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Samare-Najaf M, Razavinasab SA, Samareh A, Jamali N. Omics-based novel strategies in the diagnosis of endometriosis. Crit Rev Clin Lab Sci 2024; 61:205-225. [PMID: 37878077 DOI: 10.1080/10408363.2023.2270736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
Endometriosis, an enigmatic and chronic disorder, is considered a debilitating condition despite being benign. Globally, this gynecologic disorder affects up to 10% of females of reproductive age, impacting almost 190 million individuals. A variety of genetic and environmental factors are involved in endometriosis development, hence the pathophysiology and etiology of endometriosis remain unclear. The uncertainty of the etiology of the disease and its complexity along with nonspecific symptoms have led to misdiagnosis or lack of diagnosis of affected people. Biopsy and laparoscopy are referred to as the gold standard for endometriosis diagnosis. However, the invasiveness of the procedure, the unnecessary operation in disease-free women, and the dependence of the reliability of diagnosis on experience in this area are considered the most significant limitations. Therefore, continuous studies have attempted to offer a noninvasive and reliable approach. The recent advances in modern technologies have led to the generation of large-scale biological data sets, known as -omics data, resulting in the proceeding of the -omics century in biomedical sciences. Thereby, the present study critically reviews novel and noninvasive biomarkers that are based on -omics approaches from 2020 onward. The findings reveal that biomarkers identified based on genomics, epigenomics, transcriptomics, proteomics, and metabolomics are potentially able to diagnose endometriosis, predict prognosis, and stage patients, and potentially, in the near future, a multi-panel of these biomarkers will generate clinical benefits.
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Affiliation(s)
- Mohammad Samare-Najaf
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Kerman Regional Blood Transfusion Center, Kerman, Iran
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ali Samareh
- Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Navid Jamali
- Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
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2
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Lin X, Dai Y, Gu W, Zhang Y, Zhuo F, Zhao F, Jin X, Li C, Huang D, Tong X, Zhang S. The involvement of RNA N6-methyladenosine and histone methylation modification in decidualization and endometriosis-associated infertility. Clin Transl Med 2024; 14:e1564. [PMID: 38344897 PMCID: PMC10859880 DOI: 10.1002/ctm2.1564] [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: 11/05/2023] [Revised: 12/18/2023] [Accepted: 01/14/2024] [Indexed: 02/15/2024] Open
Abstract
Defective decidualization of endometrial stromal cells (ESCs) in endometriosis (EM) patients leads to inadequate endometrial receptivity and EM-associated infertility. Hypoxia is an inevitable pathological process of EM and participates in deficient decidualization of the eutopic secretory endometrium. Enhancer of zeste homology 2 (EZH2) is a methyltransferase which catalyses H3K27Me3, leading to decreased expression levels of target genes. Although EZH2 expression is low under normal decidualization, it is abundantly increased in the eutopic secretory endometrium of EM and is induced by hypoxia. Chromatin immunoprecipitation-PCR results revealed that decidua marker IGFBP1 is a direct target of EZH2, partially explaining the increased levels of histone methylation modification in defected decidualization of EM. To mechanism controlling this, we examined the effects of hypoxia on EZH2 and decidualization. EZH2 mRNA showed decreased m6 A modification and increased expression levels under hypoxia and decidualization combined treatment. Increased EZH2 expression was due to the increased expression of m6 A demethylase ALKBH5 and decreased expression of the m6 A reader protein YTHDF2. YTHDF2 directly bind to the m6 A modification site of EZH2 to promote EZH2 mRNA degradation in ESCs. Moreover, selective Ezh2 depletion in mouse ESCs increased endometrial receptivity and improved mouse fertility by up-regulating decidua marker IGFBP1 expression. This is the first report showing that YTHDF2 can act as a m6 A reader to promote decidualization by decreasing the stability of EZH2 mRNA and further increasing the expression of IGFBP1 in ESCs. Taken together, our findings highlight the critical role of EZH2/H3K27Me3 in decidualization and reveal a novel epigenetic mechanism by which hypoxia can suppress EM decidualization by decreasing the m6 A modification of EZH2 mRNA.
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Affiliation(s)
- Xiang Lin
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Yongdong Dai
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Weijia Gu
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
| | - Yi Zhang
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
| | - Feng Zhuo
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Fanxuan Zhao
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
| | - Xiaoying Jin
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Chao Li
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Dong Huang
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Xiaomei Tong
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
| | - Songying Zhang
- Assisted Reproduction UnitDepartment of Obstetrics and GynecologySir Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang ProvinceHangzhouChina
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Martire FG, Giorgi M, D’Abate C, Colombi I, Ginetti A, Cannoni A, Fedele F, Exacoustos C, Centini G, Zupi E, Lazzeri L. Deep Infiltrating Endometriosis in Adolescence: Early Diagnosis and Possible Prevention of Disease Progression. J Clin Med 2024; 13:550. [PMID: 38256683 PMCID: PMC10816815 DOI: 10.3390/jcm13020550] [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: 12/14/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Endometriosis has a prevalence of 10% worldwide in premenopausal women. Probably, endometriosis begins early in the life of young girls, and it is commonly diagnosed later in life. The prevalence of deep infiltrating endometriosis (DIE) in adolescence is currently unknown due to diagnostic limits and underestimation of clinical symptoms. Dysmenorrhea is a common symptom in adolescents affected by DIE, often accompanied by dyspareunia and chronic acyclic pelvic pain. Ultrasonography-either performed transabdominal, transvaginal or transrectal-should be considered the first-line imaging technique despite the potential for missed diagnosis due to early-stage disease. Magnetic resonance imaging should be preferred in the case of virgo patients or when ultrasonographic exam is not accepted. Diagnostic laparoscopy is deemed acceptable in the case of suspected DIE not responding to conventional hormonal therapy. An early medical and/or surgical treatment may reduce disease progression with an immediate improvement in quality of life and fertility, but at the same time, painful symptoms may persist or even recur due to the surgery itself. The aim of this narrative review is to report the prevalence of DIE in adolescents, describe the pathogenetic theories and discuss the management in adolescent women, including the challenging road to diagnosis and the treatment alternatives.
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Affiliation(s)
- Francesco Giuseppe Martire
- Gynecological Unit, Department of Surgical Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.G.M.); (C.E.)
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Matteo Giorgi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Claudia D’Abate
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Irene Colombi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Alessandro Ginetti
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Alberto Cannoni
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Francesco Fedele
- Department of Obstetrics and Gynecology, Fondazione “Policlinico-Mangiagalli-Regina Elena” University of Milan, 20122 Milan, Italy;
| | - Caterina Exacoustos
- Gynecological Unit, Department of Surgical Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.G.M.); (C.E.)
| | - Gabriele Centini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Errico Zupi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
| | - Lucia Lazzeri
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy; (M.G.); (C.D.); (I.C.); (A.G.); (A.C.); (G.C.); (L.L.)
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Davoodi Asl F, Sahraei SS, Kalhor N, Fazaeli H, Sheykhhasan M, Soleimani Moud S, Naserpour L, Sheikholeslami A. Promising effects of exosomes from menstrual blood-derived mesenchymal stem cells on endometriosis. Reprod Biol 2023; 23:100788. [PMID: 37542905 DOI: 10.1016/j.repbio.2023.100788] [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: 05/06/2023] [Revised: 06/26/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
Endometriosis as a non-malignant gynecological disease leads to dysregulation of numerous cellular functions including apoptosis, angiogenesis, migration, proliferation, and inflammation. Accumulating evidence has shed light on the importance of endometrial stem cells within the menstrual blood which are involved in the establishment and progression of endometriotic lesions in a retrograde manner. According to the fact that the therapeutic benefits of mesenchymal stem cells are provided through paracrine functions, we used exosomes from menstrual blood-derived stem cells (MenSCs) for treating endometriotic stem cells to inhibit their lesion formation tendency. Menstrual blood samples from healthy and endometriosis women were collected. Isolated MenSCs by the density-gradient centrifugation method were characterized by flow cytometry. Secreted exosomes were isolated from healthy MenSCs (NE-MenSCs) and used to treat endometriotic cells (E-MenSCs). 72 h after treatment, different mechanisms and pathways including inflammation, proliferation, apoptosis, migration, and angiogenesis were analyzed using Real-Time PCR, ELISA, immunocytochemistry, annexin V/PI, and scratching assay. Exosome treatment significantly reduce the expression level of markers related to inflammation, proliferation, migration, and angiogenesis in E-MenSCs which are aberrantly expressed in endometriosis. Moreover, apoptosis was induced in E-MenSCs after treatment which was evaluated in both gene and protein levels. In this study, we give preliminary evidence for the potential of MenSCs-Exo in ameliorating endometriosis. Regarding our results, we suggest that after relevant clinical trial, MenSCs-derived exosomes can be considered as a better treatment option to improve endometriosis compared to common and conventional treatments and show their potential as a cell-free product in endometriosis repair.
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Affiliation(s)
- Faezeh Davoodi Asl
- Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Seyedeh Saeideh Sahraei
- Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Naser Kalhor
- Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Hoda Fazaeli
- Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Mohsen Sheykhhasan
- Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Sanaz Soleimani Moud
- Midwifery ward, Infertility treatment center, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Leila Naserpour
- Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran
| | - Azar Sheikholeslami
- Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom Branch, Qom, Iran.
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Setiawan A, Anwar R, Syamsunarno MRAA, Mose JC, Santoso B, Maskoen AM, Permadi W, Setiabudiawan B, Dhamayanti M, Hidayat YM. Epigenetic Regulation Interplays with Endometriosis Pathogenesis in Low-Birth-Weight Patients via the Progesterone Receptor B-VEGF-DNMT1 Axis. Diagnostics (Basel) 2023; 13:2085. [PMID: 37370979 DOI: 10.3390/diagnostics13122085] [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: 04/05/2023] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Low birth weight (LBW) is a risk factor associated with endometriosis. Our study aimed to analyze the risk of endometriosis in women with a LBW history and the relationships of progesterone receptor B (PR-B) gene promoter methylation, DNA methyltransferase-1 (DNMT1) expression, PR-B expression, and vascular endothelial growth factors (VEGF) with endometriosis. METHODS This study was conducted in two stages, a retrospective case-control design and a cross-sectional design, with 52 cases of endometriosis and 30 controls, which were further subdivided into LBW and non-LBW groups, at Hasan Sadikin General Hospital and its hospital networks from October 2017 to August 2021. Menstrual blood was taken from subjects and analyzed using pyrosequencing techniques to assess DNA methylation, while q-RT PCR was used to assess gene expression. RESULTS There were significant differences in PR-B methylation, DNMT1 expression, PR-B expression, and VEGF expression (p < 0.001) between the case and control groups. There was a significant negative correlation between PR-B methylation and PR-B expression (r = -0.558; p = 0.047). Based on a multiple logistic analysis, the most dominant factor affecting endometriosis incidence is PR-B (OR 10.40, 95% CI 3.24-33.4, R2 = 45.8). We found that patients with a low birth weight history had a 1.41-times-higher risk of developing endometriosis (95% CI 0.57-3.49, p = 0.113), although the relationship was not statistically significant. CONCLUSION Endometriosis is associated with PR-B gene promoter hypermethylation, decreased PR-B expression, and increased DNMT1 and VEGF expression. The methylation of PR-B is the most dominant factor affecting endometriosis incidence.
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Affiliation(s)
- Arief Setiawan
- Endocrinology Reproduction and Fertilisation Division, Department of Obstetrics and Gynaecology, Hasan Sadikin Hospital, Bandung 40161, Indonesia
| | - Ruswana Anwar
- Endocrinology Reproduction and Fertilisation Division, Department of Obstetrics and Gynaecology, Hasan Sadikin Hospital, Bandung 40161, Indonesia
| | | | | | - Budi Santoso
- Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | | | - Wiryawan Permadi
- Endocrinology Reproduction and Fertilisation Division, Department of Obstetrics and Gynaecology, Hasan Sadikin Hospital, Bandung 40161, Indonesia
| | | | - Meita Dhamayanti
- Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
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Manfredini M, Breschi M, Fornasin A, Esposito M. Maternal nutritional status and offspring childlessness: Evidence from the late-nineteenth to early-twentieth centuries in a group of Italian populations. POPULATION STUDIES 2022; 76:477-493. [PMID: 35899492 DOI: 10.1080/00324728.2022.2099566] [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: 12/25/2022]
Abstract
The role of maternal nutrition in affecting offspring fertility, through alteration of foetal programming, has been demonstrated in animal-based experiments. However, results from human populations appear inconsistent and sometimes contradictory, likely because they have been based on single famine events. In this paper, we adopt a different approach. We combine official annual time series of daily nutrient availability with a sample of women's reproductive histories from the 1961 Italian Census to investigate the role of maternal nutritional status in pregnancy on offspring childlessness. The analysis therefore covers cohorts of females born between 1861 and 1939. Our results show a negative association between calorie availability in pregnancy and the odds of offspring childlessness, whereas no association is found between protein availability and offspring childlessness. The consequences of poor calorie intake were aggravated during the summer, likely due to the participation of pregnant women in physically demanding work.
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Passos JRS, Guerreiro DD, Otávio KS, Dos Santos-Neto PC, Souza-Neves M, Cuadro F, Nuñez-Olivera R, Crispo M, Vasconcelos FR, Bezerra MJB, Silva RF, Lima LF, Figueiredo JR, Bustamante-Filho IC, Menchaca A, Moura AA. How in vitro maturation changes the proteome of ovine cumulus-oocyte complexes? Mol Reprod Dev 2022; 89:459-470. [PMID: 35901249 DOI: 10.1002/mrd.23638] [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: 02/16/2022] [Revised: 05/29/2022] [Accepted: 07/21/2022] [Indexed: 11/11/2022]
Abstract
The present study evaluated the effects of in vitro maturation (IVM) on the proteome of cumulus-oocyte complexes (COCs) from ewes. Extracted COC proteins were analyzed by LC-MS/MS. Differences in protein abundances (p < 0.05) and functional enrichments in immature versus in vitro-matured COCs were evaluated using bioinformatics tools. There were 2550 proteins identified in the COCs, with 89 and 87 proteins exclusive to immature and mature COCs, respectively. IVM caused downregulation of 84 and upregulation of 34 proteins. Major upregulated proteins in mature COCs were dopey_N domain-containing protein, structural maintenance of chromosomes protein, ubiquitin-like modifier-activating enzyme 2. Main downregulated proteins in mature COCs were immunoglobulin heavy constant mu, inter-alpha-trypsin inhibitor heavy chain 2, alpha-2-macroglobulin. Proteins exclusive to mature COCs and upregulated after IVM related to immune response, complement cascade, vesicle-mediated transport, cell cycle, and extracellular matrix organization. Proteins of immature COCs and downregulated after IVM were linked to metabolic processes, immune response, and complement cascade. KEGG pathways and miRNA-regulated genes attributed to downregulated and mature COC proteins related to complement and coagulation cascades, metabolism, humoral response, and B cell-mediated immunity. Thus, IVM influenced the ovine COC proteome. This knowledge supports the future development of efficient IVM protocols for Ovis aries.
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Affiliation(s)
- José Renato S Passos
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
| | - Denise D Guerreiro
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
| | - Kamila S Otávio
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
| | | | - Marcela Souza-Neves
- Instituto de Reproducción Animal Uruguay, Fundación IRAUy, Montevideo, Uruguay
| | - Federico Cuadro
- Instituto de Reproducción Animal Uruguay, Fundación IRAUy, Montevideo, Uruguay
| | | | - Martina Crispo
- Unidad de Biotecnología en Animales de Laboratorio, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - Fábio R Vasconcelos
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
| | - Maria Julia B Bezerra
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
| | - Renato F Silva
- Laboratory of Manipulation of Oocyte and Preantral Follicles (LAMOFOPA), Ceará State University, Fortaleza, Brazil
| | - Laritza F Lima
- Laboratory of Manipulation of Oocyte and Preantral Follicles (LAMOFOPA), Ceará State University, Fortaleza, Brazil
| | - José Ricardo Figueiredo
- Laboratory of Manipulation of Oocyte and Preantral Follicles (LAMOFOPA), Ceará State University, Fortaleza, Brazil
| | | | - Alejo Menchaca
- Instituto de Reproducción Animal Uruguay, Fundación IRAUy, Montevideo, Uruguay.,Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria, Montevideo, Uruguay
| | - Arlindo A Moura
- Laboratory of Animal Physiology, Department of Animal Science, Federal University of Ceará, Fortaleza, Brazil
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Frincu F, Carp-Veliscu A, Petca A, Badiu DC, Bratila E, Cirstoiu M, Mehedintu C. Maternal-Fetal Outcomes in Women with Endometriosis and Shared Pathogenic Mechanisms. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1258. [PMID: 34833476 PMCID: PMC8625694 DOI: 10.3390/medicina57111258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022]
Abstract
The connection between endometriosis and pregnancy outcomes is trending among the research topics. Until recently, endometriosis and its painful symptomatology were considered to be alleviated by pregnancy. However, these beliefs have shifted, as emerging literature has demonstrated the role of this condition in affecting pregnancy evolution. The underlying pathogenesis of endometriosis is still poorly understood, all the more when pregnancy complications are involved. Debatable opinions on endometriosis associated with obstetric complications exist because of the potential bias resulting from the heterogeneity of preceding evidence. This review aims to evaluate the connection between endometriosis and adverse pregnancy outcomes and their shared pathogenic mechanisms. We searched PubMed and EMBASE and focused on the studies that include placenta praevia, premature rupture of membranes, spontaneous preterm birth, gestational hypertension, preeclampsia, obstetric hemorrhages (ante- and postpartum bleeding, abruptio placentae), miscarriage, stillbirth, neonatal death, gestational diabetes mellitus, gestational cholestasis, small for gestational age, and their association with endometriosis. Not only the risks of emergence were highlighted, but also the pathogenic connections. Epigenetic alterations of some genes were found to be mirrored both in endometriosis and obstetric complications. This review issues a warning for providing increased attention to pregnant women with endometriosis and newborns as higher risks of preeclampsia, placental issues, and preterm deliveries are associated.
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Affiliation(s)
- Francesca Frincu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
| | - Andreea Carp-Veliscu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
| | - Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
| | - Dumitru-Cristinel Badiu
- Department of General Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Elvira Bratila
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
| | - Monica Cirstoiu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (F.F.); (A.P.); (E.B.); (M.C.); (C.M.)
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Shared Molecular Features Linking Endometriosis and Obstetric Complications. Reprod Sci 2020; 27:1089-1096. [PMID: 32046439 DOI: 10.1007/s43032-019-00119-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/19/2019] [Indexed: 12/12/2022]
Abstract
Recent epidemiological research has shown the increased risk of adverse pregnancy outcomes in women with endometriosis compared with the general population. The aim of this review is to explore common pathophysiologic mechanisms between endometriosis and obstetric complications. A computerized literature search was performed to identify relevant studies. The search covered the period between January 2008 and October 2018. One of the potential mechanisms driving the initiation and progression of endometriosis is the accumulation of a variety of epigenetic changes in endometrial cells. Epigenetic control of gene expression which is considered to be responsible for the development of endometriosis is commonly seen in patients with preeclampsia, small for gestational age (SGA), or preterm birth. DLX5 and GATA3, paternally imprinted genes, and CDKN1C, a maternally imprinted gene, were aberrantly expressed in placenta tissues of the preeclampsia; CDKN1C, the growth inhibitor gene, was upregulated in human SGA placentas; and hypomethylation of PTGER2 would be associated with preterm birth. Preeclampsia, SGA, or preterm birth may share common epigenetic alterations with endometriosis, which raises the possibility that the occurrence of two conditions might be nonrandom. To date, however, there is a lack of evidence that links endometriosis and other obstetric complications, such as postpartum hemorrhage or placental abruption, at the epigenetic level. In conclusion, epigenetic changes may be a common hallmark of two conditions: endometriosis and obstetrical complications, such as preeclampsia, SGA, or preterm birth.
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Gerkowicz SA, Curtis SW, Knight AK, Cobb DO, Spencer JB, Conneely KN, Terrell ML, Marcus M, Smith AK. Endometriosis, endocrine disrupters, and epigenetics: an investigation into the complex interplay in women with polybrominated biphenyl exposure and endometriosis. J Assist Reprod Genet 2020; 37:427-436. [PMID: 32026200 PMCID: PMC7056781 DOI: 10.1007/s10815-020-01695-9] [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: 10/02/2019] [Accepted: 01/10/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Endocrine disrupting compounds (EDCs) have been shown to affect multiple biologic processes especially steroid-hormone processes. We sought to determine differences in DNA methylation exists between women with and without endometriosis following exposure to polybrominated biphenyl (PBB). METHODS Cross-sectional study of 305 females in the Michigan PBB Registry. DNA was extracted, and DNA methylation was interrogated using the MethylationEPIC BeadChip (Illumina, San Diego, California). Demographic data was analyzed using Chi-squared and T tests. Linear regressions were performed for each cytosine-guanine dinucleotide (CpG) site, modeling the logit transformation of the β value as a linear function of the presence of endometriosis. Sensitivity analyses were conducted controlling for estradiol levels and menopausal status. Replication study performed evaluating for any association between CpGs reported in the literature and our findings. RESULTS In total, 39,877 CpGs nominally associated with endometriosis (p < 0.05) after adjusting for age and cellular heterogeneity, although none remained significant after correction for multiple comparisons (FDR < 0.05). Pathway analysis of these CpGs showed enrichment in 68 biologic pathways involved in various endocrine, immunologic, oncologic, and cell regulation processes as well as embryologic reproductive tract development and function (FoxO, Wnt, and Hedgehog signaling). We identified 42,261 CpG sites in the literature reported to be associated with endometriosis; 2012 of these CpG sites were also significant in our cohort. CONCLUSION We found 39,877 CpG sites that nominally associated with endometriosis (p < 0.05) after adjusting for age and cellular heterogeneity; however, none remained significant after correction for multiple comparisons (FDR < 0.05).
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Affiliation(s)
- Sabrina A Gerkowicz
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Emory University, Atlanta, GA, USA
| | - Sarah W Curtis
- Genetics and Molecular Biology Program, Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Anna K Knight
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA
| | - Dawayland O Cobb
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Emory University, Atlanta, GA, USA
| | - Karen N Conneely
- Genetics and Molecular Biology Program, Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Metrecia L Terrell
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michele Marcus
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Alica K Smith
- Department of Gynecology and Obstetrics, Emory University, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA.
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle NE, Suite 4217, Atlanta, GA, 30322, USA.
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11
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Koninckx PR, Ussia A, Adamyan L, Wattiez A, Gomel V, Martin DC. Pathogenesis of endometriosis: the genetic/epigenetic theory. Fertil Steril 2018; 111:327-340. [PMID: 30527836 DOI: 10.1016/j.fertnstert.2018.10.013] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To study the pathophysiology of endometriosis. DESIGN Overview of observations on endometriosis. SETTING Not applicable. PATIENT(S) None. INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) The hypothesis is compatible with all observations. RESULT(S) Endometriosis, endometrium-like tissue outside the uterus, has a variable macroscopic appearance and a poorly understood natural history. It is a hereditary and heterogeneous disease with many biochemical changes in the lesions, which are clonal in origin. It is associated with pain, infertility, adenomyosis, and changes in the junctional zone, placentation, immunology, plasma, peritoneal fluid, and chronic inflammation of the peritoneal cavity. The Sampson hypothesis of implanted endometrial cells following retrograde menstruation, angiogenic spread, lymphogenic spread, or the metaplasia theory cannot explain all observations if metaplasia is defined as cells with reversible changes and an abnormal behavior/morphology due to the abnormal environment. We propose a polygenetic/polyepigenetic mechanism. The set of genetic and epigenetic incidents transmitted at birth could explain the hereditary aspects, the predisposition, and the endometriosis-associated changes in the endometrium, immunology, and placentation. To develop typical, cystic ovarian or deep endometriosis lesions, a variable series of additional transmissible genetic and epigenetic incidents are required to occur in a cell which may vary from endometrial to stem cells. Subtle lesions are viewed as endometrium in a different environment until additional incidents occur. Typical cystic ovarian or deep endometriosis lesions are heterogeneous and represent three different diseases. CONCLUSION(S) The genetic epigenetic theory is compatible with all observations on endometriosis. Implications for treatment and prevention are discussed.
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Affiliation(s)
- Philippe R Koninckx
- Obstetrics-Gynecology, KU Leuven, Bierbeek, Belgium; Gruppo Italo Belga, Rome, Italy; Latiffa Hospital, Dubai, United Arab Emirates; Università Cattolica, Roma, Italy.
| | - Anastasia Ussia
- Gruppo Italo Belga, Rome, Italy; Università Cattolica, Roma, Italy
| | - Leila Adamyan
- Department of Operative Gynecology, Federal State Budget Institution V. I. Kulakov Research Centre for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, and Department of Reproductive Medicine and Surgery, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Arnaud Wattiez
- Latiffa Hospital, Dubai, United Arab Emirates; Department of Obstetrics and Gynecology, University of Strasbourg, Strasbourg, France
| | - Victor Gomel
- Department of Obstetrics and Gynecology, University of British Columbia and Women's Hospital, Vancouver, British Columbia, Canada
| | - Dan C Martin
- School of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, and Virginia Commonwealth University, Richmond, Virginia
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12
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Pathogenomics of Endometriosis Development. Int J Mol Sci 2018; 19:ijms19071852. [PMID: 29937493 PMCID: PMC6073754 DOI: 10.3390/ijms19071852] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/10/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022] Open
Abstract
For over 100 years, endometriosis, as a chronic, estrogen-dependent, inflammatory, heritable disease affecting approximately 5–10% of women in reproductive age has been the focus of clinicians and scientists. In spite of numerous environmental, genetic, epigenetic, endocrine, and immunological studies, our knowledge of endometriosis is still fragmentary, and its precise pathophysiology and pathogenomics remain a mystery. The implementation of new technologies has provided tremendous progress in understanding the many intrinsic molecular mechanisms in the development of endometriosis, with progenitor and stem cells (SCs) of the eutopic endometrium as the starting players and endometriotic lesions as the final pathomorphological trait. Novel data on the molecular, genetic, and epigenetic mechanisms of the disease are briefly outlined. We hypothesize the existence of an endometriosis development genetic program (EMDP) that governs the origin of endometrium stem cells programmed for endometriosis (1), their transition (metaplasia) into mesenchymal SCs (2), and their invasion of the peritoneum and progression to endometriotic lesions (3). The pros and cons of the recent unifying theory of endometriosis are also discussed. Complex genomic and epigenetic interactions at different stages of the endometriosis process result in different forms of the disease, with specific features and clinical manifestations. The significance of the EMDP in elaborating a new strategy for endometriosis prediction, prevention, and treatment is discussed.
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13
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Leeners B, Damaso F, Ochsenbein-Kölble N, Farquhar C. The effect of pregnancy on endometriosis—facts or fiction? Hum Reprod Update 2018; 24:290-299. [DOI: 10.1093/humupd/dmy004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/03/2018] [Indexed: 01/12/2023] Open
Affiliation(s)
- Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Fabia Damaso
- Department of Reproductive Endocrinology, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | - Cindy Farquhar
- Department of Gynaecology and Obstetrics, University Hospital Auckland, Park Road, 1023 Auckland, New Zealand
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14
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Pathogenesis of deep endometriosis. Fertil Steril 2017; 108:872-885.e1. [DOI: 10.1016/j.fertnstert.2017.08.036] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 08/22/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022]
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15
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Laganà AS, Salmeri FM, Vitale SG, Triolo O, Götte M. Stem Cell Trafficking During Endometriosis: May Epigenetics Play a Pivotal Role? Reprod Sci 2017; 25:978-979. [PMID: 28100109 DOI: 10.1177/1933719116687661] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Antonio Simone Laganà
- 1 Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi," University of Messina, Messina, Italy
| | - Francesca Maria Salmeri
- 2 Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Salvatore Giovanni Vitale
- 1 Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi," University of Messina, Messina, Italy
| | - Onofrio Triolo
- 1 Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi," University of Messina, Messina, Italy
| | - Martin Götte
- 3 Department of Gynecology and Obstetrics, Münster University Hospital, Münster, Germany
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16
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Nirgianakis K, Grandi G, McKinnon B, Bersinger N, Cagnacci A, Mueller M. Dienogest mediates midkine suppression in endometriosis. Hum Reprod 2016; 31:1981-6. [DOI: 10.1093/humrep/dew180] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/20/2016] [Indexed: 01/22/2023] Open
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17
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Guan YT, Huang YQ, Wu JB, Deng ZQ, Wang Y, Lai ZY, Wang HB, Sun XX, Zhu YL, Du MM, Zhu LY, Chen LX, Wang LW. Overexpression of chloride channel-3 is associated with the increased migration and invasion ability of ectopic endometrial cells from patients with endometriosis. Hum Reprod 2016; 31:986-98. [PMID: 26965430 DOI: 10.1093/humrep/dew034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/07/2016] [Indexed: 12/21/2022] Open
Abstract
STUDY QUESTION Is chloride channel-3 (ClC-3) involved in regulating the biological behavior of endometrial stromal cells (ESCs)? SUMMARY ANSWER ClC-3 promotes endometriotic cell migration and invasion. WHAT IS KNOWN ALREADY ClC-3 plays a significant role in the migration and invasion of various kinds of cells. STUDY DESIGN, SIZE, DURATION An ITALIC! in vitro investigation of the effect of ClC-3 on the migration and invasion of ectopic ESCs from patients with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS The ectopic and eutopic endometrial samples from 43 female patients with endometriosis and the endometrial samples from 39 non-endometriotic female patients were collected. Primary cells from these samples were isolated and cultured. Real-time RT-PCR, immunohistochemistry and western blot were used to detect the expression of ClC-3 and matrix metalloproteinase 9 (MMP-9). Small interfering RNA (siRNA) technology was employed to knock down ClC-3 expression. The migration and invasion ability of ESCs was measured by the transwell assay with uncoated or Matrigel-coated membranes. MAIN RESULTS AND THE ROLE OF CHANCE The expression of ClC-3 mRNA and proteins was significantly up-regulated in the ectopic tissues from endometriotic patients, while that in the eutopic endometrial tissues of the same patients did not significantly differ from that in non-endometriotic patients. The migration and invasion ability and MMP-9 expression was increased in the ESCs from ectopic endometrial tissues. The knockdown of ClC-3 expression by ClC-3 siRNA inhibited ESC migration and invasion and attenuated the expression of MMP-9. ClC-3 expression level was well-correlated to the clinical characteristics and symptoms of endometriosis patients, including infertility, dysmenorrhea, chronic pelvic pain, dyspareunia and diameter of endometriosis lesion. LIMITATIONS, REASONS FOR CAUTION Further studies are needed to examine the regulatory mechanism of estrogen on ClC-3 expression of ESCs. WIDER IMPLICATIONS OF THE FINDINGS ClC-3 is involved in the migration and invasion processes of ESCs and can regulate MMP-9 expression. Up-regulation of ClC-3 expression may contribute to endometriosis development by regulating MMP-9 expression. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Natural Science Foundation of China (81173064, 81272223, 81273539), the Ministry of Education of China (20124401110009), the Natural Science Foundation of Guangdong Province (S2011010001589) and the Science and Technology Programs of Guangdong (2013B051000059), Guangzhou (2013J500015) and Dongguan (2011108102006). The authors have no conflict of interest.
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Affiliation(s)
- Yu-tao Guan
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China Department of Pathophysiology, Medical College, Jinan University, Guangzhou, China
| | - Yan-qing Huang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jia-bao Wu
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China
| | - Zhi-qin Deng
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China Department of Pathophysiology, Medical College, Jinan University, Guangzhou, China
| | - Yuan Wang
- Department of Physiology, Medical College, Jinan University, Guangzhou 510632, China
| | - Zhou-yi Lai
- Department of Physiology, Medical College, Jinan University, Guangzhou 510632, China
| | - Hai-bo Wang
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China
| | - Xiao-xue Sun
- Department of Physiology, Medical College, Jinan University, Guangzhou 510632, China
| | - Ya-li Zhu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Miao-miao Du
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Lin-yan Zhu
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China
| | - Li-xin Chen
- Department of Pharmacology, Medical College, Jinan University, Guangzhou 510632, China Department of Pathophysiology, Medical College, Jinan University, Guangzhou, China
| | - Li-wei Wang
- Department of Pathophysiology, Medical College, Jinan University, Guangzhou, China Department of Physiology, Medical College, Jinan University, Guangzhou 510632, China
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18
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Baranov VS, Ivaschenko TE, Yarmolinskaya MI. Comparative systems genetics view of endometriosis and uterine leiomyoma: Two sides of the same coin? Syst Biol Reprod Med 2016; 62:93-105. [PMID: 26828864 DOI: 10.3109/19396368.2015.1123325] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Endometriosis (EM) and uterine leiomyoma (UL) are two most frequent benign tumors of monoclonal origin affecting about 30% of all women in their reproductive age. Modern molecular technologies have made a tremendous impact in understanding both disorders. Here is the first comparative analysis of molecular mechanisms underlying development of EM and UL as it looks from the platform of systems genetics. Similarities and differences of EM and UL at their incipient stages are enlightened with special emphasis on their gene networks, gene expression, and epigenetic regulation, of pathologic development. The analysis substantiates a new hypothesis postulating tumors as outgrowths of the stem cells with mesenchymal commitment lineage (mSC) which migrate from the endometrium/myometrium junctional zone of the uterus. Comparative analysis has revealed basic similarities of molecular pathogenesis of EM and UL suggesting molecular syntropy of both disorders. Peculiarities of the epigenetic landscape determining development of mSC may explain the existence of different clinical forms of EM and UL as well as their unique clinical manifestation. Some perspectives for practical and scientific application in EM and UL studies of this new hypothesis are outlined.
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Affiliation(s)
- Vladislav S Baranov
- a D.O. Ott Research Institute of Obstetrics , Gynecology and Reproductology , Saint-Petersburg , Russian Federation
| | - Tatyana E Ivaschenko
- a D.O. Ott Research Institute of Obstetrics , Gynecology and Reproductology , Saint-Petersburg , Russian Federation
| | - Maria I Yarmolinskaya
- a D.O. Ott Research Institute of Obstetrics , Gynecology and Reproductology , Saint-Petersburg , Russian Federation
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19
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Borrelli GM, Abrão MS, Taube ET, Darb-Esfahani S, Köhler C, Chiantera V, Mechsner S. (Partial) Loss of BAF250a (ARID1A) in rectovaginal deep-infiltrating endometriosis, endometriomas and involved pelvic sentinel lymph nodes. Mol Hum Reprod 2016; 22:329-37. [PMID: 26832958 DOI: 10.1093/molehr/gaw009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/18/2016] [Indexed: 01/01/2023] Open
Abstract
STUDY HYPOTHESIS Loss of protein BAF250a (ARID1A) expression is present in women with rectovaginal deep-infiltrating endometriosis (DIE) and endometriosis affecting the pelvic sentinel lymph nodes (PSLN). STUDY FINDING Partial loss of protein BAF250a was found in some of our patient samples, comprising all endometriosis entities, including rectovaginal DIE and endometriosis affecting the PSLN. WHAT IS KNOWN ALREADY Loss of BAF250a (BRG-associated factor 250a)/ARIDIA (AT-rich interactive domain 1A) protein expression was identified among endometriosis-associated ovarian carcinomas and ovarian endometriosis, and this phenomenon was described as a possible early event in the transformation of endometriosis into cancer. DIE affecting the bowel/rectovaginal site is the most aggressive presentation of endometriosis and its 'risk' of malignant transformation has not been studied so far. STUDY DESIGN, SAMPLES/MATERIALS, METHODS We evaluated the immunohistochemical expression of BAF250a protein in 70 samples from patients enrolled in this study who were surgically treated at a tertiary center, university Hospital. The samples submitted to investigation were from rectovaginal DIE (n= 25/30), endometriosis affecting the PSLN (n= 5/7), ovarian endometriosis (n= 20/20) and endometrium from patients without endometriosis used as controls (n= 20/20). MAIN RESULTS AND THE ROLE OF CHANCE Partial loss (i.e. in one tissue section some cells stained positive for BAF250a while other cells, usually an adjacent group, were negative) of BAF250a protein was identified in 36% (9/25) of rectovaginal DIE samples, 40% (2/5) of endometriosis lesions involving the PSLN, 30% (6/20) of endometriomas, and also in 25% (5/20) of endometrium from controls. We found no statistical correlation between occurrence of partial loss of BAF250a protein and the use or not of hormone medications (P = 0.106), cycle phase (P = 0.917) and stage of disease (P = 0.717). LIMITATIONS, REASONS FOR CAUTION We only found partial loss of BAF250a protein expression, and in a small population of women, with relatively high frequency in all benign tissues assessed in the present analysis. Therefore, this finding alone should not be correlated directly with the risk of malignant transformation in these lesions. WIDER IMPLICATIONS OF THE FINDINGS The occurrence of partial loss of BAF250a protein expression in women with rectovaginal DIE and endometriosis affecting the PSLN is described for the first time. The value of this finding as a predictor of malignant transformation in endometriosis must still be clarified and further studied in association with other molecular events, such as PTEN (phosphatase and tensin homolog) deletion and PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) mutation. We might then be able to identify in the future which patients with endometriosis are at higher risk of cancer. STUDY FUNDING AND COMPETING INTERESTS This study was supported by an internal Charité grant to the Endometriosis Research Center and the authors declare no conflicts of interest.
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Affiliation(s)
- G M Borrelli
- Clinic for Gynecology - Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany Department of Obstetrics and Gynecology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - M S Abrão
- Department of Obstetrics and Gynecology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - E T Taube
- Institute of Pathology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - S Darb-Esfahani
- Institute of Pathology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - C Köhler
- Clinic for Gynecology - Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany Department of Gynecology, Asklepios Klinik Harburg, Hamburg, Germany
| | - V Chiantera
- Clinic for Gynecology - Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S Mechsner
- Clinic for Gynecology - Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
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20
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Bungum HF, Nygaard U, Vestergaard C, Martensen PM, Knudsen UB. Increased IL-25 levels in the peritoneal fluid of patients with endometriosis. J Reprod Immunol 2016; 114:6-9. [PMID: 26852387 DOI: 10.1016/j.jri.2016.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/01/2016] [Accepted: 01/19/2016] [Indexed: 01/10/2023]
Abstract
Previous studies have indicated a higher prevalence of allergic disease among women with endometriosis. It is already well established that type 1 allergies develop in a Th2 cytokine environment. Recent studies have shown, however, that IL-25 induces a Th2 development of naive T lymphocytes and is central in the Th2 response. The aim of this case-control study was to investigate the presence of IL-25 in the peritoneal fluid of women suffering from endometriosis. PF was obtained both from women undergoing laparoscopic surgery due to endometriosis (25 cases) and from women wanting sterilisation (19 controls). IL-25 levels were then investigated by ELISA. Women with endometriosis showed significantly higher levels of IL-25 in their PF (p=0.019) compared to controls. IL-25 levels did not correlate with the stage of endometriosis. Both Th2-cells and mast cells express IL-25, which could favor the development of allergies by perpetuating a hypersensitivity reaction. Further, IL-25 may also hold a role as a diagnostic tool.
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Affiliation(s)
- Helle Folge Bungum
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Uffe Nygaard
- Department of Dermatology, Aarhus University Hospital, P.P.Ørumsgade 11, 8000 Aarhus C, Denmark; Department of Clinical medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Christian Vestergaard
- Department of Dermatology, Aarhus University Hospital, P.P.Ørumsgade 11, 8000 Aarhus C, Denmark
| | - Pia M Martensen
- Department of Molecular Biology and Genetics, Aarhus University, C.F. Møllers Allé, 8000 Aarhus C, Denmark
| | - Ulla Breth Knudsen
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
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21
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Saare M, Modhukur V, Suhorutshenko M, Rajashekar B, Rekker K, Sõritsa D, Karro H, Soplepmann P, Sõritsa A, Lindgren CM, Rahmioglu N, Drong A, Becker CM, Zondervan KT, Salumets A, Peters M. The influence of menstrual cycle and endometriosis on endometrial methylome. Clin Epigenetics 2016; 8:2. [PMID: 26759613 PMCID: PMC4710036 DOI: 10.1186/s13148-015-0168-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/30/2015] [Indexed: 12/29/2022] Open
Abstract
Background Alterations in endometrial DNA methylation profile have been proposed as one potential mechanism initiating the development of endometriosis. However, the normal endometrial methylome is influenced by the cyclic hormonal changes, and the menstrual cycle phase-dependent epigenetic signature should be considered when studying endometrial disorders. So far, no studies have been performed to evaluate the menstrual cycle influences and endometriosis-specific endometrial methylation pattern at the same time. Results Infinium HumanMethylation 450K BeadChip arrays were used to explore DNA methylation profiles of endometrial tissues from various menstrual cycle phases from 31 patients with endometriosis and 24 healthy women. The DNA methylation profile of patients and controls was highly similar and only 28 differentially methylated regions (DMRs) between patients and controls were found. However, the overall magnitude of the methylation differences between patients and controls was rather small (Δβ ranging from –0.01 to –0.16 and from 0.01 to 0.08, respectively, for hypo- and hypermethylated CpGs). Unsupervised hierarchical clustering of the methylation data divided endometrial samples based on the menstrual cycle phase rather than diseased/non-diseased status. Further analysis revealed a number of menstrual cycle phase-specific epigenetic changes with largest changes occurring during the late-secretory and menstrual phases when substantial rearrangements of endometrial tissue take place. Comparison of cycle phase- and endometriosis-specific methylation profile changes revealed that 13 out of 28 endometriosis-specific DMRs were present in both datasets. Conclusions The results of our study accentuate the importance of considering normal cyclic epigenetic changes in studies investigating endometrium-related disease-specific methylation patterns. Electronic supplementary material The online version of this article (doi:10.1186/s13148-015-0168-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Merli Saare
- Competence Centre on Health Technologies Tartu, Tartu, Estonia.,Tartu University Women's Clinic, Tartu, Estonia.,Institute of Bio- and Translational Medicine, University of Tartu, Tartu, Estonia
| | | | | | | | - Kadri Rekker
- Competence Centre on Health Technologies Tartu, Tartu, Estonia.,Tartu University Women's Clinic, Tartu, Estonia
| | - Deniss Sõritsa
- Competence Centre on Health Technologies Tartu, Tartu, Estonia.,Tartu University Women's Clinic, Tartu, Estonia.,Elite Clinic, Tartu, Estonia.,Women's Clinic, Tartu University Hospital, Tartu, Estonia
| | - Helle Karro
- Tartu University Women's Clinic, Tartu, Estonia.,Women's Clinic, Tartu University Hospital, Tartu, Estonia
| | | | | | - Cecilia M Lindgren
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nilufer Rahmioglu
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Alexander Drong
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Christian M Becker
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
| | - Krina T Zondervan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.,Endometriosis CaRe Centre, Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
| | - Andres Salumets
- Competence Centre on Health Technologies Tartu, Tartu, Estonia.,Tartu University Women's Clinic, Tartu, Estonia.,Institute of Bio- and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Maire Peters
- Competence Centre on Health Technologies Tartu, Tartu, Estonia.,Tartu University Women's Clinic, Tartu, Estonia
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22
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Borrelli GM, Abrão MS, Taube ET, Darb-Esfahani S, Köhler C, Kaufmann AM, Chiantera V, Mechsner S. Immunohistochemical Investigation of Metastasis-Related Chemokines in Deep-Infiltrating Endometriosis and Compromised Pelvic Sentinel Lymph Nodes. Reprod Sci 2015; 22:1632-42. [PMID: 26169037 DOI: 10.1177/1933719115592711] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Endometriosis is a prevalent benign disease, despite sharing several similarities with malignancies, such as the possibility of lymphatic spread. In malignancies, chemokines play a sovereign role in the process of metastasis. Metastasis-related chemokine axes have not yet been assessed in deep-infiltrating endometriosis (DIE), and this investigation was the aim of our study. The expression of these chemokines was investigated by immunohistochemistry in rectovaginal DIE lesions and in matched pelvic sentinel lymph nodes (PSLNs) of patients with endometriosis (n = 27), and their expression in the eutopic endometrium (EE) of endometriosis-free women (n = 20) was used as controls. Their staining pattern in rectovaginal DIE, in endometriotic lesions affecting the PSLN as well as in the EE of patients without endometriosis was characterized for the first time. Overall, these chemokines were highly expressed in DIE and endometriosis in PSLN. Chemokines might be involved in the spread of endometriosis and should be further investigated.
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Affiliation(s)
- G M Borrelli
- Clinic for Gynecology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Department of Obstetrics and Gynecology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - M S Abrão
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - E T Taube
- Institute of Pathology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - S Darb-Esfahani
- Institute of Pathology, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - C Köhler
- Clinic for Gynecology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Department of Gynecology, Asklepios Klinik Harburg, Hamburg, Germany
| | - A M Kaufmann
- Clinic for Gynecology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - V Chiantera
- Clinic for Gynecology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - S Mechsner
- Clinic for Gynecology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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23
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Sofo V, Götte M, Laganà AS, Salmeri FM, Triolo O, Sturlese E, Retto G, Alfa M, Granese R, Abrão MS. Correlation between dioxin and endometriosis: an epigenetic route to unravel the pathogenesis of the disease. Arch Gynecol Obstet 2015; 292:973-86. [DOI: 10.1007/s00404-015-3739-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
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24
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Koike N, Higashiura Y, Akasaka J, Uekuri C, Ito F, Kobayashi H. Epigenetic dysregulation of endometriosis susceptibility genes (Review). Mol Med Rep 2015; 12:1611-6. [PMID: 25891066 DOI: 10.3892/mmr.2015.3635] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 03/05/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present review was to illustrate how dysregulation of hormonal signaling regulates expressional changes of spatially associated genes in endometriosis. From a multi‑platform endometriosis dataset, an integrated analysis was performed of epigenomic changes of several biologically relevant genes that have been validated in the literature. Estrogen receptor (ER) may act as a direct epigenetic driver for endometriosis establishment, maintenance and progression. A majority of endometriosis susceptibility genes may be present in functional downstream targets of ER and located near the known imprinting genes. Previous studies have shed light on the overlapping genetic signatures between endometriosis development and the defective decidualization process. The steroid hormone‑mediated decidualization signaling pathway was shown to be frequently dysregulated in endometriosis. DNA methylation is associated with various intragenic or intergenic epigenetic modifications of chromatin. Chromatin architecture may be established in temporal and spatial orchestration of the recruitment of genes specifically downregulated in endometriosis. In conclusion, defective chromatin architecture at the ER target locus may have a key role in endometriosis. Endometriosis represents an interesting model to explore the variation of expression of spatially associated genes.
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Affiliation(s)
- Natsuki Koike
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Yumi Higashiura
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Juria Akasaka
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Chiharu Uekuri
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Fuminori Ito
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan
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25
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KOBAYASHI HIROSHI, IMANAKA SHOGO, NAKAMURA HARUKI, TSUJI AYUMI. Understanding the role of epigenomic, genomic and genetic alterations in the development of endometriosis (Review). Mol Med Rep 2014; 9:1483-505. [DOI: 10.3892/mmr.2014.2057] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 03/03/2014] [Indexed: 11/05/2022] Open
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26
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Kobayashi H, Higashiura Y, Koike N, Akasaka J, Uekuri C, Iwai K, Niiro E, Morioka S, Yamada Y. Genes Downregulated in Endometriosis Are Located Near the Known Imprinting Genes. Reprod Sci 2014; 21:966-972. [PMID: 24615936 DOI: 10.1177/1933719114526473] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
There is now accumulating evidence that endometriosis is a disease associated with an epigenetic disorder. Genomic imprinting is an epigenetic phenomenon known to regulate DNA methylation of either maternal or paternal alleles. We hypothesize that hypermethylated endometriosis-associated genes may be enriched at imprinted gene loci. We sought to determine whether downregulated genes associated with endometriosis susceptibility are associated with chromosomal location of the known paternally and maternally expressed imprinting genes. Gene information has been gathered from National Center for Biotechnology Information database geneimprint.com. Several researchers have identified specific loci with strong DNA methylation in eutopic endometrium and ectopic lesion with endometriosis. Of the 29 hypermethylated genes in endometriosis, 19 genes were located near 45 known imprinted foci. There may be an association of the genomic location between genes specifically downregulated in endometriosis and epigenetically imprinted genes.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Yumi Higashiura
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Natsuki Koike
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Juria Akasaka
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Chiharu Uekuri
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Kana Iwai
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Emiko Niiro
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Sachiko Morioka
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Yuki Yamada
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
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