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Pérez-Prieto I, Vargas E, Salas-Espejo E, Lüll K, Canha-Gouveia A, Pérez LA, Fontes J, Salumets A, Andreson R, Aasmets O, Whiteson K, Org E, Altmäe S. Gut microbiome in endometriosis: a cohort study on 1000 individuals. BMC Med 2024; 22:294. [PMID: 39020289 PMCID: PMC11256574 DOI: 10.1186/s12916-024-03503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/26/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Endometriosis, defined as the presence of endometrial-like tissue outside of the uterus, is one of the most prevalent gynecological disorders. Although different theories have been proposed, its pathogenesis is not clear. Novel studies indicate that the gut microbiome may be involved in the etiology of endometriosis; nevertheless, the connection between microbes, their dysbiosis, and the development of endometriosis is understudied. This case-control study analyzed the gut microbiome in women with and without endometriosis to identify microbial targets involved in the disease. METHODS A subsample of 1000 women from the Estonian Microbiome cohort, including 136 women with endometriosis and 864 control women, was analyzed. Microbial composition was determined by shotgun metagenomics and microbial functional pathways were annotated using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Partitioning Around Medoids (PAM) algorithm was performed to cluster the microbial profile of the Estonian population. The alpha- and beta-diversity and differential abundance analyses were performed to assess the gut microbiome (species and KEGG orthologies (KO)) in both groups. Metagenomic reads were mapped to estrobolome-related enzymes' sequences to study potential microbiome-estrogen metabolism axis alterations in endometriosis. RESULTS Diversity analyses did not detect significant differences between women with and without endometriosis (alpha-diversity: all p-values > 0.05; beta-diversity: PERMANOVA, both R 2 < 0.0007, p-values > 0.05). No differential species or pathways were detected after multiple testing adjustment (all FDR p-values > 0.05). Sensitivity analysis excluding women at menopause (> 50 years) confirmed our results. Estrobolome-associated enzymes' sequence reads were not significantly different between groups (all FDR p-values > 0.05). CONCLUSIONS Our findings do not provide enough evidence to support the existence of a gut microbiome-dependent mechanism directly implicated in the pathogenesis of endometriosis. To the best of our knowledge, this is the largest metagenome study on endometriosis conducted to date.
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Affiliation(s)
- Inmaculada Pérez-Prieto
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain.
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain.
| | - Eva Vargas
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Systems Biology Unit, Department of Experimental Biology, Faculty of Experimental Sciences, University of Jaen, Jaen, Spain
| | - Eduardo Salas-Espejo
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
| | - Kreete Lüll
- Institute of Genomics, Estonian Genome Centre, University of Tartu, Tartu, Estonia
| | - Analuce Canha-Gouveia
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Department of Physiology, Faculty of Veterinary, University of Murcia, IMIB-Arrixaca, Campus Mare Nostrum, Murcia, Spain
| | - Laura Antequera Pérez
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Department of Computer Engineering, Automation and Robotics, University of Granada, Granada, Spain
| | - Juan Fontes
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- U. Reproducción, UGC Laboratorio Clínico y UGC Obstetricia y Ginecología. HU Virgen de Las Nieves, Granada, Spain
| | - Andres Salumets
- Competence Centre On Health Technologies, Tartu, Estonia
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Reidar Andreson
- Institute of Genomics, Estonian Genome Centre, University of Tartu, Tartu, Estonia
- Institute of Genomics, Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Oliver Aasmets
- Institute of Genomics, Estonian Genome Centre, University of Tartu, Tartu, Estonia
| | - Katrine Whiteson
- School of Biological Sciences, University of California, Irvine, CA, USA
| | - Elin Org
- Institute of Genomics, Estonian Genome Centre, University of Tartu, Tartu, Estonia
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
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2
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Wang X, Zhang W, Zhou S. Multifaceted physiological and therapeutical impact of curcumin on hormone-related endocrine dysfunctions: A comprehensive review. Phytother Res 2024; 38:3307-3336. [PMID: 38622915 DOI: 10.1002/ptr.8208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
Over the past five decades, Curcumin (Cur), derived from turmeric (Curcuma longa), has gained considerable attention for its potential therapeutic applications. Synthesizing insights from clinical trials conducted over the last 25 years, this review delves into diseases where Cur has demonstrated promise, offering a nuanced understanding of its pharmacokinetics, safety, and effectiveness. Focusing on specific examples, the impact of Cur on various human diseases is explored. Endocrine glands and associated signaling pathways are highlighted, elucidating how Cur influences cellular signaling. The article underscores molecular mechanisms such as hormone level alteration, receptor interaction, cytokine and adipokine expression inhibition, antioxidant enzyme activity, and modulation of transcription factors. Cur showcases diverse protective mechanisms against inflammation and oxidative damage by suppressing antiapoptotic genes and impeding tumor promotion. This comprehensive overview emphasizes the potential of Cur as a natural agent for countering aging and degenerative diseases, calling for further dedicated research in this realm.
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Affiliation(s)
- Xiuying Wang
- College of Chinese Medicine, Jilin Agricultural Science and Technology College, Jilin, China
| | - Wei Zhang
- College of Chinese Medicine, Jilin Agricultural Science and Technology College, Jilin, China
| | - Shengxue Zhou
- College of Chinese Medicine, Jilin Agricultural Science and Technology College, Jilin, China
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3
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Tsikouras P, Oikonomou E, Bothou A, Chaitidou P, Kyriakou D, Nikolettos K, Andreou S, Gaitatzi F, Nalbanti T, Peitsidis P, Michalopoulos S, Zervoudis S, Iatrakis G, Nikolettos N. The Impact of Endometriosis on Pregnancy. J Pers Med 2024; 14:126. [PMID: 38276248 PMCID: PMC10820275 DOI: 10.3390/jpm14010126] [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: 11/04/2023] [Revised: 12/14/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
Despite the increased frequency of endometriosis, it remains one of the most enigmatic disorders regarding its effects on pregnancy. Endometriosis adversely affects both natural and assisted conception. Impaired folliculogenesis, which causes follicular dysfunction and low egg quality, as well as luteal phase problems, reduced fertilization, and abnormal embryogenesis, are some of the mechanisms advocated to explain reproductive dysfunction. There is a rising need for a comprehensive study of the potential negative consequences of this condition on pregnancy outcomes, including the postpartum period, as more women with a medical history of endometriosis become pregnant. Obstetrical complications (small for gestational age [SGA], cesarean section [CS], miscarriage, hemorrhage, low placental adhesion, and preterm delivery) are statistically elevated in women with endometriosis. Furthermore, ruptured ovarian endometrioma, appendicitis, intestinal perforation, and hemoperitoneum have been described in pregnancy. Obstetricians are largely unfamiliar with these complications, as they have not been thoroughly investigated. The development and pathogenesis of endometriosis is an important field of study and has not yet been fully elucidated. Finding these mechanisms is crucial for the development of new and more effective strategies to treat this condition. Endometriosis can have an impact on obstetric and neonatal outcomes of pregnancy, in addition to its potential effects on conception. To date, no additional monitoring is recommended for pregnancies with a history of endometriosis. However, more studies are urgently needed to assess the need for the tailored pregnancy monitoring of women with endometriosis.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (A.B.); (P.C.); (D.K.); (K.N.); (S.A.); (F.G.); (T.N.); (P.P.); (S.Z.); (G.I.); (N.N.)
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4
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Velarde MC, Bucu MEM, Habana MAE. Endometriosis as a highly relevant yet neglected gynecologic condition in Asian women. Endocr Connect 2023; 12:e230169. [PMID: 37676242 PMCID: PMC10563646 DOI: 10.1530/ec-23-0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/07/2023] [Indexed: 09/08/2023]
Abstract
Endometriosis is a chronic, debilitating disease characterized by the growth of endometrial tissues outside the endometrium. Its prevalence seems to differ across ethnicities, with the disease affecting and presenting with advanced stages in Asians more than any other race. Despite this, data on endometriosis in Asians is limited, and there seems to be a lack of support for endometriosis research in Asia. Hence, this review aims to consolidate the available literature on endometriosis in Asians to identify the gaps in knowledge regarding its occurrence in this population and emphasize the need to address the disease in this part of the world. Certain genetic, dietary, and environmental factors that predominate in Asians compared to other ethnicities may potentially impact endometriosis. Understanding these differences is essential in providing innovative strategies for reducing health disparities in endometriosis incidence and presentation across ethnic groups, thus improving disease management and health outcomes.
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Affiliation(s)
- Michael C Velarde
- Institute of Biology, College of Science, University of the Philippines Diliman, Quezon, Metro Manila, Philippines
| | - Mikaela Erlinda M Bucu
- Department of Obstetrics and Gynecology, College of Medicine, University of the Philippines Manila, Metro Manila, Philippines
| | - Maria Antonia E Habana
- Department of Obstetrics and Gynecology, College of Medicine, University of the Philippines Manila, Metro Manila, Philippines
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5
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Huang X, Wu L, Pei T, Liu D, Liu C, Luo B, Xiao L, Li Y, Wang R, Ouyang Y, Zhu H, Huang W. Single-cell transcriptome analysis reveals endometrial immune microenvironment in minimal/mild endometriosis. Clin Exp Immunol 2023; 212:285-295. [PMID: 36869723 PMCID: PMC10243848 DOI: 10.1093/cei/uxad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
Endometriosis is a common inflammatory disorder in women of reproductive age due to an abnormal endometrial immune environment and is associated with infertility. This study aimed to systematically understand the endometrial leukocyte types, inflammatory environment, and impaired receptivity at single-cell resolution. We profiled single-cell RNA transcriptomes of 138 057 endometrial cells from endometriosis patients (n = 6) and control (n = 7), respectively, using 10x Genomics platform. We found that one cluster of epithelial cells that expressed PAEP and CXCL14 was mostly from the control during the window of implantation (WOI). This epithelial cell type is absent in the eutopic endometrium during the secretory phase. The proportion of endometrial immune cells decreased in the secretory phase in the control group, whereas the cycle variation of total immune cells, NK cells, and T cells was absent in endometriosis. Endometrial immune cells secreted more IL-10 in the secretory phase than in the proliferative phase in the control group; the opposite trend was observed in endometriosis. Proinflammatory cytokines levels in the endometrial immune cells were higher in endometriosis than in the control group. Trajectory analysis revealed that the secretory phase epithelial cells decreased in endometriosis. Ligand-receptor analysis revealed that 11 ligand-receptor pairs were upregulated between endometrial immune and epithelial cells during WOI. These results provide new insights into the endometrial immune microenvironment and impaired endometrial receptivity in infertile women with minimal/mild endometriosis.
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Affiliation(s)
- Xin Huang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
| | - Lukanxuan Wu
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
| | - Tianjiao Pei
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
| | - Dong Liu
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Chang Liu
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Bin Luo
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Li Xiao
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Yujing Li
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
| | - Ruiying Wang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
| | - Yunwei Ouyang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Huili Zhu
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
| | - Wei Huang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu, Sichuan, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, Sichuan, China
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6
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Chen LH, Lo WC, Huang HY, Wu HM. A Lifelong Impact on Endometriosis: Pathophysiology and Pharmacological Treatment. Int J Mol Sci 2023; 24:ijms24087503. [PMID: 37108664 PMCID: PMC10139092 DOI: 10.3390/ijms24087503] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
Endometriosis is a chronic inflammatory disease associated with bothersome symptoms in premenopausal women and is complicated with long-term systemic impacts in the post-menopausal stage. It is generally defined by the presence of endometrial-like tissue outside the uterine cavity, which causes menstrual disorders, chronic pelvic pain, and infertility. Endometriotic lesions can also spread and grow in extra-pelvic sites; the chronic inflammatory status can cause systemic effects, including metabolic disorder, immune dysregulation, and cardiovascular diseases. The uncertain etiologies of endometriosis and their diverse presentations limit the treatment efficacy. High recurrence risk and intolerable side effects result in poor compliance. Current studies for endometriosis have paid attention to the advances in hormonal, neurological, and immunological approaches to the pathophysiology and their potential pharmacological intervention. Here we provide an overview of the lifelong impacts of endometriosis and summarize the updated consensus on therapeutic strategies.
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Affiliation(s)
- Liang-Hsuan Chen
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Wei-Che Lo
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Hong-Yuan Huang
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Hsien-Ming Wu
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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7
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Kanellopoulos D, Karagianni D, Pergialiotis V, Nikiteas N, Lazaris AC, Iliopoulos D. Endometriosis and Subfertility: A Literature Review. MAEDICA 2022; 17:458-463. [PMID: 36032627 PMCID: PMC9375884 DOI: 10.26574/maedica.2022.17.2.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Endometriosis is a condition that mainly concerns women of reproductive age, which causes several problems, including subfertility. The phenotypic presentation of endometriosis is defined by a complex interplay between genetic profile, immunological and mechanical factors. In this literature review we examine the causality between endometriosis and subfertility, outlining possible mechanisms involved in the pathogenesis. Aim: The purpose of this study was to conduct a literature review in order to identify the correlation between endometriosis and subfertility through possible mechanisms involved in the pathogenesis of endometriosis-associated subfertility and treatment. Methods:A search in Medline/PubMed was done, using the terms "endometriosis" and "subfertility", to identify the most relevant studies that were published during the last six years. Results:Pathogenesis of endometriosis-associated subfertility is not clear yet, although some data indicate that there are several factors that could affect a patient's fertility. Involved mechanisms include mechanical obstruction such as ovarian tubal dysfunction and the abnormal peritoneal microenvironment, genetic, and epigenetic mechanisms, and immunological traits. It is fundamental to better understand these mechanisms in order to improve the therapeutic approach. Conclusions:The clinical management of endometiosis-related subfertility has to be improved. It is important to consider a change in the classification of endometriosis and, more importantly, an effort to avoid surgical procedures. There is a crucial need for effective protocols and novel targets for specific diagnosis and treatment. Consequently, the importance of understanding pathogenesis and genetic mechanisms is underlined. Future researchers should focus on novel non-invasive treatment methods that target specific pathogenic pathways.
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Affiliation(s)
- Dimitrios Kanellopoulos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece
| | - Dimitra Karagianni
- 1st Department of Pathology, National and Kapodistrian University of Athens, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece
| | - Nikolaos Nikiteas
- 2nd Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Greece
| | - Andreas C Lazaris
- 1st Department of Pathology, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece
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8
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The effect of endometriosis on placental histopathology and perinatal outcome in singleton live births resulting from in vitro fertilization. Reprod Biomed Online 2022; 45:754-761. [DOI: 10.1016/j.rbmo.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/28/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022]
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10
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Huang X, Xiao L, Long Y, Pei T, Luo B, Liao T, Li Y, Zhu H, Ouyang Y, Huang W. Comparative Proteomic Analysis Reveals Metformin Improves the Expression of Biomarkers of Endometrial Receptivity in Infertile Women with Minimal/Mild Endometriosis. Reprod Sci 2022; 29:2593-2606. [PMID: 35088363 DOI: 10.1007/s43032-022-00869-3] [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: 11/22/2021] [Accepted: 01/23/2022] [Indexed: 10/19/2022]
Abstract
The prevalence of endometriosis is approximately 10% in women of reproductive age, and 30-50% of women with endometriosis are infertile. Metformin has been reported to inhibit the growth of ectopic lesions in endometriosis. However, its effect on the eutopic endometrium of endometriosis is unknown. This study aimed to identify whether metformin affects endometrial receptivity in infertile women with minimal/mild endometriosis. We enrolled 10 infertile women who were diagnosed with minimal/mild endometriosis through laparoscopy. Paired endometrial tissues of the secretory phase from participants were collected during surgery and after 2 months of metformin treatment (n = 5) or no medical treatment (n = 5). Protein expression profiles of the paired endometrium were detected by proteomics and compared using the self-control method (2 months later vs. in surgery). Proteomics data revealed six proteins associated with endometrial receptivity among the significantly upregulated proteins after metformin treatment (fold change > 1.5, P < 0.05). Insulin-like growth factor binding protein 7 (IGFBP-7) showed the most robust increase in these six endometrial receptivity-related proteins (fold change: 8.668, P < 0.05), while there was no significant change in the controls (fold change: 1.906, P > 0.05). The upregulation of IGFBP-7 has been validated through target proteomics, immunohistochemistry, and further demonstrated in endometriosis mouse models induced by autotransplantation. This study revealed that metformin upregulated the expression of IGFBP-7 in the endometrium of human and mouse models of endometriosis. Metformin potentially affects endometrial receptivity of minimal/mild endometriosis by improving the expression of the endometrial receptivity marker IGFBP-7.
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Affiliation(s)
- Xin Huang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China.,NHC Key Laboratory of Chronobiology, Sichuan University), Chengdu Sichuan, 610041, China
| | - Li Xiao
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Ying Long
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Tianjiao Pei
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Bin Luo
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Tianji Liao
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Yujing Li
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China.,NHC Key Laboratory of Chronobiology, Sichuan University), Chengdu Sichuan, 610041, China
| | - Huili Zhu
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Yunwei Ouyang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China
| | - Wei Huang
- Division of Reproductive Medicine, West China Second University Hospital of Sichuan University, Chengdu Sichuan, 610041, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Chengdu Sichuan, 610041, China. .,NHC Key Laboratory of Chronobiology, Sichuan University), Chengdu Sichuan, 610041, China.
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11
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Wu R, Li J, Li J, Zhang N, Zhou W, Ren L, Chen Q, Li Y. Construction of Competing Endogenous RNA Networks Incorporating Transcription Factors to Reveal Differences in Granulosa Cells from Patients with Endometriosis. Genet Test Mol Biomarkers 2021; 25:453-462. [PMID: 34280006 DOI: 10.1089/gtmb.2020.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study aimed to reveal the molecular differences in granulosa cells (GCs) from patients with endometriosis (EM). Methods: RNA sequencing was performed on GCs from patients with EM-related infertility (n = 3) and controls (n = 3). Differentially expressed long noncoding RNAs [differentially expressed lncRNAs (DELs), |log2 FC|>4, false discovery rate (FDR) <0.05] and genes [differentially expressed genes (DEGs), |log2 FC|>1.4, FDR <0.05] in patients with EM-related infertility and controls were screened. Protein-protein interaction (PPI) networks of the DEGs were constructed. Then, mRNA-miRNA-lncRNA pairs based on DEGs and DELs were constructed by comprehensive bioinformatics analyses. In addition, overlapping genes identified from both the PPI and mRNA-miRNA-lncRNA pairs were selected. Finally, a competing endogenous RNA (ceRNA) network incorporating transcription factors (TFs) was constructed. Results: A total of 25,806 lncRNAs and 19,684 mRNAs were detected, and 7 DELs and 46 DEGs were identified. Five hub genes from the PPI network were also identified. A single overlapping gene, NR4A2, from both the PPI network and mRNA-miRNA-lncRNA pairs was identified. Finally, a ceRNA network incorporating TFs, including one mRNA (NR4A2), one miRNA (hsa-miR-217), three lncRNAs (XIST, MCM3AP-AS1, and C17orf51), and five TFs (SRF, POLR2A, NRF1, MNT, and TCF7L2), was successfully constructed. Conclusions: The proposed ceRNA network and the prediction of TFs in GCs from EM-related infertility revealed differences in GCs from patients with EM. Importantly, the novel TFs, lncRNAs, miRNAs, and mRNAs involved in the ceRNA network might provide new insights into the underlying molecular mechanisms of EM-related infertility.
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Affiliation(s)
- Rongfeng Wu
- Reproductive Medical Center, and The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Junzui Li
- The Key Laboratory of Research and Diagnosis of Gynecological Diseases of Xiamen and Department of Obstetrics and Gynecology, The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Jingjing Li
- School of Life Sciences, Xiamen University, Fujian, P.R. China
| | - Ningqing Zhang
- The Key Laboratory of Research and Diagnosis of Gynecological Diseases of Xiamen and Department of Obstetrics and Gynecology, The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Weidong Zhou
- Reproductive Medical Center, and The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Lulu Ren
- Reproductive Medical Center, and The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Qionghua Chen
- The Key Laboratory of Research and Diagnosis of Gynecological Diseases of Xiamen and Department of Obstetrics and Gynecology, The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
| | - Youzhu Li
- Reproductive Medical Center, and The First Affiliated Hospital, School of Medicine, Xiamen University, Fujian, P.R. China
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Shume MM, Banu J, Ishrat S, Munira S, Uddin MJ, Sultana S. The Effects of Cabergoline Compared to Dienogest in Women with Symptomatic Endometrioma. FERTILITY & REPRODUCTION 2021. [DOI: 10.1142/s2661318221500067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: New vessel formation or neovascularization has been recognized as a feature of endometriosis. Treatment with cabergoline suppresses cell proliferation and vascular-endothelial-growth-factor-mediated angiogenesis, thereby promoting regression of endometriotic lesions. Dienogest, a fourth-generation progestin currently in use for the treatment of endometriosis significantly decreases the volume of endometrial implants. Objective: The objective of the study was to see if cabergoline is as effective as dienogest in reducing the size of endometriomas and pelvic pain in women with endometriosis. Methods: The prospective comparative study was carried out on 56 women with endometrioma (diagnosed by ultrasound), divided by odd and even numbers into two groups. Cabergoline, 0.5 mg tablet twice weekly, was given to 28 women for 3 months. Dienogest, 2 mg tablet daily, was given to 28 women for the same duration. Pre- and post-treatment assessment of endometrioma size by transvaginal sonography and pelvic pain using the 10-cm visual analog scale (VAS) were recorded. Results: The percentage reduction in endometrioma size in women given dienogest was twice that compared to the women given cabergoline. Mean VAS score after 3 months was significantly lower in the cabergoline group compared to dienogest ([Formula: see text] ¡ 0.05). The incidence of nausea, vomiting, and headache were similar in cabergoline and dienogest group. There was polymenorrhea in the cabergoline group and irregular spotting in the dienogest group. Conclusions: Reduction of the size of endometrioma is less apparent with cabergoline than dienogest after 3 months of treatment. Cabergoline yields better results in decreasing pelvic pain compared to dienogest.
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Affiliation(s)
- Mehnaz Mustary Shume
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
| | - Jesmine Banu
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
| | - Shakeela Ishrat
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
| | - Serajoom Munira
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
| | - Muhammad Jasim Uddin
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
| | - Sabiha Sultana
- Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh
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Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet 2021; 397:839-852. [PMID: 33640070 DOI: 10.1016/s0140-6736(21)00389-5] [Citation(s) in RCA: 386] [Impact Index Per Article: 128.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 08/09/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022]
Abstract
Endometriosis is a common disease affecting 5-10% of women of reproductive age globally. However, despite its prevalence, diagnosis is typically delayed by years, misdiagnosis is common, and delivery of effective therapy is prolonged. Identification and prompt treatment of endometriosis are essential and facilitated by accurate clinical diagnosis. Endometriosis is classically defined as a chronic, gynaecological disease characterised by endometrial-like tissue present outside of the uterus and is thought to arise by retrograde menstruation. However, this description is outdated and no longer reflects the true scope and manifestations of the disease. The clinical presentation is varied, the presence of pelvic lesions is heterogeneous, and the manifestations of the disease outside of the female reproductive tract remain poorly understood. Endometriosis is now considered a systemic disease rather than a disease predominantly affecting the pelvis. Endometriosis affects metabolism in liver and adipose tissue, leads to systemic inflammation, and alters gene expression in the brain that causes pain sensitisation and mood disorders. The full effect of the disease is not fully recognised and goes far beyond the pelvis. Recognition of the full scope of the disease will facilitate clinical diagnosis and allow for more comprehensive treatment than currently available. Progestins and low-dose oral contraceptives are unsuccessful in a third of symptomatic women globally, probably as a result of progesterone resistance. Oral gonadotropin-releasing hormone (GnRH) antagonists constitute an effective and tolerable therapeutic alternative when first-line medications do not work. The development of GnRH antagonists has resulted in oral drugs that have fewer side-effects than other therapies and has allowed for rapid movement between treatments to optimise and personalise endometriosis care. In this Review, we discuss the latest understanding of endometriosis as a systemic disease with multiple manifestations outside the parameters of classic gynaecological disease.
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Affiliation(s)
- Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
| | - Alexander M Kotlyar
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Valerie A Flores
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
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Kyozuka H, Nishigori H, Murata T, Fukuda T, Yamaguchi A, Kanno A, Yasuda S, Sato A, Ogata Y, Kuse M, Hosoya M, Yasumura S, Hashimoto K, Fujimori K. Prepregnancy antiinflammatory diet in pregnant women with endometriosis: The Japan Environment and Children's Study. Nutrition 2021; 85:111129. [PMID: 33545538 DOI: 10.1016/j.nut.2020.111129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Increased risk of preterm birth (PTB) in women with endometriosis is considered to be associated with chronic inflammatory conditions. Accordingly, we hypothesized that a prepregnancy antiinflammatory diet is a potential form of preconception care for preventing PTB in women with endometriosis and conducted this study to investigate the correlation of a prepregnancy antiinflammatory diet with obstetric outcomes in this patient population. METHODS We used singleton pregnancy data from the Japan Environment and Children's Study involving live births from 2011 to 2014. Individual meal patterns before pregnancy, derived through food frequency questionnaires, were used to calculate the Dietary Inflammatory Index. Participants were categorized according to Dietary Inflammatory Index quintiles (Q1 and Q5 were the most proinflammatory and antiinflammatory groups, respectively), and a multiple logistic regression model was used to estimate the effect of the antiinflammatory diet on PTB before 37 or 34 wk and on low birth weight (LBW) <2500 or 1500 g. RESULTS In women who did not undergo assisted reproduction, significantly reduced risk was found in the Q5 group for both PTB at <34 wk significantly decreased (adjusted odds ratio, 0.25; 95% confidence interval, 0.07-0.83) and low birth weight <1500 g (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.60). CONCLUSIONS This study suggests a distinct effect of an antiinflammatory diet on more severe obstetric outcomes, specifically PTB before 34 wk and low birth weight <1500 g, for women with endometriosis. Preconception lifestyle can improve perinatal mortality and morbidity among these women.
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Affiliation(s)
- Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Hidekazu Nishigori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Fukushima Medical Center for Children and Women, Fukushima, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Toma Fukuda
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akiko Yamaguchi
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Aya Kanno
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shun Yasuda
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Masahito Kuse
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koichi Hashimoto
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
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15
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Perinatal and neonatal outcome in poor ovarian responders in assisted reproductive technology (ART) pregnancy. GINECOLOGIA.RO 2020. [DOI: 10.26416/gine.29.3.2020.4064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Boroumand S, Hosseini S, Pashandi Z, Faridi-Majidi R, Salehi M. Curcumin-loaded nanofibers for targeting endometriosis in the peritoneum of a mouse model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 31:8. [PMID: 31838602 DOI: 10.1007/s10856-019-6337-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 11/16/2019] [Indexed: 05/21/2023]
Abstract
Endometriosis is a common, chronic gynecological disorder associated with ongoing pelvic pain, infertility, and adhesions in reproductive age women. Current therapeutic strategies are not effective and the recurrent nature of endometriosis makes it difficult to treat. In this study, we have designed a drug delivery system to control sustained and prolonged release of curcumin in the peritoneum and pelvic cavity of a mouse model of endometriosis. Poly ε-Caprolactone (PCL) and poly ethylene glycol (PEG) polymers were used to synthesize curcumin loaded nanofibers. After scanning electron microscopy (SEM) observation of the nanofiber's morphology, we evaluated the drug release profile and in vitro degradation rate of the curcumin-loaded nanofibers. Next, we tested these nanofibers in vivo in the peritoneum of an endometriosis mouse model to determine their anti-endometriosis effects. Histological evaluations were also performed. Curcumin loaded nanofibers were successfully synthesized in the 8 and 10 wt% polymers. The release test of the curcumin-loaded nanofibers showed that approximately 23% of the loaded curcumin was released during 30 min, 35% at 24 h, and 50% at 30 days. Endometriosis was successfully induced in Balb/c mice, as noted by the observed characteristics of endometriosis in all of the mice and confirmation of endometriosis by hematoxylin and eosin (H&E) staining. In vivo experiments showed the ability of these implanted curcumin loaded nanofibers to mitigate endometriosis. We observed a considerable reduction in the endometrial glands and stroma, along with significant reduction in infiltration of inflammatory cells. Implantable curcumin loaded nanofibers successfully mitigated intraperitoneal endometriosis.
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Affiliation(s)
- Safieh Boroumand
- Department of Medical Nanotechnology, School of Advanced Technology in Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Sara Hosseini
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zaiddodine Pashandi
- Department of Medical Nanotechnology, School of Advanced Technology in Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Reza Faridi-Majidi
- Department of Medical Nanotechnology, School of Advanced Technology in Medicine, Tehran University of Medical Science, Tehran, Iran.
| | - Mohammad Salehi
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Harada T, Taniguchi F, Amano H, Kurozawa Y, Ideno Y, Hayashi K, Harada T. Adverse obstetrical outcomes for women with endometriosis and adenomyosis: A large cohort of the Japan Environment and Children's Study. PLoS One 2019; 14:e0220256. [PMID: 31374085 PMCID: PMC6677302 DOI: 10.1371/journal.pone.0220256] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/11/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Because of the increased number of diagnosed cases of endometriosis or adenomyosis resulting in infertility, many women require assisted reproductive technology (ART) to become pregnant. However, incidences of obstetric complications are increased for women who conceive using ART. There has been no prospective cohort study examining the influence of endometriosis and adenomyosis on obstetric outcomes after adjusting for the confounding influence of ART therapy. OBJECTIVE This study evaluated the impact of endometriosis and adenomyosis on the incidence of adverse pregnancy outcomes. STUDY DESIGN Data were obtained from a prospective cohort study, known as the Japan Environment and Children's Study (JECS), of the incidence of obstetric complications for women with endometriosis and adenomyosis. The data of 103,099 pregnancies that resulted in live birth or stillbirth or that were terminated through abortion between February 2011 and July 2014 in Japan were included. RESULTS Women with endometriosis or adenomyosis were at increased risk for complications during pregnancy compared to those without a medical history of endometriosis (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.23 to 1.41) or adenomyosis (OR, 1.72; 95% CI, 1.37 to 2.16). Our analysis showed that the adjusted ORs for obstetric complications of pregnant women who conceived naturally or after infertility treatment that did not involve ART therapy were 1.26 (CI, 1.17 to 1.35) for pregnant women with a history of endometriosis and 1.52 (CI, 1.19 to 1.94) for those with a history of adenomyosis. CONCLUSIONS The presence of endometriosis and adenomyosis significantly increased the prevalence of obstetric complications after adjusting for the influence of ART outcomes.
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Affiliation(s)
- Takashi Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Fuminori Taniguchi
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hiroki Amano
- Department of Public Health, Tottori University Faculty of Medicine, Yonago, Japan
| | - Youichi Kurozawa
- Department of Public Health, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuki Ideno
- Department of Laboratory Science and Environmental Health Sciences, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kunihiko Hayashi
- Department of Laboratory Science and Environmental Health Sciences, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
- * E-mail:
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Retroperitoneal Endometrioid Carcinoma Arising from Ureteral Endometriosis. Case Rep Obstet Gynecol 2019; 2019:9273858. [PMID: 31281695 PMCID: PMC6590549 DOI: 10.1155/2019/9273858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 05/28/2019] [Indexed: 01/27/2023] Open
Abstract
Primary ureteral endometriosis is considered to be an uncommon form with an incidence of less than 0.1% in endometriosis. We reported a case of retroperitoneal endometrioid carcinoma possibly arising from ureteral endometriosis. A 52-year-old woman complained left backache. A solid mass in left retroperitoneal cavity with hydronephrosis was found. Diagnostic laparotomy with bilateral salpingo-oophorectomy and biopsy of the mass were performed. Although the primary lesion was not defined in the surgery, the histopathological diagnosis of specimen was endometrioid carcinoma. In the interval debulking surgery after the chemotherapy, tumor adjacent the left iliac vessels was observed. We resected the mass together with 5 cm left ureter and performed ureterectomy and anastomosis. The patient was diagnosed as the malignant transformation of ureteral endometriosis. Adjuvant chemotherapy is now undergoing. In case of finding the cancer tissue in women, we should take into account the malignant transformation of less common endometriosis, including ureteral endometriosis.
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Cantor A, Tannus S, Son WY, Tan SL, Dahan MH. A comparison of two months pretreatment with GnRH agonists with or without an aromatase inhibitor in women with ultrasound-diagnosed ovarian endometriomas undergoing IVF. Reprod Biomed Online 2019; 38:520-527. [DOI: 10.1016/j.rbmo.2018.12.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/07/2018] [Accepted: 12/10/2018] [Indexed: 01/01/2023]
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Yen CF, Kim MR, Lee CL. Epidemiologic Factors Associated with Endometriosis in East Asia. Gynecol Minim Invasive Ther 2019; 8:4-11. [PMID: 30783582 PMCID: PMC6367920 DOI: 10.4103/gmit.gmit_83_18] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 01/11/2023] Open
Abstract
Aim With a perplexing pathogenesis and an incidence rate of approximately 10% among women of reproductive age, endometriosis affects more women in Asia than in any other continent in the world. This paper reviews the available data on the epidemiology and risk factors associated with endometriosis in East Asia. Methods Included studies were published between January 2000 and December 2016. Articles were required to include East Asian patients with a diagnosis of endometriosis and to study epidemiology, such as the prevalence and/or incidence, associated with inherited, environmental, and/or lifestyle factors. A total of 65 candidate articles were retrieved and 22 were included in the final review. Results Only one study provided an estimate of prevalence (6.8%). Short menstrual cycle, family history of endometriosis, and some genetic polymorphisms are associated with the risk of developing endometriosis. Smoking, lower body mass index, and lower parity associated with increased risk of endometriosis were suggested as modifiable factors. Limitations of this study include the poor quality of data identified, and the language barriers behind the study retrieval. Conclusions Data on the epidemiology of endometriosis in the East Asian populations are limited. The available data that examine potential genetic factors do not unveil whether such factors directly contribute to the increased risk of endometriosis. Further extensive studies on endometriosis in Asian women are required to improve the management of this disease.
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Affiliation(s)
- Chih-Feng Yen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Mee-Ran Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chyi-Long Lee
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Osuga Y, Torng PL, Jeng CJ. Clinical studies investigating the use of leuprorelin in Asian women with endometriosis: a review. J OBSTET GYNAECOL 2019; 39:291-296. [PMID: 30653368 DOI: 10.1080/01443615.2018.1460584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We aimed to examine how leuprorelin has been studied for the treatment of women with endometriosis in Asia. We conducted a literature search of PubMed, the Cochrane Library and ClinicalTrials.gov. This review includes randomised trials of women with endometriosis treated with leuprorelin in Asia. Phase I-IV clinical trials published between January 1 2000 and December 31 2016 and written in English were included. Four studies were identified, showing that leuprorelin significantly improves pain and quality of life. The oestrone and oestradiol levels are decreased by leuprorelin but can be increased using an 'add-back' therapy with conjugated equine oestrogen and methoxyprogesterone. Menopause is more common in women treated with leuprorelin. The bone mineral density is reduced in women treated with leuprorelin. There are limited studies investigating the use of leuprorelin for the treatment of endometriosis in Asian populations. However, the research that has been conducted supports the use of leuprorelin in an Asian population.
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Affiliation(s)
- Yutaka Osuga
- a Department of Obstetrics and Gynecology , University of Tokyo , Tokyo , Japan
| | - Pao-Ling Torng
- b Department of Obstetrics and Gynecology , National Taiwan University Hospital , Hsin-Chu , Taiwan
| | - Cherng-Jye Jeng
- c Department of Obstetrics and Gynecology , Kaoshiung Medical University Hospital , Kaohsiung , Taiwan.,d Department of Obstetrics and Gynecology, School of Medicine , Kaoshiung Medical University , Kaohsiung , Taiwan
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Taniguchi F, Uegaki T, Nakamura K, Mon KY, Harada T, Ohbayashi T, Harada T. Inhibition of IAP (inhibitor of apoptosis) proteins represses inflammatory status via
nuclear factor-kappa B pathway in murine endometriosis lesions. Am J Reprod Immunol 2017; 79. [DOI: 10.1111/aji.12780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/10/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Fuminori Taniguchi
- Department of Obstetrics and Gynecology; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Takashi Uegaki
- Department of Obstetrics and Gynecology; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Kazuomi Nakamura
- Division of Laboratory Animal Science; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Khine Yin Mon
- Department of Obstetrics and Gynecology; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Takashi Harada
- Department of Obstetrics and Gynecology; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Tetsuya Ohbayashi
- Division of Laboratory Animal Science; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology; Research Center for Bioscience and Technology; Tottori University Faculty of Medicine; Yonago Japan
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Harada T, Taniguchi F, Onishi K, Kurozawa Y, Hayashi K, Harada T. Obstetrical Complications in Women with Endometriosis: A Cohort Study in Japan. PLoS One 2016; 11:e0168476. [PMID: 28005934 PMCID: PMC5179019 DOI: 10.1371/journal.pone.0168476] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 12/01/2016] [Indexed: 02/03/2023] Open
Abstract
Background Endometriosis, which occurs in approximately 10% of women of reproductive age, is defined as the presence of endometrial tissue outside the uterus. Women with endometriosis are more likely to have difficulty conceiving and tend to receive infertility treatment, including assisted reproductive technology (ART) therapy. There has not yet been a prospective cohort study examining the effects of endometriosis on pregnancy outcome in pregnant Japanese women. Methodology This was a prospective cohort study of the incidence of obstetrical complications in women with endometriosis using data of the Japan Environment & Children’s Study (JECS). Included in this study were 9,186 pregnant women in the JECS with or without a history of endometriosis who gave birth or stillbirth or whose pregnancy was terminated with abortion between February and December 2011. Main Outcome Measures The effects of endometriosis on pregnancy outcome. Results Of the 9,186 pregnant women in the JECS, 4,119 (44.8%) had obstetrical complications; 330 participants reported a diagnosis of endometriosis before pregnancy, and these women were at higher risk for complications of pregnancy than those without a history of endometriosis (odds ratio (OR) = 1.50; 95% confidence interval (CI) 1.20 to 1.87). Logistic regression analyses showed that the adjusted OR for obstetrical complications of pregnant women who conceived naturally and had a history of endometriosis was 1.45 (CI 1.11 to 1.90). Among pregnant women with endometriosis, the ORs of preterm premature rupture of the membranes (PROM) and placenta previa were significantly higher compared with women never diagnosed with endometriosis who conceived naturally or conceived after infertility treatment, except for ART therapy (OR 2.14, CI 1.03–4.45 and OR 3.37, CI 1.32–8.65). Conclusions This study showed that endometriosis significantly increased the incidence of preterm PROM and placenta previa after adjusting for confounding of the data by ART therapy.
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Affiliation(s)
- Takashi Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Fuminori Taniguchi
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazunari Onishi
- Department of Public Health, Tottori University Faculty of Medicine, Yonago, Japan
| | - Youichi Kurozawa
- Department of Public Health, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kunihiko Hayashi
- Department of Laboratory Science and Environmental Health Sciences, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
- * E-mail:
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