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Azeze GG, Wu L, Alemu BK, Lee WF, Fung LWY, Cheung ECW, Zhang T, Wang CC. Proteomics approach to discovering non-invasive diagnostic biomarkers and understanding the pathogenesis of endometriosis: a systematic review and meta-analysis. J Transl Med 2024; 22:685. [PMID: 39061077 DOI: 10.1186/s12967-024-05474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Endometriosis is one of the most common gynaecological diseases, yet it lacks efficient biomarkers for early detection and unravels disease mechanisms. Proteomic profiling has revealed diverse patterns of protein changes in various clinical samples. Integrating and systematically analysing proteomics data can facilitate the development of biomarkers, expediting diagnosis and providing insights for potential clinical and therapeutic applications. Hence, this systematic review and meta-analysis aimed to explore potential non-invasive diagnostic biomarkers in various biological samples and therapeutic targets for endometriosis. METHODS Online databases, including Scopus, PubMed, Web of Science, MEDLINE, Embase via Ovid, and Google Scholar, were searched using MeSH terms. Two independent authors screened the articles, extracted the data, and assessed the methodological quality of the included studies. GO and KEGG analyses were performed to identify the pathways that were significantly enriched. Protein‑protein interaction and hub gene selection analyses were also conducted to identify biomarker networks for endometriosis. RESULTS Twenty-six observational studies with a total of 2,486 participants were included. A total of 644 differentially expressed proteins (180 upregulated and 464 downregulated) were identified from 9 studies. Proteins in peripheral blood exhibited a sensitivity and specificity of 38-100% and 59-99%, respectively, for detecting endometriosis, while proteins in urine had a sensitivity of 58-91% and specificity of 76-93%. Alpha-1-antitrypsin, albumin, and vitamin D binding proteins were significantly DEPs in both serum and urine. Complement C3 is commonly expressed in serum, menstrual blood, and cervical mucus. Additionally, S100-A8 is commonly expressed in both menstrual blood and cervical mucus. Haptoglobin is commonly detected in both serum and plasma, whereas cathepsin G is found in urine, serum, and plasma. GO and KEGG enrichment analyses revealed that proteoglycans in cancer pathways, which regulate cell-to-cell interactions, modulate the extracellular matrix, and promote the proliferation and invasion of endometrial cells, are commonly enriched in serum and urine. CONCLUSION This comprehensive study revealed potential proteomes that were significantly differentially expressed in women with endometriosis utilizing various non-invasive clinical samples. Exploring common differentially expressed proteins in various biological samples provides insights into the diagnosis and pathophysiology of endometriosis, as well as potential clinical and therapeutic applications.
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Affiliation(s)
- Getnet Gedefaw Azeze
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- Department of Midwifery, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Ling Wu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Bekalu Kassie Alemu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- Department of Midwifery, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Wing Fong Lee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Linda Wen Ying Fung
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Eva Chun Wai Cheung
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Tao Zhang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
- School of Biomedical Sciences; Li Ka Shing Institute of Health Sciences; Chinese University of Hong Kong - Sichuan University Joint Laboratory in Reproductive Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
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Nasu K, Aoyagi Y, Zhu R, Okamoto M, Kai K, Kawano Y. Promising therapeutic targets of endometriosis obtained from microRNA studies. Med Mol Morphol 2021; 55:85-90. [PMID: 34846581 DOI: 10.1007/s00795-021-00308-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
Endometriosis is a benign tumor that affect 6-10% women of reproductive age. To date, it is suggested that the aberrant microRNA (miRNA) expressions play important roles in the pathogenesis of endometriosis. Reviewing the literature, we found nine overexpressed miRNAs, which were thoroughly investigated in the context of endometriotic tissues and cells. Most of the overexpressed miRNAs induced endometriosis-specific characteristics including inhibition of apoptosis and decidualization, upregulation of fibrogenesis, invasion, migration, cell proliferation, attachment to extracellular matrix, inflammation, and angiogenesis in the endometriotic cells. Then, we found that the downstream target molecules of these miRNAs, such as early growth response protein-1, extracellular signal-regulated kinase, matrix metallopeptidase 1, signal transducer and activator of transcription 3, cyclooxygenase-2, phosphoinositide 3-kinase, AKT, mammalian target of rapamycin, and vascular endothelial growth factor-A are promising for the therapeutic targets of endometriosis. Recent findings suggest that complex molecular mechanisms leading to development and progression of endometriosis by miRNAs may exist in endometriosis. The meticulous balance between tumorigenic miRNAs and tumoristatic miRNAs may destine the natural course and response to the surgical, medical, and hormonal treatments of this disease. Further investigations into endometriosis-associated miRNAs may elucidate the pathogenesis of endometriosis and help to develop novel therapeutics.
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Affiliation(s)
- Kaei Nasu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan. .,Division of Obstetrics and Gynecology, Support System for Community Medicine, Faculty of Medicine, Oita University, Oita, Japan.
| | - Yoko Aoyagi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| | - Ruofei Zhu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| | - Mamiko Okamoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| | - Kentaro Kai
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| | - Yasushi Kawano
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
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Zhao Z, Wu Y, Zhang H, Wang X, Tian X, Wang Y, Qiu Z, Zou L, Tang Z, Huang M. Association of leptin and adiponectin levels with endometriosis: a systematic review and meta-analysis. Gynecol Endocrinol 2021; 37:591-599. [PMID: 33501880 DOI: 10.1080/09513590.2021.1878139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND We aimed to summarize the available data regarding the levels of leptin and adiponectin and the key modulators of endometriosis compared to the controls. METHODS The electronic databases such as MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science were searched up to October 2020. The circulating and peritoneal levels of leptin and circulating levels of adiponectin were included. We used the Cochrane's Q test and the I2 statistic in this study. These tests' weighted mean difference (WMD) and 95% CIs were considered as the summary effect size. They were then pooled using a random-effects model with the DerSimonian-Laird method. RESULTS Twenty eligible articles (or 25 studies) with 2645 participants (1362 women with endometriosis and 1283 controls) were included. Pooled results showed that women with endometriosis had significantly higher leptin levels (WMD = 4.45 mg/ml, 95%CI = 2.42-6.49, p < .01) and leptin/BMI ratio (WMD = 0.32 mg/ml, 95%CI = 0.23-0.42, p < .001) than the controls, whereas adiponectin levels (WMD = -0.24 mg/ml, 95%CI = -4.27 to -0.01, p = .038) were significantly lower. The pooled results also indicated significantly lower leptin levels in women with advanced-stage endometriosis (WMD = -8.07 mg/ml, 95%CI = -14.22 to -1.92, p = .01) than in the early stage. It was found, however, that there were no significant differences in adiponectin levels of women with advanced-stage endometriosis (WMD = -0.16 mg/ml, 95%CI = -0.64 to 0.32, p = .512) and the early-stage ones. CONCLUSION We showed that leptin levels and leptin/BMI ratio were significantly higher in women with endometriosis than the controls. Nonetheless, patients with endometriosis had significantly lower levels of adiponectin than the controls.
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Affiliation(s)
- Zongquan Zhao
- Department of General Practice, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Yihong Wu
- Department of General Practice, Runda Community Health Service Center, Suzhou, China
| | - Hao Zhang
- Department of General Practice, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Xiaohong Wang
- Department of General Practice, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Xiangfan Tian
- Department of General Practice, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Yijing Wang
- Community Health Management Center, Suzhou Municipal Hospital, Suzhou, China
| | - Zhenjuan Qiu
- Nursing Department, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Lingyan Zou
- Department of General Practice, Pingjiang New Town Community Health Service Center, Suzhou, China
| | - Zhenyuan Tang
- Community Health Management Center, Suzhou Municipal Hospital, Suzhou, China
| | - Min Huang
- Department of General Practice, Suzhou Municipal Hospital, Suzhou, China
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Kuo HH, Huang CY, Ueng SH, Huang KG, Lee CL, Yen CF. Unexpected epithelial ovarian cancers arising from presumed endometrioma: A 10-year retrospective analysis. Taiwan J Obstet Gynecol 2017; 56:55-61. [PMID: 28254227 DOI: 10.1016/j.tjog.2015.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To evaluate the incidence and prognosis of unexpected epithelial ovarian cancers (EOCs) occurring in presumed benign endometrioma. MATERIALS AND METHODS Patients who underwent primary surgery at Chang Gung Memorial Hospital between November 2003 and October 2013 were searched with the Systematized Nomenclature of Medicine code followed by chart review. RESULTS The incidence of unexpected EOCs in presumed ovarian endometrioma was 0.14%, as 11 patients were revealed after reviewing 497 patients of pathology-proven EOCs in the current series. All patients were aged ≥ 40 years; seven (63.6%) had inward mass within ovarian cyst in preoperative images, six had cancer antigen-125 (CA-125) > 200 U/mL, and two with CA-125 > 1500 U/mL. Ten patients underwent laparoscopy initially, including five with ovarian preservation at the beginning. Ten patients subsequently completed concurrent or secondary staging surgery, including four totally with laparoscopy. The histologic subtypes had clear-cell (8/11), endometrioid (1/11), mixed clear-cell and endometrioid (1/11), and low-grade serous adenocarcinoma (1/11). Seven patients had endometriosis-associated ovarian carcinoma (EAOC), while the other four were non-EAOC with no endometriosis component. The only mortality was a patient of non-EAOC in Stage IIIc, whereas the other 10 in Stage I were alive. The overall survival rate was 90.9% (10/11) with follow-up ranging from 23 months to 130 months. CONCLUSION Unexpected EOCs occurring in presumed ovarian endometrioma was rare and, if present, the prognosis was good in Stage I disease with laparoscopic management. Combining parameters of patient's age, CA-125 level, and inward solid mass at imaging could help to raise the precautions.
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Affiliation(s)
- Hsin-Hong Kuo
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chen-Ying Huang
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Shir-Hwa Ueng
- Department of Pathology, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Kuan-Gen Huang
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chyi-Long Lee
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chih-Feng Yen
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, Tao-Yuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
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