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Carrubba AR, Leon MG, Robertson MW. Mucinous Borderline Ovarian Cystadenoma Interpreted as Endometriosis in an Adolescent. J Gynecol Surg 2021. [DOI: 10.1089/gyn.2021.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aakriti R. Carrubba
- Department of Medical and Surgical Gynecology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Mateo G. Leon
- Department of Medical and Surgical Gynecology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Matthew W. Robertson
- Department of Medical and Surgical Gynecology, Mayo Clinic Florida, Jacksonville, Florida, USA
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Santulli P, Marcellin L, Chouzenoux S, Boulard V, Just PA, Nicco C, Chereau C, Tosti C, Chapron C, Batteux F. Role of the protein kinase BRAF in the pathogenesis of endometriosis. Expert Opin Ther Targets 2016; 20:1017-29. [PMID: 27087167 DOI: 10.1080/14728222.2016.1180367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Mitogen-activated protein kinases (MAPKs) are involved in the proliferation and survival of endometriotic lesions. Vemurafenib (PLX4032) is a novel protein kinase inhibitor that targets BRAF, a member of the MAPK pathway. The present study tested the in vitro and in vivo effects of PLX4032 on endometriotic cells. RESEARCH DESIGN AND METHODS We conducted a laboratory study in a tertiary-care university hospital from January 2013 to September 2013. We enrolled a cohort of 40 patients: 20 with histologically proven endometriosis and 20 unaffected women. A thorough surgical examination of the abdominopelvic cavity was performed on all of the study participants. Ex vivo stromal and epithelial cells were extracted from endometrial and endometriotic biopsies from both sets of patients. Proliferation, apoptosis, pERK/ERK ratio, cell cycle regulation (Cyclin D1 and CDK4) and inflammation (PTGS2) were explored with and without PLX4032 treatment. Human endometriotic lesions were implanted into 40 nude mice that were separated into two groups according to PLX4032 or vehicle treatment, which they received for four weeks, before sacrifice and histological examination. RESULTS Treating endometriotic cells with PLX4032 abrogated the phosphorylation of ERK, significantly reducing the pERK/ERK ratio in both epithelial and stromal cells from endometriotic women compared to the controls (p < 0.05). In addition, treatment with PLX4032 significantly decreased proliferation in both stromal and epithelial cells with a concomitant decrease in Cyclin D1/CDK4 complex and PTGS2 levels. Using a murine model of endometriosis, we observed that PLX4032-treated mice displayed a significant decrease in implant volume compared to the initial size; a slight, but non-significant, increase in size was observed in the vehicle-treated mice. CONCLUSION Our data suggest that MAPKs and BRAF are involved in the pathogenesis of endometriosis. PLX4032-induced inhibition of BRAF controlled endometriotic growth, both in vitro and in vivo, and could constitute a promising target for the treatment of endometriosis.
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Affiliation(s)
- Pietro Santulli
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Louis Marcellin
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Sandrine Chouzenoux
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Veronique Boulard
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | | | - Carole Nicco
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Christiane Chereau
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Claudia Tosti
- d Obstetrics and Gynecology, Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Charles Chapron
- a Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynecology Obstetrics II and Reproductive Medicine , Université Paris Descartes , Paris , France.,b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France
| | - Frédéric Batteux
- b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Equipe Pr Batteux , Université Paris Descartes, Sorbonne Paris Cité , Paris , France.,e Department of Immunology , Hôpital Cochin, AP-HP , Paris , France
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Endometrioma: From Pathogenesis to Clinical Management. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2013. [DOI: 10.5301/je.5000163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An endometrioma (OMA) is the localization of endometriosis in ovary, and it most often develops as a cyst. The pathogenesis of OMA is still an open question and controversial; a cystic hemorrhagic corpus luteum may be a prerequisite, occurring as a transition to an endometriotic cyst. Inversion and progressive invagination of the ovarian cortex after the accumulation of menstrual debris derived from bleeding of superficial endometriotic implants, located on the ovarian surface and adherent to the peritoneum, is another hypothesis. Gene studies show that WNT4 and FN1 are predisposing genes for OMA development. A role of environmental toxicants in the development of OMA is also under investigation; dioxins and dioxin-like compounds (DLCs), interacting with steroid receptors, are possible factors. Even if women with endometriosis have a 1.5 times greater lifetime risk to develop an ovarian carcinoma, an OMA is not to be considered a preneoplastic lesion. The clinical management of OMAs is complex and should be individualized. Ultrasounds and magnetic resonance imaging (MRI) are sensitive but not specific for diagnosis. Treatment is influenced by patient age, desire for pregnancy, pain severity, cyst dimensions and characteristics (unilateral/bilateral), coexistence of deep endometriosis, previous gynecological or obstetrical history and previous surgery. Laparoscopic surgery is considered the treatment of choice in cases of infertile patients with a large OMA or pain, and in patients not responding to medical therapy. It should be performed with proper techniques by trained surgeons to decrease the damage to the remaining ovarian tissue, and to maintain the ovarian reserve after surgery. A medical hormonal and nonhormonal treatment is used for asymptomatic and/or pain-associated OMA (progestins, estroprogestins and antiinflammatory drugs). Considering the relative high recurrence rate after surgery, a medical treatment should be offered.
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