostic technique for the discrimination of endometriosis women with endometrioma and control blood sera. The FTIR spectra of 100 serum samples acquired from 50 patients and 50 healthy individuals were used for this study. For this purpose, multivariate analyses such as Principal Component Analysis (PCA), Partial Last Square analysis (PLS) with Variables Importance in Projection (VIP), and probability models, were performed. Our results showed that FTIR range 1500 cm-1 and 1700 cm-1 and around 2700 cm-1 - 3000 cm-1, regions may be used for the diagnosis of endometriosis. Also, we find that proteins and lipids fraction increase with the volume of endometrioma. Moreover, PLS and VIP analysis suggested that lipids could be helpful in the diagnosis of endometriosis women with endometrioma.
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Affiliation(s)
- Zozan Guleken
- Uskudar University Faculty of Medicine, Department of Physiology Istanbul, Turkey.
| | - Huri Bulut
- Istinye University of Faculty of Medicine, Department Medical Biochemistry, Istanbul, Turkey
| | - Joanna Depciuch
- Institute of Nuclear Physics Polish Academy of Science, Krakow 31-342, Poland.
| | - Nevzat Tarhan
- Uskudar University, NPIstanbul Hospital, Istanbul, Turkey
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78
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Kobayashi H. Proposal for adenomyosis classification based on the endometriosis phenotype. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2021.110742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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79
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Li H, Cai E, Cheng H, Ye X, Ma R, Zhu H, Chang X. FGA Controls VEGFA Secretion to Promote Angiogenesis by Activating the VEGFR2-FAK Signalling Pathway. Front Endocrinol (Lausanne) 2022; 13:791860. [PMID: 35498401 PMCID: PMC9043601 DOI: 10.3389/fendo.2022.791860] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/15/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Our previous work revealed the high expression of fibrinogen alpha chain (FGA) in patients with endometriosis (EM) and that it could promote the migration and invasion of endometrial stromal cells. Angiogenesis is the key condition for the development of EM. This study was aimed to elucidate the role of FGA in endometrial stromal cells involved in angiogenesis in EM. METHODS Immunohistochemistry was used to detect the microvessel density (MVD) and VEGF expression in the eutopic endometrium samples from EM and non-EM. The conditioned medium (CM) of human primary eutopic endometrial stromal cells (EuESC) and immortalized endometrial stromal cell line hEM15A with FGA knockdown were collected and used to treat human umbilical vein endothelial cells (HUVECs). Then, tube formation assay, EdU assay, wound assay, transwell assay and flow cytometry assays were performed to assess the function of HUEVCs in vitro. The angiogenic capability of HUVECs was further measured using a matrigel plug assay with BALB/c nude mice in vivo. Immunofluorescence was used to detect the expression of F-actin and VE-cadherin. RT-PCR and western blotting were used to detect the expression of angiogenesis-related factors in endometrial stromal cells and downstream signalling pathways in HUVECs. RESULTS MVD and VEGF expression in the eutopic endometrium of EM patients were significantly higher than those in the normal endometrium of non-EM patients, and the increased MVD in EM indicates an increased risk of recurrence. Functionally, we found that CM of endometrial stromal cells with FGA knockdown could inhibit HUEVCs migration and tube formation in vitro and in vivo, while having no significant effect on HUVECs proliferation, apoptosis and cell cycle. Mechanically, the expression of VEGFA, PDGF, FGF-B, VEGF, MMP-2 and MMP-9 was reduced in hEM15A cells with FGA knockdown. CM of hEM15A cells with FGA knockdown reduced the number of microfilaments and pseudopodia, as well as the expression of VE-cadherin, and inhibited the activity of VEGFR2 and the FAK signalling pathway in HUVECs. CONCLUSION Our study demonstrated FGA could enhance the interaction between endometrial stromal cells and HUVECs via the potential VEGA-VEGFR-FAK signalling axis and promote EM angiogenesis, revealing a promising therapeutic approach for EM.
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Affiliation(s)
- Hui Li
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
| | - E. Cai
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
| | - Hongyan Cheng
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
| | - Xue Ye
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
| | - Ruiqiong Ma
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
| | - Honglan Zhu
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- *Correspondence: Xiaohong Chang, ; Honglan Zhu,
| | - Xiaohong Chang
- Department of Obstetrics and Gynaecology, Peking University People’s Hospital, Beijing, China
- Center of Gynaecological Oncology, Peking University People’s Hospital, Beijing, China
- *Correspondence: Xiaohong Chang, ; Honglan Zhu,
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Ahmed RM. Greenness assessment of micellar spectrofluorometric approach for determination of Elagolix: application to dosage form, content uniformity and human plasma. Heliyon 2021; 7:e08521. [PMID: 34934839 PMCID: PMC8654795 DOI: 10.1016/j.heliyon.2021.e08521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
Ecological, sensitive, fast and economic approaches are the main aspects in quality control of pharmaceutical products. Elagolix (ELG) is an orally non-peptidic GnRH antagonist, recently approved drug by Food and drug administration in 2018 for treatment of pain associated with endometriosis. A green, and sensitive method was developed and validated for determination of ELG based on micellar spectrofluorometric approach. Many factors were studied to enhance the fluorescence intensity of ELG and the highest sensitivity was obtained upon using 1% Sodium dodecyl sulphate (SDS) at 438 nm after excitation at 270 nm. A linear relationship was obtained over a range of 50-1000 ng mL-1 between ELG concentration and corresponding fluorescence intensity. The developed method was validated according to ICH guidelines and successfully applied for testing the content uniformity and determination of ELG in pharmaceutical dosage forms with percentage recovery 99.31 ± 1.98. Furthermore, the capability of the method due to its high sensitivity to determine ELG in human plasma with percentage recoveries in a range of 98.54-100.46. The greenness of the method was investigated using three different approaches; Analytical Procedure Index (GAPI), Analytical Eco-Scale and Analytical Greenness Metric (AGREE).
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Affiliation(s)
- Rasha M Ahmed
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Misr International University, Cairo, Egypt
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81
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Wu Y, Zhu F, Sun W, Shen W, Zhang Q, Chen H. Knockdown of CCL28 inhibits endometriosis stromal cell proliferation and invasion via ERK signaling pathway inactivation. Mol Med Rep 2021; 25:56. [PMID: 34913072 PMCID: PMC8711019 DOI: 10.3892/mmr.2021.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022] Open
Abstract
Endometriosis (EM), the presence of functional endometrial glands and stroma outside the uterine cavity, is a common gynecological disorder. At present, the pathogenesis of EM has not been fully elucidated, so there is still a lack of effective therapy. The present study aimed to explore the role of C-C motif chemokine ligand 28 (CCL28) and its underlying mechanism in endometrial stromal cells to propose a novel therapy for EM treatment. The expression of CCL28 and CC chemokine receptor 10 (CCR10) were examined. After CCL28 knockdown or overexpression by lentivirus infection, cell proliferation and invasion were measured. It was revealed that compared with normal, the expression levels of CCL28 and CCR10 were significantly elevated in endometrial tissues of patients with EM. Knockdown of CCL28 in endometrial stromal cells significantly suppressed cell proliferation and invasion, and this was accompanied by significantly reduced expression levels of CCR10, MMP2, MMP9, integrin β1 (ITGB1) and phosphorylated (p)-ERK/ERK ratio. The addition of the CCL28 recombinant protein had an opposite effect to CCL28 downregulation. Furthermore, the ERK inhibitor, PD98059, reduced CCL28-induced cell proliferation and invasion, as well as the expression levels of MMP2, MMP9, ITGB1 and p-ERK. Therefore, the present study indicated that CCL28 may contribute to the progression of EM by regulating MMP2, MMP9 and ITGB1 expression and function via the activation of the ERK signaling pathway.
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Affiliation(s)
- Yingting Wu
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P.R. China
| | - Feilong Zhu
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P.R. China
| | - Wenqin Sun
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P.R. China
| | - Weiwei Shen
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P.R. China
| | - Qin Zhang
- Phase I Clinical Trial Unit, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Huifen Chen
- Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200040, P.R. China
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The Effect of Letrozole Combined with Dydrogesterone for Endometriosis in China: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9946060. [PMID: 34901283 PMCID: PMC8660186 DOI: 10.1155/2021/9946060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022]
Abstract
Purpose To discuss the effects of dydrogesterone combined with letrozole on the effectiveness, sex hormone levels, and serological indicators in patients with endometriosis. This study is registered with PROSPERO (CRD42020213172). Methods We searched relevant randomized controlled trials (RCTs) through PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database. The standardized mean differences (SMDs), the mean differences (MDs), or odds ratios (ORs) with their 95% confidence intervals (95% CIs) were computed to be outcome indicators, including total effectiveness, Vascular Endothelial Growth Factor (VEGF) level, Carbohydrate Antigen 125 (CA125) level, Follicle-Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level, estrogen (E2) level, progesterone (P) level, interleukin-6 (IL-6) level, and tumor necrosis factor-a (TNF-a) level. Results A total of 19 RCTs involving 1,591 patients were included in this study. Our results showed that letrozole combined with dydrogesterone can significantly reduce the levels of VEGF (SMD -2.23, 95% CI -2.39 to -2.07; p < 0.00001), CA125 (MD -10.53, 95% CI -11.19 to -9.88; p < 0.00001), E2 (SMD -1.64, 95% CI -1.81 to -1.47; p < 0.00001), P (MD -5.11, 95% CI -6.26 to -3.96; p < 0.00001), IL-6 (MD -4.41, 95% CI -5.16 to -3.67; p < 0.00001), and TNF-a (MD -5.67, 95% CI -6.34 to -5.00; p < 0.00001) in patients with endometriosis compared with the control group. In addition, the results indicated that total effectiveness was significantly higher in the experiment group (OR 6.21, 95% CI 4.17 to 9.24; p < 0.00001) compared to the control. However, there was no significant difference between FSH and LH levels in both groups (p > 0.05). Conclusion This combination therapy can effectively decrease the levels of VEGF, CA125, E2, P, IL-6, and TNF-a and increase the total effectiveness when comparing with the control group.
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Dominguez JL, Mattinson TJ, Wang SS, Revels JW. Infiltrative endometriosis without endometrioma: A case report and imaging findings mimicking a bladder malignancy. Radiol Case Rep 2021; 17:41-45. [PMID: 34765057 PMCID: PMC8569421 DOI: 10.1016/j.radcr.2021.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 11/19/2022] Open
Abstract
Endometriosis affects 10%-15% of women of childbearing age, but the incidence can be as high as 90% in those with chronic pelvic pain. Endometriosis is categorized into ovarian endometriomas, superficial peritoneal implants, and deep infiltrating endometriosis. In this case report a 40-year-old woman gravida 1, para 1 with a history of hysterectomy in Mexico presented with chronic abdominal pain and severe hematuria. Magnetic resonance imaging revealed an infiltrative pelvic mass involving the bladder concerning for a neoplasm that demonstrated subtle hyperintense components on T1-weighted images. The diagnosis of infiltrative endometriosis was established following cystoscopy and tissue sampling. This case highlights the importance of considering endometriosis in the differential for patients with pelvic masses, and recognizing potential features that could suggest the diagnosis.
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Affiliation(s)
- Jennifer Ledezma Dominguez
- Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Ty J Mattinson
- School of Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195
| | - Sherry S Wang
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT
| | - Jonathan W Revels
- Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM 87131, USA
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Association of Inflammatory Markers/Cytokines with Cardiovascular Risk Manifestation in Patients with Endometriosis. Mediators Inflamm 2021; 2021:3425560. [PMID: 34754275 PMCID: PMC8572614 DOI: 10.1155/2021/3425560] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
This study is aimed at determining the association of inflammatory markers and proinflammatory cytokines with cardiovascular risk manifestation in women with endometriosis as compared to healthy controls. A total of 181 females of reproductive age with the absence of other inflammatory or autoimmune disorders and a lack of hormonal therapy for at least 6 months voluntarily participated in this investigation. Patients were 81 females, laparoscopically diagnosed with endometriosis, while the control group comprised 80 healthy females without any pelvic pathology. All subjects were 20-40 years of age. Exclusion criteria were diabetes, obesity, hypertension, metabolic diseases, cardiovascular, and renal disorders. C-reactive protein, fibrinogen, homocysteine, interleukin-17, and interleukin-33 were analyzed using commercially available ELISA kits. For statistical interpretation, the unpaired Student “t” test was used. All inflammatory markers and cytokines demonstrated elevated levels (P < 0.001) in endometriosis patients as compared to healthy controls. The results of the study revealed that the patients with endometriosis demonstrate a hypercoagulable status due to inflammation, which initiates atherosclerosis and associated complications. Hence, endometriosis can cause a risk of cardiovascular disorders in these patients.
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Vermeulen N, Abrao MS, Einarsson JI, Horne AW, Johnson NP, Lee TTM, Missmer S, Petrozza J, Tomassetti C, Zondervan KT, Grimbizis G, De Wilde RL. Endometriosis Classification, Staging and Reporting Systems: A Review on the Road to a Universally Accepted Endometriosis Classification. J Minim Invasive Gynecol 2021; 28:1822-1848. [PMID: 34690085 DOI: 10.1016/j.jmig.2021.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In the field of endometriosis, several classification, staging and reporting systems have been developed. Which endometriosis classification, staging and reporting systems have been published and validated for use in clinical practice? DATA SOURCES A systematic PUBMED literature search was performed. Data were extracted and summarized. METHODS OF STUDY SELECTION na TABULATION, INTEGRATION AND RESULTS: Twenty-two endometriosis classification, staging and reporting systems have been published between 1973 and 2021, each developed for specific, and different, purposes. There still is no international agreement on how to describe the disease. Studies evaluating the different systems are summarized showing a discrepancy between the intended and the evaluated purpose, and a general lack of validation data confirming a correlation with pain symptoms or quality of life for any of the current systems. A few studies confirm the value of the ENZIAN system for surgical description of deep endometriosis. With regards to infertility, the endometriosis fertility index has been confirmed valid for its intended purpose. CONCLUSION Of the 22 endometriosis classification, staging and reporting systems identified in this historical overview, only a few have been evaluated for the purpose for which they were developed. The literature search was limited to PUBMED. Unpublished classification, staging or reporting systems, or those published in books were not considered. It can be concluded that there is no international agreement on how to describe endometriosis or how to classify it, and that most classification/staging systems show no or very little correlation with patient outcomes. This overview of existing systems is a first step in working towards a universally accepted endometriosis classification.
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Affiliation(s)
- Nathalie Vermeulen
- ESHRE, Central office (Dr. Vermeulen), Meerstraat 60, Grimbergen, BE 1852, Belgium
| | - Mauricio S Abrao
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia (Dr. Abrao), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; Gynecologic Division, BP - A Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
| | - Jon I Einarsson
- Brigham and Women's Hospital, Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery (Dr. Einarsson), Boston, MA, USA
| | - Andrew W Horne
- University of Edinburgh, MRC Centre for Reproductive Health (Dr. Horne), QMRI, 49 Little France Crescent, Edinburgh, UK EH16 4TJ
| | - Neil P Johnson
- Repromed Auckland, 105 Remuera Road, Remuera, Auckland (Dr. Johnson), New Zealand 1050
| | - Ted T M Lee
- Magee Womens Hospital of UPMC, Department of Obstetrics, Gynecology and Reproductive Sciences (Dr. Lee), Pittsburgh, PA, USA
| | - Stacey Missmer
- Michigan State University College of Human Medicine, Department of Obstetrics, Gynecology and Reproductive Biology (Dr. Missmer), East Lansing, MI, USA; Harvard University T H Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; World Endometriosis Research Foundation, WERF, London, UK
| | - John Petrozza
- Massachusetts General Hospital Fertility Center, Department of Obstetrics and Gynecology (Dr. Petrozza), Boston, MA, USA
| | - Carla Tomassetti
- University Hospital Leuven, Department of Obstetrics and Gynaecology, Leuven University Fertility Centre (Dr. Tomassetti), Leuven, Belgium
| | - Krina T Zondervan
- University of Oxford, Oxford Endometriosis CaRe Centre, Nuffield Department of Women's & Reproductive Health (Dr. Zondervan), Oxford, Oxfordshire, UK; University of Oxford, Wellcome Centre for Human Genetics, Oxford, Oxfordshire, UK
| | - Grigoris Grimbizis
- Medical School, Aristotle University of Thessaloniki (Dr. Grimbizis), 1st Dept Obstet Gynecol, Tsimiski 51 Street, Thessaloniki, Greece 54623
| | - Rudy Leon De Wilde
- Carl von Ossietzky Universitat Oldenburg, University Hospital for Gynecology (Dr. De Wilde), Oldenburg, Germany.
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86
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Vermeulen N, Abrao MS, Einarsson JI, Horne AW, Johnson NP, Lee TTM, Missmer S, Petrozza J, Tomassetti C, Zondervan KT, Grimbizis G, De Wilde RL. Endometriosis classification, staging and reporting systems: a review on the road to a universally accepted endometriosis classification . Hum Reprod Open 2021; 2021:hoab025. [PMID: 34693032 PMCID: PMC8530712 DOI: 10.1093/hropen/hoab025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/11/2021] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Which endometriosis classification, staging and reporting systems have been published and validated for use in clinical practice? SUMMARY ANSWER Of the 22 endometriosis classification, staging and reporting systems identified in this historical overview, only a few have been evaluated, in 46 studies, for the purpose for which they were developed. WHAT IS KNOWN ALREADY In the field of endometriosis, several classification, staging and reporting systems have been developed. PARTICIPANTS/MATERIALS, SETTING, METHODS A systematic PUBMED literature search was performed. Data were extracted and summarized. MAIN RESULTS AND THE ROLE OF CHANCE Twenty-two endometriosis classification, staging and reporting systems have been published between 1973 and 2021, each developed for specific, and different, purposes. There still is no international agreement on how to describe the disease. Studies evaluating the different systems are summarized showing a discrepancy between the intended and the evaluated purpose, and a general lack of validation data confirming a correlation with pain symptoms or quality of life for any of the current systems. A few studies confirm the value of the ENZIAN system for surgical description of deep endometriosis. With regards to infertility, the endometriosis fertility index has been confirmed valid for its intended purpose. LARGE SCALE DATA NA. LIMITATIONS, REASONS FOR CAUTION The literature search was limited to PUBMED. Unpublished classification, staging or reporting systems, or those published in books were not considered. WIDER IMPLICATIONS OF THE FINDINGS It can be concluded that there is no international agreement on how to describe endometriosis or how to classify it, and that most classification/staging systems show no or very little correlation with patient outcomes. This overview of existing systems is a first step in working toward a universally accepted endometriosis classification. STUDY FUNDING/COMPETING INTEREST(S) The meetings and activities of the working group were funded by the American Association of Gynecologic Laparoscopists, European Society for Gynecological Endoscopy, European Society of Human Reproduction and Embryology and World Endometriosis Society. A.W.H. reports grant funding from the MRC, NIHR, CSO, Wellbeing of Women, Roche Diagnostics, Astra Zeneca, Ferring, Charles Wolfson Charitable Trust, Standard Life, Consultancy fees from Roche Diagnostics, AbbVie, Nordic Pharma and Ferring, outside the submitted work. In addition, A.W.H. has a patent Serum biomarker for endometriosis pending. N.P.J. reports personal fees from Abbott, Guerbet, Myovant Sciences, Vifor Pharma, Roche Diagnostics, outside the submitted work; he is also President of the World Endometriosis Society and chair of the trust board. S.M. reports grants and personal fees from AbbVie, and personal fees from Roche outside the submitted work. C.T. reports grants, non-financial support and other from Merck SA, non-financial support and other from Gedeon Richter, non-financial support from Ferring Pharmaceuticals, outside the submitted work and without private revenue. K.T.Z. reports grants from Bayer Healthcare, MDNA Life Sciences, Roche Diagnostics Inc, Volition Rx, outside the submitted work; she is also a Board member (Secretary) of the World Endometriosis Society and World Endometriosis Research Foundation, Research Advisory Board member of Wellbeing of Women, UK (research charity), and Chair, Research Directions Working Group, World Endometriosis Society. The other authors had nothing to disclose. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
| | | | - Mauricio S Abrao
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Gynecologic Division, BP - A Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP, Brazil
| | - Jon I Einarsson
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew W Horne
- University of Edinburgh, MRC Centre for Reproductive Health, QMRI, Edinburgh, UK
| | | | - Ted T M Lee
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Womens Hospital of UPMC, Pittsburgh, PA, USA
| | - Stacey Missmer
- Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University College of Human Medicine, East Lansing, MI, USA.,Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, MA, USA.,World Endometriosis Research Foundation, WERF, London, UK
| | - John Petrozza
- Department of Obstetrics and Gynecology, Massachusetts General Hospital Fertility Center, Boston, MA, USA
| | - Carla Tomassetti
- Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven University Fertility Centre, Leuven, Belgium
| | - Krina T Zondervan
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford Endometriosis CaRe Centre, Oxford, Oxfordshire, UK.,University of Oxford, Wellcome Centre for Human Genetics, Oxford, UK
| | - Grigoris Grimbizis
- 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Rudy Leon De Wilde
- Carl von Ossietzky Universitat Oldenburg, University Hospital for Gynecology, Oldenburg, Germany
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Fibronectin Molecular Status in Plasma of Women with Endometriosis and Fertility Disorders. Int J Mol Sci 2021; 22:ijms222111410. [PMID: 34768846 PMCID: PMC8583846 DOI: 10.3390/ijms222111410] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/15/2022] Open
Abstract
The diagnosis of endometriosis and fertility disorders is difficult; therefore, it is necessary to look for reliable biomarkers. Analysis of the molecular status of fibronectin as a key player in repair and wound healing processes, as well as in coagulation and fibrinolysis pathways, is justified. ELISA and SDS-agarose immunoblotting were applied to determine the fibronectin concentration and presence and occurrence of soluble FN-fibrin complexes in the blood plasma of women with endometriosis (n = 38), fertility disorders (n = 28) and the healthy group (n = 25). The concentration of fibronectin in the blood plasma of women with endometriosis (292.61 ± 96.17 mg/L) and fertility disorders (287.53 ± 122.68 mg/L) was significantly higher than in the normal group (226.55 ± 91.98 mg/L). The presence of FN-fibrin complexes of 750, 1000, 1300, 1600 and 1900 kDa in the plasma of women with endometriosis and fertility disorders was shown. The presence of FN-fibrin complexes with a molecular mass of more than 1300 kDa in women with endometriosis and infertility and the complete absence of these complexes in healthy women may indicate an increased and chronic activation of coagulation mechanisms in these patients. The presence of complexes of high molecular mass may be one of the biomarkers of fertility disorders in women.
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Vermeulen N, Abrao MS, Einarsson JI, Horne AW, Johnson NP, Lee TTM, Missmer S, Petrozza J, Tomassetti C, Zondervan KT, Grimbizis G, De Wilde RL. Endometriosis classification, staging and reporting systems: a review on the road to a universally accepted endometriosis classification. Facts Views Vis Obgyn 2021; 13:305-330. [PMID: 34672508 PMCID: PMC9148706 DOI: 10.52054/fvvo.13.3.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background In the field of endometriosis, several classification, staging and reporting systems have been developed. However, endometriosis classification, staging and reporting systems that have been published and validated for use in clinical practice have not been systematically reviewed up to now. Objectives The aim of the current review is to provide a historical overview of these different systems based on an assessment of published studies. Materials and Methods A systematic Pubmed literature search was performed. Data were extracted and summarised. Results Twenty-two endometriosis classification, staging and reporting systems have been published between 1973 and 2021, each developed for specific and different purposes. There is still no international agreement on how to describe the disease. Studies evaluating different systems are summarised showing a discrepancy between the intended and the evaluated purpose, and a general lack of validation data confirming a correlation with pain symptoms or quality of life for any of the current systems. A few studies confirm the value of the Enzian system for surgical description of deep endometriosis. With regards to infertility, the endometriosis fertility index has been confirmed valid for its intended purpose. Conclusions Of the 22 endometriosis classification, staging and reporting systems identified in this historical overview, only a few have been evaluated, in 46 studies, for the purpose for which they were developed. It can be concluded that there is no international agreement on how to describe endometriosis or how to classify it, and that most classification/staging systems show no or very little correlation with patient outcomes. What is new? This overview of existing systems is a first step in working towards a universally accepted endometriosis classification.
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89
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Sarbazi F, Akbari E, Karimi A, Nouri B, Noori Ardebili SH. The Clinical Outcome of Laparoscopic Surgery for Endometriosis on Pain, Ovarian Reserve, and Cancer Antigen 125 (CA-125): A Cohort Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2021; 15:275-279. [PMID: 34913296 PMCID: PMC8530215 DOI: 10.22074/ijfs.2021.137035.1018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Endometriosis is an important cause of chronic pain and infertility. Surgery is considered the gold standard for diagnosis and treatment. In this study, we aim to describe the clinical outcomes of women who undergo laparoscopic surgery for endometriosis. MATERIALS AND METHODS In this cohort study, a total of 174 women who referred to Farmaniyeh Hospital, Tehran, Iran from August 2015 to December 2017 with surgical diagnoses of endometriosis stages III and IV enrolled. The participants' demographic, gynaecological, and clinical characteristics were recorded and they were asked to use a numeric rating scale (NRS) to record their severity of pain before and three months after surgery. Blood samples were also taken from the patients before and three months after surgery for measurement of serum levels of anti-Müllerian hormone (AMH) and cancer antigen 125 (CA-125). Data were analysed using SPSS version 21. RESULTS The patients had a mean age of 34.86 ± 6.47 years, 60.9% were married, and 49.4% were housewives. The primary indication for surgery was pain (68.4%), followed by both pain and infertility in the remainder of patients. Types of endometriotic lesions included endometrioma (19%), deep infiltrating endometriosis (DIE, 3.4%), and both endometrioma and DIE (77.6%). There was a reduction in pain from 6.79 ± 2.19 before surgery to 1.48 ± 1.68 after surgery; serum AMH levels reduced from 2.80 ± 1.86 ng/mL to 1.76 ± 1.40 ng/mL and CA125 reduced from 257.06 ± 220.25 U/mL to 23.27 ± 23.25 U/mL (all P<0.001). Of the 21.2% who experienced recurrence, 13.5% underwent additional surgery. The total additional surgery rate was 2.8%. Of the 55 patients with infertility, 78.1% became pregnant after surgery, 54.5% of which was spontaneous. CONCLUSION Surgical treatment of endometriosis had a favourable effect on the patients' pain and inflammation and resolved the patients' infertility with a minimal need for additional surgery.
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Affiliation(s)
- Fereshte Sarbazi
- Department of Obstetrics and Gynaecology, Farmanieh Hospital, Tehran, Iran.
| | - Elham Akbari
- Department of Obstetrics and Gynaecology, Farmanieh Hospital, Tehran, Iran
| | - Anita Karimi
- Department of Obstetrics and Gynaecology, Farmanieh Hospital, Tehran, Iran
| | - Behnaz Nouri
- Department of Obstetrics and Gynaecology, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrish Hospital, Tehran, Iran
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90
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Gonçalves-Henriques M, Brandão P, Almeida A, Ramôa P. Cesarean Section Scar Nodule, Ovarian Cyst, and Dysmenorrhea. J Med Ultrasound 2021; 29:302-304. [PMID: 35127417 PMCID: PMC8772476 DOI: 10.4103/jmu.jmu_71_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/17/2020] [Accepted: 08/07/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manuel Gonçalves-Henriques
- Department of Obstetrics and Gynecology, Hospital Professor Fernando da Fonseca, Amadora, Lisbon, Portugal
| | - Pedro Brandão
- Department of Reproductive Medicine, Instituto Valenciano de Infertilidad, Valencia, Spain.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Amélia Almeida
- Department of Obstetrics and Gynecology, Centro Hospitalar Médio Ave, Famalicão, Portugal
| | - Paula Ramôa
- Department of Obstetrics and Gynecology, Hospital Lusíadas Porto, Porto, Portugal
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91
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Stepwise Approach to the Management of Endometriosis-Related Dysmenorrhea: A Cost-Effectiveness Analysis. Obstet Gynecol 2021; 138:557-564. [PMID: 34623067 DOI: 10.1097/aog.0000000000004536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the cost effectiveness of sequential medical and surgical therapy for the treatment of endometriosis-related dysmenorrhea. METHODS A cost-effectiveness model was created to compare three stepwise medical and surgical treatment strategies compared with immediate surgical management for dysmenorrhea using a health care payor perspective. A theoretical study cohort was derived from the estimated number of reproductive age (18-45) women in the United States with endometriosis-related dysmenorrhea. The treatment strategies modeled were: strategy 1) nonsteroidal antiinflammatory drugs (NSAIDs) followed by surgery; strategy 2) NSAIDs, then short-acting reversible contraceptives or long-acting reversible contraceptives (LARCs) followed by surgery; strategy 3) NSAIDs, then a short-acting reversible contraceptive or LARC, then a LARC or gonadotropin-releasing hormone modulator followed by surgery; strategy 4) proceeding directly to surgery. Probabilities, utilities, and costs were derived from the literature. Outcomes included cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. Univariate, bivariate, and multivariate sensitivity analyses were performed. RESULTS In this theoretical cohort of 4,817,894 women with endometriosis-related dysmenorrhea, all medical and surgical treatment strategies were cost effective at a standard willingness-to-pay threshold of $100,000 per QALY gained when compared with surgery alone. Strategy 2 was associated with the lowest cost per QALY gained ($1,155). Requiring a trial of a third medication before surgery would cost an additional $257 million, compared with proceeding to surgery after failing two medical treatments. The probability of improvement with surgery would need to exceed 83% for this to be the preferred first-line approach. CONCLUSION All sequential medical and surgical management strategies for endometriosis-related dysmenorrhea were cost effective when compared with surgery alone. A trial of hormonal management after NSAIDs, before proceeding to surgery, may provide cost savings. Delaying surgical management in an individual with pain refractory to more than three medications may decrease quality of life and increase cost.
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92
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Vandenameele AS, Platteeuw L, Alaerts H. Acute haemoperitoneum caused by endometriosis infiltrating the uterine artery - Two case reports and a literature review. Facts Views Vis Obgyn 2021; 13:261-266. [PMID: 34555880 PMCID: PMC8823272 DOI: 10.52054/fvvo.13.3.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report 2 cases of haemoperitoneum due to a bleeding of the uterine artery caused by infiltrating endometriosis. We have also conducted a literature review on endometriosis-related intra-abdominal haemorrhage and wrote a practical guideline on how this entity can be recognized and handled. Case 1: A 49-year-old multiparous woman presented with intense stabbing pain in the lower abdomen during her menstruation. CT angiography showed a bleeding from a side branch of the internal iliac artery. Laparoscopy was performed and an active bleeding from the right uterine artery was confirmed, clearly caused by infiltrating endometriosis lesions. Haemostasis was achieved by bipolar coagulation. Case 2: A 29-year-old nulliparous woman was admitted for observation because of heavy stabbing pain in the right lower quadrant and presence of free fluid on CT abdomen. The day after the admission, laparoscopy was performed because of a decreasing haemoglobin level. An arterial bleeding from the right parametrium was observed, probably originating from the right uterine artery. Histopathological examination of a biopsy of the right parametrium proved the presence of endometriosis. Haemostasis was achieved by bipolar coagulation. Although endometriosis-related haemoperitoneum is a rare entity, this diagnosis should be considered when a patient presents with an intra-abdominal haemorrhage during menstruation or withdrawal bleeding - especially in case of a history or suspicion of endometriosis. Laparoscopy is the cornerstone of the treatment.
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Cristina Mendonça Nogueira T, Vinicius Nora de Souza M. New FDA oncology small molecule drugs approvals in 2020: Mechanism of action and clinical applications. Bioorg Med Chem 2021; 46:116340. [PMID: 34416511 DOI: 10.1016/j.bmc.2021.116340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 12/30/2022]
Abstract
In 2020, fifty-three new drugs, including forty small-molecules (thirty-six new chemical entities and four new diagnostic agents) and thirteen biologic drugs were approved by the U.S. Food and Drug Administration (FDA). This year, small-molecules continue to play a role in innovative treatments representing around 75% of all drugs accepted by FDA. The dominant therapeutic area was oncology, accounting for twenty-three new approvals, including thirteen new chemical entities, four new diagnostic agents, and thirteen biologic drugs. Recognizing the importance of small-molecules on cancer treatment, this review aims to provide an overview regarding the clinical applications and mechanism of action of the thirteen new small-molecules (excluding new diagnostic agents) approved by FDA in 2020.
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Affiliation(s)
- Thais Cristina Mendonça Nogueira
- Instituto de Tecnologia em Fármacos-Far Manguinhos, Fundação Oswaldo Cruz, Rua Sizenando Nabuco 100, Manguinhos, Rio de Janeiro, RJ 21041- 250 Brazil
| | - Marcus Vinicius Nora de Souza
- Instituto de Tecnologia em Fármacos-Far Manguinhos, Fundação Oswaldo Cruz, Rua Sizenando Nabuco 100, Manguinhos, Rio de Janeiro, RJ 21041- 250 Brazil.
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Terzic M, Aimagambetova G, Kunz J, Bapayeva G, Aitbayeva B, Terzic S, Laganà AS. Molecular Basis of Endometriosis and Endometrial Cancer: Current Knowledge and Future Perspectives. Int J Mol Sci 2021; 22:9274. [PMID: 34502183 PMCID: PMC8431548 DOI: 10.3390/ijms22179274] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023] Open
Abstract
The human endometrium is a unique tissue undergoing important changes through the menstrual cycle. Under the exposure of different risk factors in a woman's lifetime, normal endometrial tissue can give rise to multiple pathologic conditions, including endometriosis and endometrial cancer. Etiology and pathophysiologic changes behind such conditions remain largely unclear. This review summarizes the current knowledge of the pathophysiology of endometriosis and its potential role in the development of endometrial cancer from a molecular perspective. A better understanding of the molecular basis of endometriosis and its role in the development of endometrial pathology will improve the approach to clinical management.
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Affiliation(s)
- Milan Terzic
- Department of Medicine, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue 53, Nur-Sultan 010000, Kazakhstan or (M.T.); (S.T.)
- National Research Center for Maternal and Child Health, Clinical Academic Department of Women’s Health, University Medical Center, Turan Avenue 32, Nur-Sultan 010000, Kazakhstan; (G.B.); (B.A.)
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Gulzhanat Aimagambetova
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue 53, Nur-Sultan 010000, Kazakhstan;
| | - Jeannette Kunz
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue 53, Nur-Sultan 010000, Kazakhstan;
| | - Gauri Bapayeva
- National Research Center for Maternal and Child Health, Clinical Academic Department of Women’s Health, University Medical Center, Turan Avenue 32, Nur-Sultan 010000, Kazakhstan; (G.B.); (B.A.)
| | - Botagoz Aitbayeva
- National Research Center for Maternal and Child Health, Clinical Academic Department of Women’s Health, University Medical Center, Turan Avenue 32, Nur-Sultan 010000, Kazakhstan; (G.B.); (B.A.)
| | - Sanja Terzic
- Department of Medicine, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue 53, Nur-Sultan 010000, Kazakhstan or (M.T.); (S.T.)
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
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95
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Becker K, Heinemann K, Imthurn B, Marions L, Moehner S, von Stockum S, Gerlinger C, Serrani M, Faustmann T. Patient-reported utilization patterns of endometriosis medications in Europe: Real-world results from the non-interventional VIPOS study. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2021. [DOI: 10.1177/22840265211035993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Women with endometriosis require individualized, long-term treatment. Analyzing prescription choices, medication switches, discontinuations, and breaks can describe real-world treatment patterns and optimize pathways for women. To our knowledge, the Visanne Post-approval Observational Study (VIPOS) is the largest real-world, non-interventional study examining the safety of hormonal treatments for the routine clinical management of endometriosis. We present data from VIPOS on endometriosis drug utilization patterns, including treatment discontinuation due to treatment failure. Methods: VIPOS was a prospective, long-term, controlled, non-interventional cohort study in six European countries (Germany, Switzerland, Russia, Poland, Ukraine, and Hungary) conducted between 2010 and 2018. Women self-reported medical and gynecological history and symptoms and treatment information via comprehensive questionnaires. Results: Overall, 27,840 women were enrolled via gynecologists or specialized centers. Inter-country variance in treatment prescription patterns suggests the influence of differential management strategies and guidelines on prescribing behavior and diagnostic methods. Most enrolled women were receiving combined hormonal contraceptives. Women receiving dienogest 2 mg or gonadotropin-releasing hormone agonists more often had a surgical diagnosis of endometriosis compared to other treatments, while most women receiving combined hormonal contraceptives, other progestins or danazol had a symptom-based diagnosis. Although treatment changes during follow-up were common, only 4733 discontinuations out of 42,342 treatment starts were reported due to side effects or treatment ineffectiveness. Conclusion: VIPOS provides valuable insights into the considerable inter-country variance in endometriosis treatment prescription and potential role of differing management guidelines and practices strategies. Findings presented here suggest the need greater alignment of clinical practice to optimize patient management.
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Affiliation(s)
| | | | - Bruno Imthurn
- Formerly of Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Lena Marions
- Department of Clinical Science and Education Karolinska Institutet, Stockholm, Sweden
| | | | | | - Christoph Gerlinger
- Statistics and Data Insights, Bayer AG, Berlin, Germany
- Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, Homburg/Saar, Germany
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96
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Szukiewicz D, Stangret A, Ruiz-Ruiz C, Olivares EG, Soriţău O, Suşman S, Szewczyk G. Estrogen- and Progesterone (P4)-Mediated Epigenetic Modifications of Endometrial Stromal Cells (EnSCs) and/or Mesenchymal Stem/Stromal Cells (MSCs) in the Etiopathogenesis of Endometriosis. Stem Cell Rev Rep 2021; 17:1174-1193. [PMID: 33411206 PMCID: PMC8316205 DOI: 10.1007/s12015-020-10115-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 02/07/2023]
Abstract
Endometriosis is a common chronic inflammatory condition in which endometrial tissue appears outside the uterine cavity. Because ectopic endometriosis cells express both estrogen and progesterone (P4) receptors, they grow and undergo cyclic proliferation and breakdown similar to the endometrium. This debilitating gynecological disease affects up to 15% of reproductive aged women. Despite many years of research, the etiopathogenesis of endometrial lesions remains unclear. Retrograde transport of the viable menstrual endometrial cells with retained ability for attachment within the pelvic cavity, proliferation, differentiation and subsequent invasion into the surrounding tissue constitutes the rationale for widely accepted implantation theory. Accordingly, the most abundant cells in the endometrium are endometrial stromal cells (EnSCs). These cells constitute a particular population with clonogenic activity that resembles properties of mesenchymal stem/stromal cells (MSCs). Thus, a significant role of stem cell-based dysfunction in formation of the initial endometrial lesions is suspected. There is increasing evidence that the role of epigenetic mechanisms and processes in endometriosis have been underestimated. The importance of excess estrogen exposure and P4 resistance in epigenetic homeostasis failure in the endometrial/endometriotic tissue are crucial. Epigenetic alterations regarding transcription factors of estrogen and P4 signaling pathways in MSCs are robust in endometriotic tissue. Thus, perspectives for the future may include MSCs and EnSCs as the targets of epigenetic therapies in the prevention and treatment of endometriosis. Here, we reviewed the current known changes in the epigenetic background of EnSCs and MSCs due to estrogen/P4 imbalances in the context of etiopathogenesis of endometriosis. Graphical Abstract.
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Affiliation(s)
- Dariusz Szukiewicz
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Aleksandra Stangret
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Carmen Ruiz-Ruiz
- Departamento de Bioquímica y Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, Avenida de la Investigación, 11, 18016 Granada, Spain
| | - Enrique G. Olivares
- Departamento de Bioquímica y Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, Avenida de la Investigación, 11, 18016 Granada, Spain
| | - Olga Soriţău
- Laboratory of Radiotherapy, Tumor and Radiobiology, Prof. Dr. Ion Chiricuţă Oncology Institute, 34-36 Republicii St, 400015 Cluj-Napoca, Romania
| | - Sergiu Suşman
- Department of Histology, Iuliu Hatieganu, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grzegorz Szewczyk
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Pawinskiego 3C, 02-106 Warsaw, Poland
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97
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Qi X, Zhang W, Ge M, Sun Q, Peng L, Cheng W, Li X. Relationship Between Dairy Products Intake and Risk of Endometriosis: A Systematic Review and Dose-Response Meta-Analysis. Front Nutr 2021; 8:701860. [PMID: 34368211 PMCID: PMC8339299 DOI: 10.3389/fnut.2021.701860] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: Diet lifestyle can influence the risk of endometriosis. Therefore, we conducted a systematic meta-analysis to investigate the association between dairy products and the risk of endometriosis. Besides, we performed a dose-response meta-analysis to evaluate the amount of dairy intake affecting the risk of endometriosis. Methods: Relevant studies were searched from Pubmed, Embase databases, Cochrane Library, and Web of Science from the inception to November 6th, 2020. Also, the dose-response meta-analysis was conducted. All the pooled results were performed by risk ratios (RRs). Results: Finally, seven high-quality studies were included in the present meta-analysis. Total dairy intake was inversely associated with the risk of endometriosis, and the risk of endometriosis tended to decrease with a decrease in the risk of endometriosis when dairy products intake was over 21 servings/week (RR 0.87, 95% CI 0.76–1.00; pnon−linearity = 0.04). Similarly, people who consumed more than 18 servings of high-fat dairy products per week had a reduced risk of endometriosis (RR 0.86, 95% CI 0.76–0.96). When stratified-analyses were conducted based on specific dairy product categories, it indicated that people with high cheese intake might have a reduced risk of endometriosis (RR 0.86, 95% CI 0.74–1.00). Other specific dairy products such as whole milk (RR 0.90, 95% CI 0.72–1.12), reduced-fat/skim milk (RR 0.83, 95% CI 0.50–1.73), ice cream (RR 0.83, 95% CI 0.50–1.73), and yogurt (RR 0.83, 95% CI 0.62–1.11) have not shown significant evidence of an association with the risk of endometriosis. However, there is a higher risk of endometriosis in the females with high butter intake compared to females with low butter intake (1.27, 95% CI 1.03–1.55). Conclusions: Overall, dairy products intake was associated with a reduction in endometriosis, with significant effects when the average daily intake ≥3 servings. When analyzed according to the specific type of dairy product, it was shown that females with higher high-fat dairy and cheese intake might have a reduced risk of endometriosis. However, high butter intake might be associated to the increased risk of endometriosis. More future studies are needed to validate and add to this finding.
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Affiliation(s)
- Xiangying Qi
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Wenyan Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Mingxiu Ge
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Qiang Sun
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Lei Peng
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shandong University, Jinan, China
| | - Wenke Cheng
- Department of Cardiology, Heart Center Leipzig at University Leipzig, Leipzig, Germany
| | - Xuepeng Li
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
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98
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Lim H, Park SJ, Paik H, Mun J, Lee EJ, Lee S, Lim W, Song G, Shim SH, Lee CH, Yim GW, Kim HS. Preservation of the ovarian reserve and hemostasis during laparoscopic ovarian cystectomy by a hemostatic agent versus suturing for patients with ovarian endometriosis: study protocol for randomized controlled, non-inferiority trial (PRAHA-2 trial). Trials 2021; 22:473. [PMID: 34289889 PMCID: PMC8293561 DOI: 10.1186/s13063-021-05431-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/07/2021] [Indexed: 12/25/2022] Open
Abstract
Background Endometriosis (EMS) can be implanted everywhere, especially in pelvic organs. EMS can be asymptomatic, but it can result in pelvic pain and infertility by inducing local inflammation and pelvic adhesion. The prevalence of EMS is about 10% in reproductive-age women and higher in women with pelvic pain or infertility. For young patients with ovarian EMS, laparoscopic ovarian cystectomy is effective in relieving pelvic pain and preventing local recurrence. However, there is a concern that the ovarian reserve would decrease after the operation because of the removal of a part of the normal ovarian tissue and thermal damage during hemostasis, which depends on the types of hemostasis such as bipolar electrocoagulation, suturing, and the use of a hemostatic agent. In this study, we aim to evaluate the protective effect for the ovarian reserve and hemostasis between a hemostatic agent and suturing during laparoscopic ovarian cystectomy for patients with ovarian EMS. Methods This study is a randomized controlled, non-inferiority trial, where a total of 90 patients with ovarian EMS will be randomly assigned to the experimental (hemostatic agent) and control (suturing) groups. In the control group, a barbed suture will be applied for hemostasis, whereas a hemostatic agent will be applied in the experimental group. If two methods are insufficient, bipolar electrocoagulation will be applied for complete hemostasis. As the primary endpoint, the reduction rate of serum anti- Müllerian hormone (AMH) levels reflecting the ovarian reserve will be compared between the two groups 12 weeks after surgery. As secondary endpoints, we will compare the reduction rate of AMH level 48 weeks after surgery, the time required to complete hemostasis, the success rate of hemostasis within 10 min, and adverse events associated with operation. Discussion We expect that the protective effect for the ovarian reserve and hemostasis may be comparable between the two methods, suggesting that a hemostatic agent may be preferred considering that it is easy to use during laparoscopic ovarian cystectomy. Trial registration ClinicalTrials.govNCT04643106. Registered on 22 November 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05431-1.
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Affiliation(s)
- Hyunji Lim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Soo Jin Park
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Haerin Paik
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Jaehee Mun
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Eun Ji Lee
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Seungmee Lee
- Department of Obstetrics & Gynecology, Keimyung University School of Medicine, Daegu, 41931, Republic of Korea
| | - Whasun Lim
- Department of Food and Nutrition, Kookmin University, Seoul, 02707, Republic of Korea
| | - Gwonhwa Song
- Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, Republic of Korea
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynecology, Konkuk University Medical center, Seoul, 05030, Republic of Korea
| | - Chae Hyeong Lee
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, 10326, Republic of Korea
| | - Ga Won Yim
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, 10326, Republic of Korea
| | - Hee Seung Kim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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99
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Cui Z, Bhandari R, Lei Q, Lu M, Zhang L, Zhang M, Sun F, Feng L, Zhao S. Identification and Exploration of Novel Macrophage M2-Related Biomarkers and Potential Therapeutic Agents in Endometriosis. Front Mol Biosci 2021; 8:656145. [PMID: 34295919 PMCID: PMC8290202 DOI: 10.3389/fmolb.2021.656145] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Endometriosis (EM) is a chronic neuroinflammatory disorder that is associated with pain and infertility that affects ∼10% of reproductive-age women. The pathophysiology and etiology of EM remain poorly understood, and diagnostic delays are common. Exploration of the underlying molecular mechanism, as well as novel diagnostic biomarkers and therapeutic targets, is urgently needed. Inflammation is known to play a key role in the development of lesions, which are a defining feature of the disorder. In our research, the CIBERSORT and WGCNA algorithms were used to establish a weighted gene co-expression network and to identify macrophage-related hub genes using data downloaded from the GEO database (GSE11691, 7305). The analysis identified 1,157 differentially expressed genes (DEGs) in EM lesions, of which five were identified as being related to M2 macrophages and were validated as differentially expressed by qRT-PCR and immunohistochemistry (IHC). Of these putative novel biomarker genes, bridging integrator 2 (BIN2), chemokine receptor 5 (CCR5), and macrophage mannose receptor 1 (MRC1) were upregulated, while spleen tyrosine kinase (SYK) and metalloproteinase 12 (ADAM12) were downregulated in ectopic endometria vs. normal endometria. Meanwhile, 23 potentially therapeutic small molecules for EM were obtained from the cMAP database, among which topiramate, isoflupredone, adiphenine, dexverapamil, MS-275, and celastrol were the top six molecules with the highest absolute enrichment values. This is our first attempt to use the CIBERSORT and WGCNA algorithms for the identification of novel Mϕ2 macrophage-related biomarkers of EM. Our findings provide novel insights into the impact of immune cells on the etiology of EM; nevertheless, further investigation of these key genes and therapeutic drugs is needed to validate their effects on EM.
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Affiliation(s)
- Zhongqi Cui
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Ramesh Bhandari
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.,Department of Pathology, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Qin Lei
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Mingzhi Lu
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.,Anhui Medical University Shanghai Clinical College, Hefei, China
| | - Lei Zhang
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Mengmei Zhang
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.,Anhui Medical University Shanghai Clinical College, Hefei, China
| | - Fenyong Sun
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Lijin Feng
- Department of Pathology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Shasha Zhao
- Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
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100
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Cai X, Liu M, Zhang B, Zhao SJ, Jiang SW. Phytoestrogens for the Management of Endometriosis: Findings and Issues. Pharmaceuticals (Basel) 2021; 14:569. [PMID: 34198709 PMCID: PMC8232159 DOI: 10.3390/ph14060569] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/15/2022] Open
Abstract
Endometriosis, a chronic disease characterized by recurrent pelvic pain and infertility, severely impacts the health and life quality of many women worldwide. Since phytoestrogens are commonly found in a variety of foods, and estrogen is a major pathological factor for the pathogenesis of endometriosis, their possible involvement cannot be ignored. This review summarizes data on the relationship between phytoestrogen intake and endometriosis risk, and analyzes the findings from in vitro experiments, rodent endometriotic models, and human intervention trials. While favorable results were often obtained from endometrial primary cultures and animal models for resveratrol, isoflavones and puerarin, only resveratrol showed promising results in human intervention trials. Critical issues concerning the current study efforts are discussed: the possible reasons beneath the discrepant observations of estrogenic/anti-estrogenic effects by phytoestrogens; the complicated interplays between phytoestrogens and endogenous estrogens; the shortage of currently used animal models; the necessity to apply reasonable doses of phytoestrogens in experiments. It is expected that the analyses would help to more properly assess the phytoestrogens' effects on the endometriosis pathogenesis and their potential values for preventive or therapeutic applications.
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Affiliation(s)
- Xia Cai
- Department of Nursing, The Affiliated Wuxi Matemity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, China; (X.C.); (M.L.)
| | - Min Liu
- Department of Nursing, The Affiliated Wuxi Matemity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, China; (X.C.); (M.L.)
| | - Bing Zhang
- Department of Gynecology, The Affiliated Wuxi Matemity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, China;
| | - Shao-Jie Zhao
- Department of Gynecology, The Affiliated Wuxi Matemity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, China;
| | - Shi-Wen Jiang
- Center of Reproductive Medicine, State Key Laboratory of Reproductive Medicine, Research Institute for Reproductive Health and Genetic Diseases, The Affiliated Wuxi Matemity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, China
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