Examination of cervical swabs of patients with endometriosis using Fourier transform infrared spectroscopy

Metabolomics for the identification of biomarkers in endometriosis

BACKGROUND

Endometriosis affects the quality of life in women during their reproductive years, causing immense pain and can result in infertility. It is characterized by inflammation and the growth of the endometrium outside the uterine cavity. Metabolomics has the potential to resolve the major bottleneck of endometriosis which is delay in diagnosis due to the invasive diagnostic approach.In this review, the author has summarized the identified biomarkers of endometriosis from different bodily fluids. Metabolomics promises a non-invasive diagnostic approach for endometriosis that could aid in earlier diagnosis and prognosis.

METHODS

Patients with endometriosis keywords were searched in correspondence with the assigned keywords, including metabolomics from PubMed, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study.

RESULTS

This article provides information regarding metabolomics studies in endometrisis.

CONCLUSIONS

We demonstrated that metabolomics is about to change the world of endometriosis by analyzing and detecting the diagnosis, prognosis, mortality and treatment response biomarkers.

A Rare Case of the Cervical Endometriosis and Overview of the Literature

Cervical endometriosis is an uncommon form of endometriosis that is frequently diagnosed incidentally during histopathological evaluation of a hysterectomy or cervical biopsy specimens. Although some cases may be asymptomatic, the symptoms in some patients range from life-threatening hemorrhage to severe chronic pelvic pain. In asymptomatic patients, no further intervention might be required apart from observation and follow-up; however, patients with significant symptoms will require surgery. Primary cervical endometriosis is defined as presence of endometrial tissue on the anterior lip of the cervix, limited to the cervix surface and not extending below the squamous epithelium. Secondary cervical endometriosis is more common than the primary type and describes the disease extensions from the pelvis, or usually the rectovaginal septum. Superficial endometriosis is usually diagnosed by fine-needle aspiration, colposcopy, and cervical biopsy after a routine cervical smear, as endometrial cells detected during a PAP smear may be mistakenly removed as atypical glandular cells. Deep endometriosis may cause pelvic pain, vaginal bleeding, and spotting. In this case report, we present a rare case of cervical endometriosis, characterized by pelvic pain and menstrual irregularity, with endometrioma and adenomyosis, confirmed by histopathological evaluation of the specimen. A summary of the cervical endometriosis cases overview has been made to describe the changing clinical landscape of this rare condition.

Is there a role for small molecule metabolite biomarkers in the development of a diagnostic test for endometriosis?

Endometriosis is a disease defined by the presence of benign lesions of endometrial-like glands and stroma outside the endometrial cavity. Affecting an estimated 11.4% of Australian women, symptoms include chronic pelvic pain, dysmenorrhea and infertility. The current gold standard of diagnosis requires an expensive and invasive laparoscopic surgery, resulting in delayed time to treatment. The identification of a non-invasive endometriosis biomarker - a measurable factor correlating with disease presence or activity - has therefore become a priority in endometriosis research, although no biomarker has yet been validated. As small molecule metabolites and lipids have emerged as a potential focus, this review with systematic approach, aims to summarize studies examining metabolomic biomarkers of endometriosis in order to guide future research. EMBASE, PubMed and Web of Science were searched using keywords: lipidomics OR metabolomics OR metabolome AND diagnostic tests OR biomarkers AND endometriosis, and only studies written in English from August 2000 to August 2020 were included. Twenty-nine studies met inclusion and exclusion criteria and were included. These studies identified potential biomarkers in serum, ectopic tissue, eutopic endometrium, peritoneal fluid, follicular fluid, urine, cervical swabs and endometrial fluid. Glycerophospholipids were identified as potential biomarkers in all specimens, except urine and cervical swab specimens. However, no individual molecule or metabolite combination has reached clinical diagnostic utility. Further research using large study populations with robust patient phenotype and specimen characterisation is required if we are to make progress in identifying and validating a non-invasive diagnostic test for endometriosis.