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He X, Xie S, Liu Y. The association of circulating lipoprotein lipids and apolipoproteins with risk of endometriosis: a Mendelian randomization study. Postgrad Med J 2024; 100:578-583. [PMID: 38491971 DOI: 10.1093/postmj/qgae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Endometriosis is a poorly understood disease that affects up to 196 million women worldwide and imposes high costs in terms of economic burden and quality of life of women. Traits of circulating lipids have been related to the onset and progression of endometriosis in previous observational studies but the results have remained contradictory. METHODS We performed univariable and multivariable Mendelian randomization (MR) analyses using instrument variables to genetically predict the associations of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides, and apolipoprotein (apo) A-I and B from the UK Biobank with endometriosis (consisting of 8288 cases and 68 969 controls from the FinnGen consortium). The inverse-variance weighted (IVW) method was used as the primary estimate, whereas MR-Egger and weighted median were conducted as complements to the IVW model. RESULTS Increased levels of triglycerides were associated with higher risk of endometriosis and endometriosis of the pelvic peritoneum in the univariable MR analyses. In multivariable MR analysis including apoB, LDL cholesterol, and triglycerides in the same model, triglycerides still retained a robust effect. Decreased levels of apoA-I and HDL cholesterol were associated with increased risk of endometriosis and endometriosis of the pelvic peritoneum in univariable MR analyses. After mutual adjustment, HDL cholesterol retained a robust effect whereas the association for apoA-I was attenuated. CONCLUSIONS This is the first MR-based evidence to suggest that triglycerides and HDL cholesterol are the predominant traits that account for the aetiological relationship of lipoprotein lipids with risk of endometriosis, in particular endometriosis of the pelvic peritoneum. Further well-designed randomized controlled trials are needed to address these results.
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Affiliation(s)
- Xiwen He
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, College of Clinical Medicine, Chengdu, 610075, China
| | - Shengyu Xie
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Yi Liu
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, College of Clinical Medicine, Chengdu, 610075, China
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2
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Wang Z, Zhan C, Liao L, Luo Y, Lin S, Yan S. Bidirectional causality between the levels of blood lipids and endometriosis: a two-sample mendelian randomization study. BMC Womens Health 2024; 24:387. [PMID: 38965508 PMCID: PMC11223312 DOI: 10.1186/s12905-024-03213-w] [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: 12/14/2023] [Accepted: 06/18/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Observational studies have found a correlation between the levels of blood lipids and the development and progression of endometriosis (EM). However, the causality and direction of this correlation is unclear. This study aimed to examine the bidirectional connection between lipid profiles and the risk of EM using publicly available genome-wide association study (GWAS) summary statistics. METHODS Eligible exposure variables such as levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were selected using a two-sample Mendelian randomization (MR) analysis method following a series of quality control procedures. Data on EM were obtained from the publicly available Finnish database of European patients. Inverse variance weighted (IVW), MR Egger, weighted median, and weighted mode methods were used to analyze the causal relationship between lipid exposure and EM, exclude confounders, perform sensitivity analyses, and assess the stability of the results. Reverse MR analyses were performed with EM as exposure and lipid results as study outcomes. RESULTS IVW analysis results identified HDL as a protective factor for EM, while TG was shown to be a risk factor for EM. Subgroup analyses based on the site of the EM lesion identified HDL as a protective factor for EM of the uterus, while TG was identified a risk factor for the EM of the fallopian tube, ovary, and pelvic peritoneum. Reverse analysis did not reveal any effect of EM on the levels of lipids. CONCLUSION Blood lipids, such as HDL and TG, may play an important role in the development and progression of EM. However, EM does not lead to dyslipidemia.
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Affiliation(s)
- Zhenna Wang
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Chunxian Zhan
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Linghua Liao
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Ye Luo
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Shunhe Lin
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China.
| | - Shihan Yan
- Department of Gynaecology and Obstetrics , Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18, Daoshan Road, Gulou District, Fuzhou City, Fujian Province, China
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3
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Brinca AT, Peiró AM, Evangelio PM, Eleno I, Oliani AH, Silva V, Vicente LF, Ramalhinho AC, Gallardo E. Follicular Fluid and Blood Monitorization of Infertility Biomarkers in Women with Endometriosis. Int J Mol Sci 2024; 25:7177. [PMID: 39000283 PMCID: PMC11241429 DOI: 10.3390/ijms25137177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Infertility is recognized globally as a social disease and a growing medical condition, posing a significant challenge to modern reproductive health. Endometriosis, the third-most frequent gynecologic disorder, is one of the most common and intricate conditions that can lead to female infertility. Despite extensive research, the etiology, malignant transformation, and biological therapy of endometriosis remain unknown. Blood and follicular fluid are two matrices that have been carefully studied and can provide insights into women's health. These matrices are clinically significant because they contain metabolites closely associated with women's illness stage and reproductive outcomes. Nowadays, the application of metabolomic analysis in biological matrices may be able to predict the outcome of assisted reproductive technologies with greater precision. From a molecular viewpoint on reproductive health, we evaluate and compare the utilization of human follicular fluid and blood as matrices in analysis for diagnostic and assisted reproductive technology (ART) predictors of success for endometriosis patients. In the follicular fluid (FF), plasma, and serum of endometriosis-affected women, researchers identified dysregulations of oxidative stress, upregulation of several immune factors, and aberrations in energy metabolic pathways. The altered signatures negatively correlate with the overall oocyte and embryo quality and fertilization rate.
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Affiliation(s)
- Ana Teresa Brinca
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal;
| | - Ana Maria Peiró
- Pharmacogenetic Unit, Clinical Pharmacology Department, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, 03010 Alicante, Spain;
- Institute of Bioengineering, Miguel Hernández University, 03202 Elche, Spain
| | | | - Irene Eleno
- Unidad de Reproduccion, Servicio de Ginecologia y Obstetricia, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain;
| | - Antonio Helio Oliani
- Assisted Reproduction Laboratory, Cova da Beira Local Health Unit, 6200-251 Covilhã, Portugal;
- São José do Rio Preto School of Medicine, Gynaecology and Obstetrics, São José do Rio Preto 15090-000, Brazil
| | - Vladimiro Silva
- Ferticentro—Centro de Estudos de Fertilidade S.A., 3000-316 Coimbra, Portugal;
- Procriar—Centro de Procriação Medicamente Assistida, 4100-130 Porto, Portugal
| | | | - Ana Cristina Ramalhinho
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal;
- Assisted Reproduction Laboratory, Cova da Beira Local Health Unit, 6200-251 Covilhã, Portugal;
| | - Eugenia Gallardo
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal;
- Laboratório de Fármaco-Toxicologia, UBIMedical, University of Beira Interior, 6200-284 Covilhã, Portugal
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4
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Wei Y, Zhang Z, Zhang Y, Li J, Ruan X, Wan Q, Yin T, Zou Y, Chen S, Zhang Y. Nontargeted metabolomics analysis of follicular fluid in patients with endometriosis provides a new direction for the study of oocyte quality. MedComm (Beijing) 2023; 4:e302. [PMID: 37265938 PMCID: PMC10229744 DOI: 10.1002/mco2.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/03/2023] Open
Abstract
Endometriosis is a common, estrogen-dependent chronic gynecological disease that endangers the reproductive system and systemic metabolism of patients. We aimed to investigate the differences in metabolic profiles in the follicular fluid between infertile patients with endometriosis and controls. A total of 25 infertile patients with endometriosis and 25 infertile controls who were similar in age, BMI, fertilization method and ovulation induction treatment were recruited in this study. Metabolomics analysis of follicular fluid was performed by two methods of high-performance liquid chromatography tandem mass spectrometry. There were 36 upregulated and 17 downregulated metabolites in the follicular fluid of patients in the endometriosis group. KEGG pathway analysis revealed that these metabolites were enriched in phenylalanine, tyrosine and tryptophan biosynthesis, aminoacyl-tRNA biosynthesis, phenylalanine metabolism and pyrimidine metabolism pathways. A biomarker panel consisting of 20 metabolites was constructed by random forest, with an accuracy of 0.946 and an AUC of 0.988. This study characterizes differences in follicular fluid metabolites and associated pathway profiles in infertile patients with endometriosis. These findings can provide a better comprehensive understanding of the disease and a new direction for the study of oocyte quality, as well as potential metabolic markers for the prognosis of endometriosis.
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Affiliation(s)
- Yiqiu Wei
- Reproductive Medicine CenterRenmin Hospital of Wuhan UniversityWuhanHubeiChina
| | - Zhourui Zhang
- The Institute for Advanced StudiesWuhan UniversityWuhanHubeiChina
| | - Yaoyao Zhang
- Department of Obstetrics and GynecologyKey Laboratory of Birth Defects and Related of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan UniversityChengduSichuanChina
| | - Jianan Li
- Reproductive Medicine CenterRenmin Hospital of Wuhan UniversityWuhanHubeiChina
| | - Xianqin Ruan
- The Institute for Advanced StudiesWuhan UniversityWuhanHubeiChina
| | - Qiongqiong Wan
- The Institute for Advanced StudiesWuhan UniversityWuhanHubeiChina
| | - Tailang Yin
- Reproductive Medicine CenterRenmin Hospital of Wuhan UniversityWuhanHubeiChina
| | - Yujie Zou
- Reproductive Medicine CenterRenmin Hospital of Wuhan UniversityWuhanHubeiChina
| | - Suming Chen
- The Institute for Advanced StudiesWuhan UniversityWuhanHubeiChina
| | - Yan Zhang
- Department of Clinical LaboratoryRenmin Hospital of Wuhan UniversityWuhanHubeiChina
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5
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Dai Y, Lin X, Liu N, Shi L, Zhuo F, Huang Q, Gu W, Zhao F, Zhang Y, Zhang Y, Pan Y, Zhang S. Integrative analysis of transcriptomic and metabolomic profiles reveals abnormal phosphatidylinositol metabolism in follicles from endometriosis‐associated infertility patients. J Pathol 2023. [PMID: 36992523 DOI: 10.1002/path.6079] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/15/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023]
Abstract
Endometriosis is a common gynecological disorder that causes female infertility. Our recent research found that excessive oxidative stress in ovaries of endometriosis patients induced senescence of cumulus granulosa cells. Here, we analyzed the transcriptomic and metabolomics profiles of follicles in a mouse model of endometriosis and in patients with endometriosis and investigated the potential function of changed metabolites in granulosa cells. RNA-sequencing indicated that both endometriosis lesions and oxidative stress in mice induced abnormalities of reactive oxidative stress, steroid hormone biosynthesis, and lipid metabolism. The mouse model and women with endometriosis showed altered lipid metabolism. Nontargeted metabolite profiling of follicular fluid from endometriosis and male-factor infertility patients by liquid chromatography mass spectrometry identified 55 upregulated and 67 downregulated metabolites. These differential metabolites were mainly involved in steroid hormone biosynthesis and glycerophospholipid metabolism. Phosphatidylinositol (PI 16:0/18:2) was significantly elevated in follicular fluid from endometriosis patients compared with controls (p < 0.05), while lysophosphatidylinositol (LPI 18:2, 20:2, 18:1, 20:3 and 18:3) was reduced (p < 0.05). Upregulated PI and downregulated LPI correlated with oocyte retrieval number and mature oocyte number. LPI inhibited cellular reactive oxidative stress induced by hemin in granulosa cells. Cell proliferation inhibition, senescence, and apoptosis induced by hemin were partially reversed by LPI. Moreover, LPI administration rescued hemin blocking of cumulus-oocyte complex expansion and stimulated expression of ovulation-related genes. Transcriptomic Switching mechanism at 5' end of the RNA transcript sequencing and western blot revealed that LPI effects on granulosa cells were associated with its regulation of MAPK-ERK1/2 signaling, which was suppressed in the presence of hemin. In conclusion, our results revealed the dysregulation of lipid metabolism in endometriotic follicles. LPI may represent a novel agent for in vitro follicular culture that reverses the excessive oxidative stress from endometriotic lesions. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Yongdong Dai
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Xiang Lin
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Na Liu
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Libing Shi
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Feng Zhuo
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Qianmeng Huang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Weijia Gu
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Fanxuan Zhao
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Yi Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Yinli Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Yinbin Pan
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
| | - Songying Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, PR China
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6
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Gas Chromatography-Mass Spectrometry (GC-MS) Metabolites Analysis in Endometriosis Patients: A Prospective Observational Translational Study. J Clin Med 2023; 12:jcm12030922. [PMID: 36769570 PMCID: PMC9918082 DOI: 10.3390/jcm12030922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/04/2023] [Accepted: 01/14/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Endometriosis affects women of reproductive age, and its pathogenesis is still unclear. Typically, it overlaps other similar medical and surgical conditions, determining a delay in early diagnosis. Metabolomics allows studying metabolic changes in different physiological or pathological states to discover new potential biomarkers. We used the gas chromatography-mass spectrometer (GC-MS) to explore metabolic alterations in endometriosis to better understand its pathophysiology and find new biomarkers. METHODS Twenty-two serum samples of patients with symptomatic endometriosis and ten without it were collected and subjected to GC-MS analysis. Multivariate and univariate statistical analyses were performed, followed by pathway analysis. RESULTS Partial least squares discriminant analysis was performed to determine the differences between the two groups (p = 0.003). Threonic acid, 3-hydroxybutyric acid, and proline increased significantly in endometriosis patients, while alanine and valine decreased. ROC curves were built to test the diagnostic power of metabolites. The pathway analysis identified the synthesis and degradation of ketone bodies and the biosynthesis of phenylalanine, tyrosine, and tryptophan as the most altered pathways. CONCLUSIONS The metabolomic approach identifies metabolic alterations in women with endometriosis. These findings may improve our understanding of the pathophysiological mechanisms of disease and the discovery of new biomarkers.
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Kartsova LA, Bessonova EA, Deev VA, Kolobova EA. Current Role of Modern Chromatography with Mass Spectrometry and Nuclear Magnetic Resonance Spectroscopy in the Investigation of Biomarkers of Endometriosis. Crit Rev Anal Chem 2023:1-24. [PMID: 36625278 DOI: 10.1080/10408347.2022.2156770] [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: 01/11/2023]
Abstract
Endometriosis has a wide range of clinical manifestations, and the disease course is unpredictable, making the diagnosis a challenging task. Despite significant advances in the pathophysiology of endometriosis and various proposed theories, the exact etiology is not fully understood and is still unknown. The most commonly used biomarker of endometriosis is CA-125, however, it is nonspecific and is applied for cancers diagnosis. Therefore, the development of reliable noninvasive diagnostic tests for the early diagnosis of endometriosis remains one of the top priorities. Omics technologies are very promising approaches for constructing diagnostic models and biomarker discovery. Their use can greatly facilitate the study of such a complex disease as endometriosis. Nowadays, powerful analytical platforms commonly used in omics, such as gas and liquid chromatography with mass spectrometry and nuclear magnetic resonance (NMR) spectroscopy, have proven to be a promising tools for biomarker discovery. The aim of this review is to summarize the various features of the analytical approaches, practical challenges and features of gas and liquid chromatography with MS and NMR spectroscopy (including sample processing protocols, technological advancements, and methodology) used for profiling of metabolites, lipids, peptides and proteins in physiological fluids and tissues from patients with endometriosis. In addition, this report devotes special attention to the issue of how comprehensive analyses of these profiles can effectively contribute to the study of endometriosis. The search query included reports published between 2012 and 2022 years in PubMed, Web-of-Science, SCOPUS, Science Direct.
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Affiliation(s)
| | | | | | - Ekaterina Alekseevna Kolobova
- Institute of Chemistry, St. Petersburg State University, St. Petersburg, Russia
- The Federal State Institute of Public Health 'The Nikiforov Russian Center of Emergency and Radiation Medicine', The Ministry of Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters, St. Petersburg, Russia
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Liu J, Yang D, Piao C, Wang X, Sun X, Li Y, Zhang S, Wu X. UPLC-Q-TOF/MS Based Plasma Metabolomics for Identification of Paeonol's Metabolic Target in Endometriosis. Molecules 2023; 28:molecules28020653. [PMID: 36677710 PMCID: PMC9864815 DOI: 10.3390/molecules28020653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Endometriosis is a common gynecological illness in women of reproductive age that significantly decreases life quality and fertility. Paeonol has been shown to play an important part in endometriosis treatments. Understanding the mechanism is critical for treating endometriosis. In this study, autologous transplantation combined with a 28 day ice water bath was used to create a rat model of endometriosis with cold clotting and blood stagnation. The levels of estradiol and progesterone in plasma were detected by ELISA, and the pathological changes of ectopic endometrial tissue were examined by H&E staining, which proved the efficacy of paeonol. For metabolomic analysis of plasma samples, UPLC-Q/TOF-MS was combined with multivariate statistical analysis to identify the influence of paeonol on small molecule metabolites relevant to endometriosis. Finally, the key targets were screened using a combination of network pharmacology and molecular docking approaches. The results showed that the pathological indexes of rats were improved and returned to normal levels after treatment with paeonol, which was the basis for confirming the efficacy of paeonol. Metabolomics results identified 13 potential biomarkers, and paeonol callbacks 7 of them, involving six metabolic pathways. Finally, four key genes were found for paeonol therapy of endometriosis, and the results of molecular docking revealed a significant interaction between paeonol and the four key genes. This study was successful in establishing a rat model of endometriosis with cold coagulation and blood stagnation. GCH1, RPL8, PKLR, and MAOA were the key targets of paeonol in the treatment of endometriosis. It is also demonstrated that metabolomic techniques give the potential and environment for comprehensively understanding drug onset processes.
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Affiliation(s)
- Jing Liu
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Dongxia Yang
- Department of Gynecology Medicine, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China
| | - Chengyu Piao
- Good Laboratory Practice of Drug, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Xu Wang
- Good Laboratory Practice of Drug, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Xiaolan Sun
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Yongyan Li
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Shuxiang Zhang
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Xiuhong Wu
- College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
- Correspondence: ; Tel.: +86-451-82193278
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9
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Tomkins NE, Girling JE, Boughton B, Holdsworth-Carson SJ. Is there a role for small molecule metabolite biomarkers in the development of a diagnostic test for endometriosis? Syst Biol Reprod Med 2022; 68:89-112. [PMID: 35361022 DOI: 10.1080/19396368.2022.2027045] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
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.
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Affiliation(s)
- Nicola E Tomkins
- Department of Obstetrics and Gynaecology, The University of Melbourne and Gynaecology Research Centre, The Royal Women's Hospital, Parkville, Australia
| | - Jane E Girling
- Department of Obstetrics and Gynaecology, The University of Melbourne and Gynaecology Research Centre, The Royal Women's Hospital, Parkville, Australia.,Department of Anatomy, The University of Otago, Dunedin, Aotearoa New Zealand
| | - Berin Boughton
- Australian National Phenome Centre, Murdoch University, Murdoch, Australia
| | - Sarah J Holdsworth-Carson
- Department of Obstetrics and Gynaecology, The University of Melbourne and Gynaecology Research Centre, The Royal Women's Hospital, Parkville, Australia.,Julia Argyrou Endometriosis Centre, Epworth HealthCare, Richmond, Australia
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10
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Sasamoto N, Zeleznik OA, Vitonis AF, Missmer SA, Laufer MR, Avila-Pacheco J, Clish CB, Terry KL. Presurgical blood metabolites and risk of postsurgical pelvic pain in young patients with endometriosis. Fertil Steril 2022; 117:1235-1245. [PMID: 35367064 PMCID: PMC9149031 DOI: 10.1016/j.fertnstert.2022.02.012] [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: 11/19/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To identify metabolites in presurgical blood associated with risk of persistent postsurgical pelvic pain 1 year after endometriosis surgery in adolescent and young adult patients. DESIGN Prospective observational study within the Women's Health Study: From Adolescence to Adulthood, a US-based longitudinal cohort of adolescents and women enrolled from 2012-2018. SETTING Two tertiary care hospitals. PATIENT(S) Laparoscopically confirmed endometriosis patients (n = 180) with blood collected before their endometriosis surgery. Of these, 77 patients additionally provided blood samples 5 weeks to 6 months after their surgery. We measured plasma metabolites using liquid chromatography tandem mass spectrometry, and a total of 390 known metabolites were included in our analysis. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Persistent postsurgical pelvic pain, defined as severe, life-impacting pelvic pain 1 year after endometriosis surgery. RESULT(S) Most patients (>95%) were at stage I/II of the revised American Society for Reproductive Medicine classification. Their average age at diagnosis was 18.7 years, with 36% reporting persistent postsurgical pelvic pain. Of the 21 metabolites in presurgical blood that were associated with risk of persistent postsurgical pelvic pain, 19 metabolites, which were mainly lipid metabolites, were associated with increased risk. Only 2 metabolites-pregnenolone sulfate (odds ratio = 0.64, 95% confidence interval = 0.44-0.92) and fucose (odds ratio = 0.69, 95% confidence interval = 0.47-0.97)-were associated with decreased risk. Metabolite set enrichment analysis revealed that higher levels of lysophosphatidylethanolamines (false discovery rate = 0.01) and lysophosphatidylcholines (false discovery rate = 0.01) in presurgical blood were associated with increased risk of persistent postsurgical pelvic pain. CONCLUSION(S) Our results suggest that dysregulation of multiple groups of lipid metabolites may play a role in the persistence of pelvic pain postsurgery among young endometriosis patients.
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Affiliation(s)
- Naoko Sasamoto
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts.
| | - Oana A Zeleznik
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Allison F Vitonis
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts
| | - Stacey A Missmer
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan
| | - Marc R Laufer
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts; Division of Gynecology, Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Clary B Clish
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Kathryn L Terry
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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11
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Song W, Zhang Z, Jiang Y, Cao Y, Zhang B, Wang Y, Shi H, Zhu L. Integrative metabolomic profiling reveals aberrations in myometrium associated with adenomyosis: a pilot study. Reprod Biol Endocrinol 2022; 20:49. [PMID: 35264202 PMCID: PMC8905769 DOI: 10.1186/s12958-022-00914-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/20/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Uterine adenomyosis is a common gynecologic disease in premenopausal women, the pathological mechanism of which remains largely unknown. The aim of this study was to identify metabolic biomarkers significantly altered in the myometrium of adenomyosis patients. METHODS The comprehensive metabolomic profiles of 17 myometrium specimens from adenomyosis patients and 25 control specimens were analyzed using untargeted approach by combination of gas chromatography-mass spectrometry and high performance liquid chromatography-mass spectrometry. Metabolic data were filtered using orthogonal partial least square-discriminant analysis and univariate statistics. RESULTS We firstly demonstrated that the myometrial metabolome of women with adenomyosis is distinct from that of women without adenomyosis. A total of 106 metabolites, mainly including nucleosides, lipids (including acylcarnitines), amino acids, organic acids and carbohydrates, were found to be differentially expressed in myometrium of uteri with adenomyosis compared to the control subjects. Functional inferences of these perturbed metabolites indicated that inflammation, oxidative stress, cell proliferation and apoptosis, and energy metabolism appeared to be involved in the progress of adenomyosis. CONCLUSION This study firstly described the integrated metabolic signatures of the adenomyosis uterus, which provided novel insights for the pathogenesis study of this disease.
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Affiliation(s)
- Wei Song
- grid.506261.60000 0001 0706 7839Medical Science Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730 China
| | - Zhibo Zhang
- grid.506261.60000 0001 0706 7839Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Disease, Beijing, 100730 China
| | - Ying Jiang
- grid.506261.60000 0001 0706 7839Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730 China
| | - Yang Cao
- grid.506261.60000 0001 0706 7839Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Disease, Beijing, 100730 China
| | - Bo Zhang
- grid.506261.60000 0001 0706 7839Medical Science Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730 China
| | - Yujie Wang
- grid.506261.60000 0001 0706 7839Medical Science Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730 China
| | - Honghui Shi
- grid.506261.60000 0001 0706 7839Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Disease, Beijing, 100730 China
| | - Lan Zhu
- grid.506261.60000 0001 0706 7839Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Disease, Beijing, 100730 China
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12
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Marchandot B, Curtiaud A, Matsushita K, Trimaille A, Host A, Faller E, Garbin O, Akladios C, Jesel L, Morel O. Endometriosis and cardiovascular disease. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac001. [PMID: 35919664 PMCID: PMC9242051 DOI: 10.1093/ehjopen/oeac001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/13/2021] [Indexed: 11/21/2022]
Abstract
Endometriosis is a chronic gynaecological disease affecting 1 in 10 reproductive-age women. It is defined as the presence of endometrium-like tissue outside the uterus. Beyond this placid anatomical definition, endometriosis is a complex, hormonal, inflammatory, and systemic condition that poses significant familial, psychological, and economic burden. The interaction between the cardiovascular system and endometriosis has become a field of interest as the underlying mutual mechanisms become better understood. On the basis of accumulating fundamental and clinical evidence, it is likely that there exists a close relationship between endometriosis and the cardiovascular system. Therefore, investigating the endometriosis-cardiovascular interaction is highly clinically significant. In this review, we highlight our current understanding of the pathophysiology of endometriosis with systemic hormonal, pro-inflammatory, pro-angiogenic, immunologic, and genetic processes beyond the peritoneal microenvironment. Additionally, we provide current clinical evidence about how endometriosis interacts with cardiovascular risk factors and cardiovascular disease (CVD). To date, only small associations between endometriosis and CVD have been reported in observational studies, inherently limited by the potential influence of unmeasured confounding. Cardiovascular disease in women with endometriosis remains understudied, under-recognized, and underdiagnosed. More detailed study of the cardiovascular-endometriosis interaction is needed to fully understand its clinical relevance, underlying pathophysiology, possible means of early diagnosis and prevention.
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Affiliation(s)
- Benjamin Marchandot
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Anais Curtiaud
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Kensuke Matsushita
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Antonin Trimaille
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Aline Host
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Emilie Faller
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Olivier Garbin
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Chérif Akladios
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
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13
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Li Q, Yuan M, Jiao X, Ji M, Huang Y, Li J, Li D, Wang G. Metabolite profiles in the peritoneal cavity of endometriosis patients and mouse models. Reprod Biomed Online 2021; 43:810-819. [PMID: 34538753 DOI: 10.1016/j.rbmo.2021.06.029] [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: 02/11/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION Which metabolites are altered in the peritoneal cavity of women with endometriosis? Could the mouse endometriosis model simulate these alterations? DESIGN Thirteen women with endometriosis and seven women with other benign gynaecological diseases, who underwent laparoscopic surgery, were included in this study. None had received hormonal therapy for 3 months before surgery. For the animal experiments, six and five mice were included in the endometriosis and control groups, respectively. Peritoneal fluid from the patients and peritoneal lavage fluid from the mice was collected and analysed. Non-targeted metabolomics via liquid chromatography with tandem mass spectrometry was used to identify the altered metabolites in the peritoneal fluid of endometriosis patients and mouse models. MetaboAnalyst 4.0 was used to visualize the data. RESULTS Several metabolites in the peritoneal cavity were significantly altered in both humans and mice with endometriosis. Concentrations of lysophosphatidylcholine (LysopC) (P=0.017 in patients and P=0.041 in the mouse model) and derivatives of phosphoethanolamine (1-arachidonoyl-sn-glycero-3-phosphoethanolamine in patients, P=0.027; 1-oleoyl-sn-glycero-3-phosphoethanolamine in patients, P=0.0086; and phosphorylethanolamine in the mouse model, P=0.0027) were significantly up-regulated in both, whereas concentrations of acylcarnitines (l-palmitoylcarnitine, P=0.047; and stearoylcarnitine, P=0.029) and kynurenine (P=0.045) were significantly increased only in humans. The human and mouse samples shared three altered enriched metabolite sets. CONCLUSIONS Women with endometriosis show an altered metabolic state in the abdominal cavity. The endometriosis mouse model shared half of the significantly altered metabolite sets found in the abdominal cavity of humans.
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Affiliation(s)
- Qiuju Li
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Ming Yuan
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Xue Jiao
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Miaomiao Ji
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Yufei Huang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Jing Li
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Dong Li
- Cryomedicine Laboratory, Qilu Hospital of Shandong University, People's Republic of China
| | - Guoyun Wang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, People's Republic of China.
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14
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Tempest N, Hill CJ, Whelan A, De Silva A, Drakeley AJ, Phelan MM, Hapangama DK. Symptomatology and Serum Nuclear Magnetic Resonance Metabolomics; Do They Predict Endometriosis in Fertile Women Undergoing Laparoscopic Sterilisation? A Prospective Cross-sectional Study. Reprod Sci 2021; 28:3480-3490. [PMID: 34524640 PMCID: PMC8580895 DOI: 10.1007/s43032-021-00725-w] [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: 03/01/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
Endometriosis is a common, chronic inflammatory condition, thought to have a higher incidence in symptomatic women, yet, commonly associated symptoms do not always correlate with the presence or severity of disease and diagnosis requires surgery. We prospectively collected data and assessed symptomology and NMR spectroscopy-based metabolomics of 102 women undergoing laparoscopic sterilisation at a tertiary referral centre in a cross-sectional study. Twelve women were incidentally diagnosed with endometriosis (11.7%). According to the pre-operative questionnaire, presence and absence of many symptoms usually attributed to endometriosis were declared at similar frequencies in women with or without endometriosis. Women with endometriosis reported apparently more persistent heavy periods (50% vs 18.9%), prolonged periods (25% versus 7.8%) and problems conceiving (27.3% versus 9%) than those without endometriosis. NMR could not discern any distinguishable differences in the serum metabolome between those with and without endometriosis. Our paper highlights the complex symptomology experienced by women, regardless of a surgical diagnosis of endometriosis. Previous literature and the current study failed to identify clear, distinguishable symptoms or biomarkers pertinent to surgically confirmed endometriosis in the general population. Therefore, development of effective, non-invasive tests for identifying this heterogenous benign condition, endometriosis, is likely to be challenging.
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Affiliation(s)
- Nicola Tempest
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK. .,Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK. .,Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital NHS Foundation Trust, Liverpool, L8 7SS, UK.
| | - C J Hill
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK
| | - A Whelan
- Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
| | - A De Silva
- Department of Obstetrics, Gynaecology and Women's Health, University of Otago, 23A Mein Street, Newtown, Wellington, 6021, New Zealand
| | - A J Drakeley
- Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital NHS Foundation Trust, Liverpool, L8 7SS, UK
| | - M M Phelan
- HLS Technology Directorate, University of Liverpool, Liverpool, L69 3BX, UK.,Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - D K Hapangama
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University Department, Liverpool Women's Hospital, University of Liverpool, Member of Liverpool Health Partners, Crown Street, Liverpool, L8 7SS, UK.,Liverpool Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, L8 7SS, UK
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15
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Loy SL, Zhou J, Cui L, Tan TY, Ee TX, Chern BSM, Chan JKY, Lee YH. Discovery and validation of peritoneal endometriosis biomarkers in peritoneal fluid and serum. Reprod Biomed Online 2021; 43:727-737. [PMID: 34446375 DOI: 10.1016/j.rbmo.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/31/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022]
Abstract
RESEARCH QUESTION What are the potential biomarkers for peritoneal endometriosis in peritoneal fluid and serum? DESIGN Case-control studies composed of independent discovery and validation sets were conducted. In the discovery set, untargeted liquid chromatography-mass spectrometry (LC-MS/MS) metabolomics, multivariable and univariable analyses were conducted to generate global metabolomic profiles of peritoneal fluid for endometriosis and to identify potential metabolites that could distinguish peritoneal endometriosis (n = 10) from controls (n = 31). The identified metabolites from the discovery set were validated in independent peritoneal fluid (n =19 peritoneal endometriosis and n = 20 controls) and serum samples (n = 16 peritoneal endometriosis and n = 19 controls) using targeted metabolomics. The area under the receiver-operating characteristics curve (AUC) analysis was used to evaluate the diagnostic performance of peritoneal endometriosis metabolites. RESULTS In the discovery set, peritoneal fluid phosphatidylcholine (34:3) and phenylalanyl-isoleucine were significantly increased in peritoneal endometriosis groups compared with control groups, with AUC 0.77 (95% CI 0.61 to 0.92; P = 0.018) and AUC 0.98 (95% CI 0.95 to 1.02; P < 0.001), respectively. In the validation set, phenylalanyl-isoleucine retained discriminatory performance to distinguish peritoneal endometriosis from controls in both peritoneal fluid (AUC 0.77, 95% CI 0.61 to 0.92; P = 0.006) and serum samples (AUC 0.81, 95% CI 0.64 to 0.99; P = 0.004), with notably stronger discrimination between peritoneal endometriosis and controls in proliferative phase. CONCLUSION Our preliminary results propose phenylalanyl-isoleucine as a potential biomarker of peritoneal endometriosis, which may be used as a minimally invasive diagnostic biomarker of peritoneal endometriosis.
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Affiliation(s)
- See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899; Obstetrics and Gynaecology-Academic Clinical Program, Duke-NUS Medical School, Singapore 169857
| | - Jieliang Zhou
- KK Research Centre, KK Women's and Children's Hospital, Singapore 229899
| | - Liang Cui
- KK Research Centre, KK Women's and Children's Hospital, Singapore 229899; Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #04-13/14 Enterprise Wing, Singapore 138602
| | - Tse Yeun Tan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899
| | - Tat Xin Ee
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899
| | - Bernard Su Min Chern
- Obstetrics and Gynaecology-Academic Clinical Program, Duke-NUS Medical School, Singapore 169857; Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore 229899
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899; Obstetrics and Gynaecology-Academic Clinical Program, Duke-NUS Medical School, Singapore 169857
| | - Yie Hou Lee
- Obstetrics and Gynaecology-Academic Clinical Program, Duke-NUS Medical School, Singapore 169857; KK Research Centre, KK Women's and Children's Hospital, Singapore 229899; Singapore-MIT Alliance for Research and Technology, 1 CREATE Way, #04-13/14 Enterprise Wing, Singapore 138602.
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Abstract
A clinically reliable non-invasive test for endometriosis is expected to reduce the diagnostic delay. Although varieties of biomarkers have been investigated for decades, and cancer antigen-125, cancer antigen-199, interleukin-6, and urocortin were the most studied ones among hundreds of biomarkers, no clinically reliable biomarkers have been confirmed so far. Some emerging technologies including “omics” technologies, molecular imaging techniques, and microRNAs are promising in solving these challenges, but their utility to detect endometriosis has yet to be verified. New combinations of researched indicators or other non-invasive methods and further exploration of the emerging technologies may be new targets and future research hotspots for non-invasive diagnosis of endometriosis. In conclusion, researches of biomarkers for the detection of endometriosis are still ongoing and may benefit from novel molecular biology, bioinformatics methods and a combination of more diverse monitoring methods. Though it will be a daunting task, the identification of a specific set of diagnostic biomarkers will undoubtedly improve the status of endometriosis.
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17
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Ortiz CN, Torres-Reverón A, Appleyard CB. Metabolomics in endometriosis: challenges and perspectives for future studies. REPRODUCTION AND FERTILITY 2021; 2:R35-R50. [PMID: 35128453 PMCID: PMC8812441 DOI: 10.1530/raf-20-0047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
Endometriosis is a complex disease characterized by inflammation and the growth of endometrial- like glands and stroma outside the uterine cavity. The pathophysiology of endometriosis is not entirely understood, however, with a prevalence of ~10% of women in their reproductive years, the disease symptoms significantly affect the quality of life of millions of women globally. Metabolomic studies have previously identified specific metabolites that could be a signature of endometriosis. This approach could potentially be used as a non-invasive tool for early diagnosis and provide a better understanding of endometriosis pathophysiology. This review aims to provide insight as to how endometriosis affects the metabolome by reviewing different studies that have used this approach to design follow-up studies. The search query included the term 'endometriosis' in combination with 'metabolomics', 'lipidomics', or 'sphingolipidomics' published between 2012 and 2020. We included studies in humans and animal models. Most studies reported differences in the metabolome of subjects with endometriosis in comparison to healthy controls and used samples taken from serum, endometrial tissue, follicular fluid, urine, peritoneal fluid, or endometrial fluid. Statistically significant metabolites contributed to group separation between patients and healthy controls. Reported metabolites included amino acids, lipids, organic acids, and other organic compounds. Differences in methods, analytical techniques, and the presence of confounding factors can interfere with results and interpretation of data. Metabolomics seems to be a promising tool for identifying significant metabolites in patients with endometriosis. Nonetheless, more investigation is needed in order to understand the significance of the study results.
Lay summary
Endometriosis is a chronic disease affecting the quality of life in one out of every ten women during their reproductive years, causing pain and infertility. It is characterized by inflammation and growth of tissue like the endometrium (uterus lining) outside the uterine cavity. Studies have searched for a predictor of endometriosis-associated changes by observing small molecules necessary for metabolism on a large scale (metabolomics). Metabolomics could serve to resolve one of the biggest challenges that patients with endometriosis face: a delay in diagnosis. In this review, the authors summarize identified potential biomarkers from various bodily fluids and tissues that are characteristic of metabolic processes observed in endometriosis. Biomarkers include cell growth, cell survival, high energy demand, oxidative stress, and fatty acid levels. A metabolomics approach offers promise as a non-invasive tool to identify significant metabolite changes in patients with endometriosis, potentially leading to earlier diagnoses and new opportunities for back-translational strategies.
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Affiliation(s)
- Camila N Ortiz
- Department of Basic Sciences, Ponce Health Sciences University, Ponce Research Institute, Ponce, Puerto Rico, USA
| | | | - Caroline B Appleyard
- Department of Basic Sciences, Ponce Health Sciences University, Ponce Research Institute, Ponce, Puerto Rico, USA
- Department of Internal Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, USA
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Tokarz J, Adamski J, Lanišnik Rižner T. Metabolomics for Diagnosis and Prognosis of Uterine Diseases? A Systematic Review. J Pers Med 2020; 10:294. [PMID: 33371433 PMCID: PMC7767462 DOI: 10.3390/jpm10040294] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/08/2020] [Accepted: 12/18/2020] [Indexed: 12/24/2022] Open
Abstract
This systematic review analyses the contribution of metabolomics to the identification of diagnostic and prognostic biomarkers for uterine diseases. These diseases are diagnosed invasively, which entails delayed treatment and a worse clinical outcome. New options for diagnosis and prognosis are needed. PubMed, OVID, and Scopus were searched for research papers on metabolomics in physiological fluids and tissues from patients with uterine diseases. The search identified 484 records. Based on inclusion and exclusion criteria, 44 studies were included into the review. Relevant data were extracted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist and quality was assessed using the QUADOMICS tool. The selected metabolomics studies analysed plasma, serum, urine, peritoneal, endometrial, and cervico-vaginal fluid, ectopic/eutopic endometrium, and cervical tissue. In endometriosis, diagnostic models discriminated patients from healthy and infertile controls. In cervical cancer, diagnostic algorithms discriminated patients from controls, patients with good/bad prognosis, and with/without response to chemotherapy. In endometrial cancer, several models stratified patients from controls and recurrent from non-recurrent patients. Metabolomics is valuable for constructing diagnostic models. However, the majority of studies were in the discovery phase and require additional research to select reliable biomarkers for validation and translation into clinical practice. This review identifies bottlenecks that currently prevent the translation of these findings into clinical practice.
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Affiliation(s)
- Janina Tokarz
- Research Unit Molecular Endocrinology and Metabolism, Helmholtz Zentrum München, German Research Centre for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; (J.T.); (J.A.)
| | - Jerzy Adamski
- Research Unit Molecular Endocrinology and Metabolism, Helmholtz Zentrum München, German Research Centre for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; (J.T.); (J.A.)
- German Centre for Diabetes Research, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, 85764 Neuherberg, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117596, Singapore
| | - Tea Lanišnik Rižner
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Guralp O, Kaya B, Tüten N, Kucur M, Malik E, Tüten A. Non-invasive diagnosis of endometriosis and moderate-severe endometriosis with serum CA125, endocan, YKL-40, and copeptin quadruple panel. J OBSTET GYNAECOL 2020; 41:927-932. [PMID: 33064040 DOI: 10.1080/01443615.2020.1803245] [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: 10/23/2022]
Abstract
Considering the complex pathogenesis of endometriosis, which is associated with many cellular or molecular processes, such as proliferation, angiogenesis, inflammation, we evaluated the diagnostic value of a quadruple panel of serum markers CA125, endocan, YKL-40 and copeptin, for the prediction of endometriosis and moderate - severe endometriosis. Seventy women with endometriosis and 70 women without endometriosis were evaluated. Serum CA125, endocan, copeptin and YKL-40 levels were significantly increased in women with endometriosis compared to the women without endometriosis and in the minimal - mild endometriosis group compared to the no-endometriosis group. YKL-40, endocan and copeptin levels were significantly increased in the moderate - severe endometriosis group compared to the mild -moderate endometriosis group but the difference in CA125 levels remained non-significant. The quadruple panel score had an AUC of 0.954, a sensitivity of 96.5% and specificity of 84.6% for prediction of moderate - severe endometriosis. Zero or one positive marker had a sensitivity of 91.4% and specificity of 88.57% to rule out endometriosis. In conclusion, a quadruple panel of serum markers-CA125, endocan, YKL-40, and copeptin may be beneficial for the diagnosis of endometriosis and especially moderate - severe endometriosis. Further studies are needed to prove the efficacy of this panel.Impact statementWhat is already known on this subject? Many serum markers including CA125 have been investigated so far and suggested to be associated with endometriosis. However, none of these markers is sensitive and specific enough to diagnose endometriosis.What do the results of this study add? A quadruple panel score (CA125, endocan, YKL-4 and copeptin) had an AUC of 0.954, a sensitivity of 96.5% and specificity of 84.6% for prediction of moderate - severe endometriosis.What are the implications of these findings for clinical practice and/or further research? A high score may be beneficial to warn the surgeon about the risk of moderate to severe endometriosis if the patient will be operated anyway. A negative test of the quadruple panel may show high odds that there is no endometriosis which may prevent unnecessary surgery.
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Affiliation(s)
- Onur Guralp
- University Hospital for Gynecology and Obstetrics, Klinikum Oldenburg AöR, Carl von Ossietzky Oldenburg University, Oldenburg, Germany
| | - Baris Kaya
- Department of Obstetrics and Gynecology, Kosuyolu Hospital, Yeditepe University, Istanbul, Turkey
| | - Nevin Tüten
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
| | - Mine Kucur
- Department of Biochemistry, Istanbul Cerrahpasa University, Istanbul, Turkey
| | - Eduard Malik
- University Hospital for Gynecology and Obstetrics, Klinikum Oldenburg AöR, Carl von Ossietzky Oldenburg University, Oldenburg, Germany
| | - Abdullah Tüten
- Department of Obstetrics and Gynecology, Istanbul Cerrahpasa University, Istanbul, Turkey
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Endometriosis Lowers the Cumulative Live Birth Rates in IVF by Decreasing the Number of Embryos but Not Their Quality. J Clin Med 2020; 9:jcm9082478. [PMID: 32752267 PMCID: PMC7464781 DOI: 10.3390/jcm9082478] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Endometriosis and infertility are closely linked, but the underlying mechanisms are still poorly understood. This study aimed to evaluate the impact of endometriosis on in vitro fertilization (IVF) parameters, especially on embryo quality and IVF outcomes. A total of 1124 cycles with intracytoplasmic sperm injection were retrospectively evaluated, including 155 cycles with endometriosis and 969 cycles without endometriosis. Women with endometriosis had significantly lower ovarian reserve markers (AMH and AFC), regardless of previous ovarian surgery. Despite receiving significantly higher doses of exogenous gonadotropins, they had significantly fewer oocytes, mature oocytes, embryos, and top-quality embryos than women in the control group. Multivariate analysis did not reveal any association between endometriosis and the proportion of top-quality embryo (OR = 0.87; 95% CI [0.66-1.12]; p = 0.3). The implantation rate and the live birth rate per cycle were comparable between the two groups (p = 0.05), but the cumulative live births rate was significantly lower in in the endometriosis group (32.1% versus 50.7%, p = 0.001), as a consequence of the lower number of frozen embryos. In conclusion, endometriosis lowers the cumulative live birth rates by decreasing the number of embryos available to transfer, but not their quality.
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21
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Govorov I, Sitkin S, Pervunina T, Moskvin A, Baranenko D, Komlichenko E. Metabolomic Biomarkers in Gynecology: A Treasure Path or a False Path? Curr Med Chem 2020; 27:3611-3622. [PMID: 30608036 DOI: 10.2174/0929867326666190104124245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/21/2018] [Accepted: 12/31/2018] [Indexed: 12/27/2022]
Abstract
Omic-technologies (genomics, transcriptomics, proteomics and metabolomics) have become more important in current medical science. Among them, it is metabolomics that most accurately reflects the minor changes in body functioning, as it focuses on metabolome - the group of the metabolism products, both intermediate and end. Therefore, metabolomics is actively engaged in fundamental and clinical studies and search for potential biomarkers. The biomarker could be used in diagnostics, management and stratification of the patients, as well as in prognosing the outcomes. The good example is gynecology, since many gynecological diseases lack effective biomarkers. In the current review, we aimed to summarize the results of the studies, devoted to the search of potential metabolomic biomarkers for the most common gynecological diseases.
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Affiliation(s)
- Igor Govorov
- Institute of Perinatology and Pediatric, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russian Federation.,International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation
| | - Stanislav Sitkin
- Institute of Perinatology and Pediatric, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russian Federation.,International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation.,North-Western State Medical University named after I.I. Mechnikov, St. Petersburg 191015, Russian Federation
| | - Tatyana Pervunina
- Institute of Perinatology and Pediatric, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russian Federation.,International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation
| | - Alexey Moskvin
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation
| | - Denis Baranenko
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation
| | - Eduard Komlichenko
- Institute of Perinatology and Pediatric, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russian Federation.,International Research Centre "Biotechnologies of the Third Millennium", ITMO University, Saint-Petersburg 197341, Russian Federation
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22
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Mirza Z, Abdel-dayem UA. Uncovering Potential Roles of Differentially Expressed Genes, Upstream Regulators, and Canonical Pathways in Endometriosis Using an In Silico Genomics Approach. Diagnostics (Basel) 2020; 10:diagnostics10060416. [PMID: 32575462 PMCID: PMC7344784 DOI: 10.3390/diagnostics10060416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 12/12/2022] Open
Abstract
Endometriosis is characterized by ectopic endometrial tissue implantation, mostly within the peritoneum, and affects women in their reproductive age. Studies have been done to clarify its etiology, but the precise molecular mechanisms and pathophysiology remain unclear. We downloaded genome-wide mRNA expression and clinicopathological data of endometriosis patients and controls from NCBI’s Gene Expression Omnibus, after a systematic search of multiple independent studies comprising 156 endometriosis patients and 118 controls to identify causative genes, risk factors, and potential diagnostic/therapeutic biomarkers. Comprehensive gene expression meta-analysis, pathway analysis, and gene ontology analysis was done using a bioinformatics-based approach. We identified 1590 unique differentially expressed genes (129 upregulated and 1461 downregulated) mapped by IPA as biologically relevant. The top upregulated genes were FOS, EGR1, ZFP36, JUNB, APOD, CST1, GPX3, and PER1, and the top downregulated ones were DIO2, CPM, OLFM4, PALLD, BAG5, TOP2A, PKP4, CDC20B, and SNTN. The most perturbed canonical pathways were mitotic roles of Polo-like kinase, role of Checkpoint kinase proteins in cell cycle checkpoint control, and ATM signaling. Protein–protein interaction analysis showed a strong network association among FOS, EGR1, ZFP36, and JUNB. These findings provide a thorough understanding of the molecular mechanism of endometriosis, identified biomarkers, and represent a step towards the future development of novel diagnostic and therapeutic options.
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Affiliation(s)
- Zeenat Mirza
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Medical Lab Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence:
| | - Umama A. Abdel-dayem
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Medical Lab Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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23
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Miller JS, Rodriguez-Saona L, Hackshaw KV. Metabolomics in Central Sensitivity Syndromes. Metabolites 2020; 10:E164. [PMID: 32344505 PMCID: PMC7240948 DOI: 10.3390/metabo10040164] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/11/2020] [Accepted: 04/19/2020] [Indexed: 01/09/2023] Open
Abstract
Central sensitization syndromes are a collection of frequently painful disorders that contribute to decreased quality of life and increased risk of opiate abuse. Although these disorders cause significant morbidity, they frequently lack reliable diagnostic tests. As such, technologies that can identify key moieties in central sensitization disorders may contribute to the identification of novel therapeutic targets and more precise treatment options. The analysis of small molecules in biological samples through metabolomics has improved greatly and may be the technology needed to identify key moieties in difficult to diagnose diseases. In this review, we discuss the current state of metabolomics as it relates to central sensitization disorders. From initial literature review until Feb 2020, PubMed, Embase, and Scopus were searched for applicable studies. We included cohort studies, case series, and interventional studies of both adults and children affected by central sensitivity syndromes. The majority of metabolomic studies addressing a CSS found significantly altered metabolites that allowed for differentiation of CSS patients from healthy controls. Therefore, the published literature overwhelmingly supports the use of metabolomics in CSS. Further research into these altered metabolites and their respective metabolic pathways may provide more reliable and effective therapeutics for these syndromes.
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Affiliation(s)
- Joseph S. Miller
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH 43016, USA;
| | - Luis Rodriguez-Saona
- Department of Food Science and Technology, Ohio State University, Columbus, OH 43210, USA;
| | - Kevin V. Hackshaw
- Department of Internal Medicine, Division of Rheumatology, Dell Medical School, The University of Texas, 1701 Trinity St, Austin, TX 78712, USA
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24
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Bouet PE, Chao de la Barca JM, El Hachem H, Descamps P, Legendre G, Reynier P, May-Panloup P. Metabolomics shows no impairment of the microenvironment of the cumulus–oocyte complex in women with isolated endometriosis. Reprod Biomed Online 2019; 39:885-892. [DOI: 10.1016/j.rbmo.2019.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/18/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022]
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25
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Feider CL, Woody S, Ledet S, Zhang J, Sebastian K, Breen MT, Eberlin LS. Molecular Imaging of Endometriosis Tissues using Desorption Electrospray Ionization Mass Spectrometry. Sci Rep 2019; 9:15690. [PMID: 31666535 PMCID: PMC6821845 DOI: 10.1038/s41598-019-51853-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 10/05/2019] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is a pathologic condition affecting approximately 10% of women in their reproductive years. Characterized by abnormal growth of uterine endometrial tissue in other body areas, endometriosis can cause severe abdominal pain and/or infertility. Despite devastating consequences to patients' quality of life, the causes of endometriosis are not fully understood and validated diagnostic markers for endometriosis have not been identified. Molecular analyses of ectopic and eutopic endometrial tissues could lead to enhanced understanding of the disease. Here, we apply desorption electrospray ionization (DESI) mass spectrometry (MS) imaging to chemically and spatially characterize the molecular profiles of 231 eutopic and ectopic endometrial tissues from 89 endometriosis patients. DESI-MS imaging allowed clear visualization of endometrial glandular and stromal regions within tissue samples. Statistical models built from DESI-MS imaging data allowed classification of endometriosis lesions with overall accuracies of 89.4%, 98.4%, and 98.8% on training, validation, and test sample sets, respectively. Further, molecular markers that are significantly altered in ectopic endometrial tissues when compared to eutopic tissues were identified, including fatty acids and glycerophosphoserines. Our study showcases the value of MS imaging to investigate the molecular composition of endometriosis lesions and pinpoints metabolic markers that may provide new knowledge on disease pathogenesis.
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Affiliation(s)
- Clara L Feider
- The University of Texas at Austin, Department of Chemistry, 100 E. 24th St, Austin, TX, 78712, USA
| | - Spencer Woody
- The University of Texas at Austin, Department of Statistics and Data Science, 2317 Speedway, Austin, TX, 78712, USA
| | - Suzanne Ledet
- Ascension Seton Medical Center, Department of Pathology, 1201W. 38th St., Austin, TX, 78705, USA
| | - Jialing Zhang
- The University of Texas at Austin, Department of Chemistry, 100 E. 24th St, Austin, TX, 78712, USA
| | - Katherine Sebastian
- The University of Texas at Austin Dell Medical School, Department of Internal Medicine, 1601 Trinity St., Austin, TX, 78712, USA
| | - Michael T Breen
- The University of Texas at Austin Dell Medical School, Department of Women's Health, 1301W. 38th St., Austin, TX, 7870, USA
| | - Livia S Eberlin
- The University of Texas at Austin, Department of Chemistry, 100 E. 24th St, Austin, TX, 78712, USA.
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26
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Braga DPAF, Montani DA, Setti AS, Turco EGL, Oliveira-Silva D, Borges E. Metabolomic profile as a noninvasive adjunct tool for the diagnosis of Grades III and IV endometriosis-related infertility. Mol Reprod Dev 2019; 86:1044-1052. [PMID: 31215101 DOI: 10.1002/mrd.23221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/18/2019] [Accepted: 05/16/2019] [Indexed: 01/09/2023]
Abstract
The aim of the present case-control study was to develop a noninvasive adjuvant tool for the diagnosis of endometriosis. Serum samples from 100 patients undergoing intracytoplasmic sperm injection were split into two groups according to the cause of infertility: an endometriosis group (n = 50), consisting of samples derived from patients with Grade III and IV endometriosis, and a control group (n = 50), comprising samples derived from patients with isolated male factor infertility. The metabolomic profile of each sample was obtained, through mass spectrometry. Partial least squares discriminant analysis was able to clearly classify the endometriosis and control groups. Ten potential biomarkers were selected based on their importance for model prediction. These ions were used to build the receiver-operating characteristic curve, which presented an area under the curve of 0.904 (95% confidence interval: 0.796-0.985). To validate the model, 30 other samples from infertile women without any evidence of endometriosis were tested. Considering these ions as possible biomarkers, the model was able to correctly classify 84% of the patients. Finally, a similar prediction potential was observed in the model validated set, when samples from the disease-free group were tested. Serum metabolomics may be useful as a noninvasive adjunct tool for the selection of patients who must undergo laparoscopy for definitive endometriosis diagnosis.
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Affiliation(s)
- Daniela P A F Braga
- Departamento de Pesquisa Científica, Fertility Medical Group, São Paulo, Brazil
| | - Daniela A Montani
- Departamento de Química Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo-UNIFESP, Diadema, Brazil
| | - Amanda S Setti
- Departamento de Pesquisa Científica, Fertility Medical Group, São Paulo, Brazil
| | - Edson G Lo Turco
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
| | - Diogo Oliveira-Silva
- Departamento de Química Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo-UNIFESP, Diadema, Brazil
| | - Edson Borges
- Departamento de Química Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo-UNIFESP, Diadema, Brazil
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27
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Abstract
Endometriosis is a benign gynecological disorder which presents significant challenges in terms of diagnosis and management. Despite decades of research, there are no sufficiently sensitive and specific signs and symptoms nor blood tests for the clinical confirmation of endometriosis, which hampers prompt diagnosis and treatment. The huge majority of potential biomarkers has been discarded in research stage and very few have been translated to clinical practice. Serum CA-125 is the most studied and used one, but studies have shown its poor diagnostic performance. Several factors involved in the chronic inflammatory process of endometriosis, such as hormones, cytokines, chemokines, angiogenic factors, oxidative stress markers and others, have been implicated in the disease's pathogenesis and have been extensively studied, but not a single one has successfully been able to accurately identify the disease. MicroRNAs have emerged more recently but their utility to detect endometriosis remains uncertain. The search for a biomarker or a set of biomarkers is still open and may benefit from novel molecular biology and bioinformatics approaches to mine and uncover molecular signatures specifically associated with the disease.
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Affiliation(s)
- Larissa M Coutinho
- Department of Maternal and Child Health, Universidade Federal de Juiz de Fora, Belo Horizonte, Brazil; Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Márcia C Ferreira
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luiza L Rocha
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Márcia M Carneiro
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando M Reis
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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28
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Saguyod SJU, Kelley AS, Velarde MC, Simmen RCM. Diet and endometriosis-revisiting the linkages to inflammation. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2018. [DOI: 10.1177/2284026518769022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Endometriosis is a chronic inflammatory condition that may cause pelvic pain, dysmenorrhea, and/or infertility in women of reproductive age. While treatments may include medical or surgical management, the majority of therapeutic options are non-curative, and women may experience longstanding pain and/or disability. In general, chronic diseases are believed to result from modifiable risk factors, including diet. In this review, we discuss recent data on evidence-based associations between diet and endometriosis and the mechanistic points of action of constituent dietary factors with emphasis on inflammatory events that may contribute to the promotion or inhibition of the disease. Understanding the convergence of diet and endometriosis may lead to the development of clinical strategies to improve the quality of life for symptomatic women.
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Affiliation(s)
- Sofia Jade U Saguyod
- Institute of Biology, University of the Philippines Diliman, Quezon City, Philippines
| | - Angela S Kelley
- Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Michael C Velarde
- Institute of Biology, University of the Philippines Diliman, Quezon City, Philippines
| | - Rosalia CM Simmen
- Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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29
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O DF, Flores I, Waelkens E, D'Hooghe T. Noninvasive diagnosis of endometriosis: Review of current peripheral blood and endometrial biomarkers. Best Pract Res Clin Obstet Gynaecol 2018; 50:72-83. [PMID: 29778458 DOI: 10.1016/j.bpobgyn.2018.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 04/06/2018] [Indexed: 12/13/2022]
Abstract
A noninvasive biomarker-based test could help shorten the diagnostic delay for endometriosis. The most investigated biomarker sources are peripheral blood and endometrium. Discovery of endometriosis biomarkers is often hypothesis-driven, i.e. when one or a few biomarkers are investigated based on their role in the disease pathogenesis. Alternatively, a hypothesis-generating approach has been followed using the "omics" technologies. A variety of biomarkers for endometriosis have been investigated, but no biomarker has been validated for clinical use. Many challenges lie ahead in the endometriosis biomarker field. In the future, harmonized collection and reporting methods should allow large-scale international collaboration for highly powered studies.
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Affiliation(s)
- Dorien F O
- KU Leuven, Department of Development and Regeneration, Organ Systems, Leuven, Belgium; Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
| | - Idhaliz Flores
- Department of Basic Sciences, Ponce Health Sciences University - School of Medicine & Ponce Research Institute, Ponce, PR, USA; Department of Ob-Gyn, Ponce Health Sciences University - School of Medicine & Ponce Research Institute, Ponce, PR, USA
| | - Etienne Waelkens
- KU Leuven, Department of Cellular and Molecular Medicine, Campus Gasthuisberg, Leuven, Belgium; SyBioMa, Interfaculty Centre for Systems Biology Based Mass Spectrometry, Campus Gasthuisberg, Leuven, Belgium
| | - Thomas D'Hooghe
- KU Leuven, Department of Development and Regeneration, Organ Systems, Leuven, Belgium; Global Medical Affairs Fertility, Research and Development, Healthcare, Merck KGaA, Darmstadt, Germany.
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30
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Serum metabolic profiling of type 2 diabetes mellitus in Chinese adults using an untargeted GC/TOFMS. Clin Chim Acta 2017; 477:39-47. [PMID: 29197503 DOI: 10.1016/j.cca.2017.11.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a huge burden in China. The Chinese patients with T2DM have several special clinical characteristics. Metabolomics studies predominantly have identified several distinguishing metabolites associated with T2DM in Western ancestry population. However, few previous metabolomics studies were conducted in Chinese populations. METHODS We performed untargeted serum metabolic profiling between 30 T2DM patients and 30 healthy controls based on GC/TOFMS. Multivariate data analyses were applied to identify the distinguishing metabolites. RESULTS Excellent separation was obtained between the two cases. And overall 54 distinguishing metabolites were identified with VIP>1 and P<0.05, which were involved in metabolic pathways of amino acid, carbohydrate, lipids, membrane transport and nucleotides. To further analyze the correlation between the identified metabolites and T2DM, 17 metabolites were selected with FC>2.0, including gentisic acid, citraconic acid, succinic acid, 2-hydroxybutanoic acid and 3-hydroxy-l-proline, the corresponding FC were respectively 5.44, 2.21, 2.10, 2.21 and -2.04. CONCLUSION Our results demonstrated that untargeted GC/TOFMS-based metabolic approach processed well performance to identify serum distinguishing metabolites of T2DM in Chinese adults, which may be as potential biomarkers in diagnose and treatment of diabetes. And the results also provided new insight into understand the underlying molecular mechanism.
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31
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Tokarz J, Haid M, Cecil A, Prehn C, Artati A, Möller G, Adamski J. Endocrinology Meets Metabolomics: Achievements, Pitfalls, and Challenges. Trends Endocrinol Metab 2017; 28:705-721. [PMID: 28780001 DOI: 10.1016/j.tem.2017.07.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 02/07/2023]
Abstract
The metabolome, although very dynamic, is sufficiently stable to provide specific quantitative traits related to health and disease. Metabolomics requires balanced use of state-of-the-art study design, chemical analytics, biostatistics, and bioinformatics to deliver meaningful answers to contemporary questions in human disease research. The technology is now frequently employed for biomarker discovery and for elucidating the mechanisms underlying endocrine-related diseases. Metabolomics has also enriched genome-wide association studies (GWAS) in this area by providing functional data. The contributions of rare genetic variants to metabolome variance and to the human phenotype have been underestimated until now.
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Affiliation(s)
- Janina Tokarz
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Mark Haid
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Alexander Cecil
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Cornelia Prehn
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Anna Artati
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Gabriele Möller
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Lehrstuhl für Experimentelle Genetik, Technische Universität München, 85350 Freising-Weihenstephan, Germany; German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.
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