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Knez J, Bean E, Nijjar S, Mavrelos D, Jurkovic D. Ultrasound study of natural progression of ovarian endometrioma. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 64:405-411. [PMID: 38337178 DOI: 10.1002/uog.27607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/30/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To determine the natural progression of ovarian endometrioma in women who are managed expectantly. METHODS This was a retrospective cohort study of 83 women with evidence of ovarian endometrioma who were managed expectantly between April 2007 and May 2022. The study was conducted in the Department of Women's Health, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK. We searched our ultrasound clinic databases to identify women aged 18 years or older with evidence of ovarian endometrioma who were managed expectantly for ≥ 6 months. All women attended for a minimum of two ultrasound scans performed by a single expert ultrasound operator. In addition to patient demographics, we recorded the number, mean diameter and location of each cyst. The cyst growth rate was expressed as annual change in the mean diameter. RESULTS A total of 1922 women who attended our gynecology clinic during the study period were found to have evidence of moderate or severe endometriosis on pelvic ultrasound examination. Of those, 83 women had evidence of ovarian endometrioma and were managed expectantly. The median age of women was 39 (range, 26-51) years at the initial visit. Each woman had at least two ultrasound scans performed by a single expert operator at a minimum interval of ≥ 6 months. Of 83 women diagnosed with endometrioma, 50 (60% (95% CI, 49-71%)) had a single cyst and the remainder had multiple cysts. The median number of endometriomas per patient was 1 (range, 1-5) and the median follow-up time was 634 (range, 187-2984) days. A total of 39/83 (47% (95% CI, 36-58%)) women experienced an overall reduction in size of cysts, in 18/83 (22% (95% CI, 13-32%)) the cysts increased in size and in 26/83 (31% (95% CI, 22-42%)) women, no meaningful change in size was observed. The median change in mean cyst diameter per woman during the study period was -2.7 (range, -57.7 to 39.3) mm, with a median annual regression rate of -1.7 (range, -24.6 to 42.0) mm/year/woman. Overall, when compared with the initial visit, cysts were significantly smaller at follow-up (median diameter, 22.3 (range, 6.7-77.0) mm vs 18.5 (range, 5.0-72.0) mm; P = 0.009). We did not identify any clinical characteristics that could reliably predict the chance of endometrioma progression. CONCLUSIONS In the majority of women with an ultrasound diagnosis of ovarian endometrioma, the cysts do not increase in size significantly over time and they could be managed expectantly. This evidence may help clinicians when counseling asymptomatic or minimally symptomatic women about management of ovarian endometrioma. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J Knez
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
- Clinic for Gynecology and Perinatology, University Medical Center Maribor, Maribor, Slovenia
| | - E Bean
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - S Nijjar
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - D Mavrelos
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - D Jurkovic
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
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Nati ID, Malutan A, Ciortea R, Oancea M, Bucuri C, Roman M, Ormindean C, Milon AG, Mihu D. Exploring the Influence of IL-8, IL-10, Patient-Reported Pain, and Physical Activity on Endometriosis Severity. Diagnostics (Basel) 2024; 14:1822. [PMID: 39202309 PMCID: PMC11353965 DOI: 10.3390/diagnostics14161822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/18/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024] Open
Abstract
Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain, and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis.
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Affiliation(s)
- Ionel Daniel Nati
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Andrei Malutan
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Razvan Ciortea
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Mihaela Oancea
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Carmen Bucuri
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
- Emergency Military Clinical Hospital “Dr Constantin Papilian”, 400610 Cluj-Napoca, Romania
| | - Maria Roman
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Cristina Ormindean
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
| | - Alexandra Gabriela Milon
- Faculty of Physical Education and Sport, Bogdan-Vodă University of Cluj Napoca, 400394 Cluj-Napoca, Romania
| | - Dan Mihu
- 2nd Department of Obstetric and Ginecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania; (I.D.N.)
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Ochoa Bernal MA, Fazleabas AT. The Known, the Unknown and the Future of the Pathophysiology of Endometriosis. Int J Mol Sci 2024; 25:5815. [PMID: 38892003 PMCID: PMC11172035 DOI: 10.3390/ijms25115815] [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: 04/02/2024] [Revised: 05/14/2024] [Accepted: 05/19/2024] [Indexed: 06/21/2024] Open
Abstract
Endometriosis is one of the most common causes of chronic pelvic pain and infertility, affecting 10% of women of reproductive age. A delay of up to 9 years is estimated between the onset of symptoms and the diagnosis of endometriosis. Endometriosis is currently defined as the presence of endometrial epithelial and stromal cells at ectopic sites; however, advances in research on endometriosis have some authors believing that endometriosis should be re-defined as "a fibrotic condition in which endometrial stroma and epithelium can be identified". There are several theories on the etiology of the disease, but the origin of endometriosis remains unclear. This review addresses the role of microRNAs (miRNAs), which are naturally occurring post-transcriptional regulatory molecules, in endometriotic lesion development, the inflammatory environment within the peritoneal cavity, including the role that cytokines play during the development of the disease, and how animal models have helped in our understanding of the pathology of this enigmatic disease.
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Affiliation(s)
- Maria Ariadna Ochoa Bernal
- Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI 49503, USA;
- Department of Animal Science, Michigan State University, East Lansing, MI 48824, USA
| | - Asgerally T. Fazleabas
- Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI 49503, USA;
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Chatterjee S, Mukhoti K, Chakraborty A. Catamenial pneumothorax in thoracic endometriosis syndrome. Lung India 2024; 41:217-218. [PMID: 38687233 PMCID: PMC11093147 DOI: 10.4103/lungindia.lungindia_576_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/10/2023] [Accepted: 12/17/2023] [Indexed: 05/02/2024] Open
Affiliation(s)
- Surajit Chatterjee
- Department of Respiratory Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India E-mail:
| | - Krishanu Mukhoti
- Department of Respiratory Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India E-mail:
| | - Ankita Chakraborty
- Department of Respiratory Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India E-mail:
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Xholli A, Cremonini F, Perugi I, Londero AP, Cagnacci A. Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications. Pharmaceuticals (Basel) 2023; 16:1696. [PMID: 38139822 PMCID: PMC10747908 DOI: 10.3390/ph16121696] [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: 10/11/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Endometriosis is a common inflammatory disease affecting women of reproductive age, characterized by the growth of endometrial tissue beyond the uterus. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease. Recent studies have revealed alterations in the gut microbiota of individuals with endometriosis, including reduced diversity, microbial composition imbalances, and pathogenic bacteria. These changes can disrupt immune function, increase inflammation, and contribute to the chronic inflammatory state observed in endometriosis. Moreover, dysregulation of intestinal permeability may further exacerbate gastrointestinal symptoms in affected individuals. Understanding the role of the gut microbiota and intestinal permeability in endometriosis can provide valuable insights into disease pathogenesis, aid in non-invasive diagnostic approaches, and open new avenues for therapeutic interventions. Probiotics, in particular, have shown promise in improving endometriosis-associated pain symptoms and reducing endometriotic lesions in animal models. This review suggests that additional research and well-designed clinical trials are necessary to validate the potential diagnostic and therapeutic benefits of manipulating the gut microbiota in managing endometriosis and its gastrointestinal symptoms, thereby improving the quality of life for those affected.
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Affiliation(s)
- Anjeza Xholli
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (A.X.); (F.C.); (I.P.)
| | - Francesca Cremonini
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (A.X.); (F.C.); (I.P.)
| | - Isabella Perugi
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (A.X.); (F.C.); (I.P.)
| | - Ambrogio Pietro Londero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy;
- Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Angelo Cagnacci
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (A.X.); (F.C.); (I.P.)
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy;
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Knez J, Bean E, Nijjar S, Tellum T, Chaggar P, Jurkovic D. Natural progression of deep pelvic endometriosis in women who opt for expectant management. Acta Obstet Gynecol Scand 2023; 102:1298-1305. [PMID: 37190782 PMCID: PMC10540915 DOI: 10.1111/aogs.14491] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 05/17/2023]
Abstract
INTRODUCTION The natural history of endometriosis is poorly understood, and despite numerous studies, the rate of the disease progression and optimal treatment planning in women who are asymptomatic or experience mild symptoms not requiring treatment are unknown. The aim of this study was to assess the behavior of deep endometriosis in women who are managed expectantly without any medical or surgical intervention. MATERIAL AND METHODS A retrospective cohort study of women diagnosed with deep endometriosis on transvaginal ultrasound scan at the Department of Gynecology, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK, from April 2007 to April 2022. All women attended for at least two ultrasound scans which were carried out by a single expert ultrasound examiner and at least 6 months apart. The number and position of endometriotic nodules were recorded, and the mean diameter of each nodule was calculated from measurements taken in three orthogonal planes. RESULTS During the study period, 1922 women were found to have moderate or severe deep endometriosis on pelvic ultrasound examination. A total of 135 premenopausal women who were managed expectantly fitted the inclusion criteria. The median number of endometriotic nodules per woman at the initial visit was 2 (range: 0-7), and the median follow-up time was 666 days (181-2984). In the follow-up period, 50/135 women (37%, 95% CI: 29-46) developed additional nodules or experienced an increase in nodule size, and 17/135 women (13%, 95% CI: 8-19) had a regression in the number or size of the nodules. In the remaining 68/135 women (50%, 95% CI: 42-59) the disease remained static during the follow-up. The median change in mean diameter of nodules during the study period per woman was +0.13 mm (-11.67 - +5.83), with an annual growth rate of +0.09 mm/year (-6.65 - +6.45). CONCLUSIONS In our study we found evidence of deep endometriosis progression in just over a third of women. In view of this, asymptomatic or mildly symptomatic women diagnosed with deep endometriosis could be reassured that their disease is unlikely to worsen with time.
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Affiliation(s)
- Jure Knez
- Department of Women's HealthUniversity College London HospitalLondonUK
- Clinic for GynecologyUniversity Medical Centre MariborMariborSlovenia
| | - Elisabeth Bean
- Department of Women's HealthUniversity College London HospitalLondonUK
| | - Simrit Nijjar
- Department of Women's HealthUniversity College London HospitalLondonUK
| | - Tina Tellum
- Department of Women's HealthUniversity College London HospitalLondonUK
- Department of GynecologyOslo University HospitalOsloNorway
| | - Prubpreet Chaggar
- Department of Women's HealthUniversity College London HospitalLondonUK
| | - Davor Jurkovic
- Department of Women's HealthUniversity College London HospitalLondonUK
- The Gynaecology Ultrasound CentreLondonUK
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Ermiş IS, Deveci E, Aşır F. Effects of Quince Gel and Hesperidin Mixture on Experimental Endometriosis. Molecules 2023; 28:5945. [PMID: 37630196 PMCID: PMC10458919 DOI: 10.3390/molecules28165945] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVES Endometriosis (EM) is the presence of endometrial tissue outside the uterus. This study aimed to examine the effects of quince gel and hesperidin treatment on uterine tissue in an experimental endometriosis model. MATERIALS AND METHODS Thirty-two rats were categorized into four groups as sham, EM, EM+quince gel (QG), and EM+QG+Hesperidin (HES). The endometriosis (EM) model was induced with surgical intervention. Estradiol benzoate (EB) was used to induce endometrial hyperplasia. In the EM group, EB was given to rats for 7 days. The EM+QG group received 2 cc QG for 21 days. HES treatment was given for 21 days after EM induction. At the end of the experiment, blood was taken from the animals and the serum total antioxidant status (TAS) and total oxidant status (TOS) values were studied. Uterine tissues were dissected and processed for histological paraffin embedding. Tissues were fixed in 4% glutaraldehyde solution and processed for ultrastructural analysis. RESULTS After EM, QG and HES treatment significantly increased the TAS and decreased the TOS value. EM caused epithelial and glandular degeneration, thinning of the basal membranes, and vascular dilatation with increased fibrosis and edema. QG+HES restored the pathology and showed protective effects in uterine tissues. Caspase-3 expression was increased in the epithelium, glands, and muscle layers of the EM group. In EM+QG+HES, hesperidin protected cell survival and decreased Caspase-3 expression in uterine tissues. TNF-α expression was intense in inflammatory cells and the muscle layer in the EM group. HES reduced inflammation by decreasing the TNF-α expression. MAPK expression was increased after EM induction in epithelial, glandular, and inflammatory cells in the EM group. After HES treatment, MAPK expression was mainly negative in cells of uterine tissue in the EM+QG+HES group. Ultrastructurally, in the EM group, organelles were disrupted and dilated and degenerated after EM induction. QG and HES treatment improved cellular organelles. CONCLUSION Local vaginal applications can be an alternative treatment method in the endometriosis model via QG+HES treatment promoting cell proliferation and angiogenesis and preventing cell death.
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Affiliation(s)
- Işılay Sezen Ermiş
- Department of Gynecology and Obstetrics, Medical Faculty, Harran University, Şanlıurfa 63050, Turkey
| | - Engin Deveci
- Department of Histology and Embryology, Medical Faculty, Dicle University, Diyarbakır 21280, Turkey; (E.D.); (F.A.)
| | - Fırat Aşır
- Department of Histology and Embryology, Medical Faculty, Dicle University, Diyarbakır 21280, Turkey; (E.D.); (F.A.)
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Chen LH, Lo WC, Huang HY, Wu HM. A Lifelong Impact on Endometriosis: Pathophysiology and Pharmacological Treatment. Int J Mol Sci 2023; 24:7503. [PMID: 37108664 PMCID: PMC10139092 DOI: 10.3390/ijms24087503] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
Endometriosis is a chronic inflammatory disease associated with bothersome symptoms in premenopausal women and is complicated with long-term systemic impacts in the post-menopausal stage. It is generally defined by the presence of endometrial-like tissue outside the uterine cavity, which causes menstrual disorders, chronic pelvic pain, and infertility. Endometriotic lesions can also spread and grow in extra-pelvic sites; the chronic inflammatory status can cause systemic effects, including metabolic disorder, immune dysregulation, and cardiovascular diseases. The uncertain etiologies of endometriosis and their diverse presentations limit the treatment efficacy. High recurrence risk and intolerable side effects result in poor compliance. Current studies for endometriosis have paid attention to the advances in hormonal, neurological, and immunological approaches to the pathophysiology and their potential pharmacological intervention. Here we provide an overview of the lifelong impacts of endometriosis and summarize the updated consensus on therapeutic strategies.
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Affiliation(s)
- Liang-Hsuan Chen
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Wei-Che Lo
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Hong-Yuan Huang
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Hsien-Ming Wu
- Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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Monnin N, Fattet AJ, Koscinski I. Endometriosis: Update of Pathophysiology, (Epi) Genetic and Environmental Involvement. Biomedicines 2023; 11:biomedicines11030978. [PMID: 36979957 PMCID: PMC10046867 DOI: 10.3390/biomedicines11030978] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Endometriosis is a chronic disease caused by ectopic endometrial tissue. Endometriotic implants induce inflammation, leading to chronic pain and impaired fertility. Characterized by their dependence on estradiol (via estrogen receptor β (ESRβ)) and their resistance to progesterone, endometriotic implants produce their own source of estradiol through active aromatase. Steroidogenic factor-1 (SF1) is a key transcription factor that promotes aromatase synthesis. The expression of SF1 and ESRβ is enhanced by the demethylation of their promoter in progenitor cells of the female reproductive system. High local concentrations of estrogen are involved in the chronic inflammatory environment favoring the implantation and development of endometriotic implants. Similar local conditions can promote, directly and indirectly, the appearance and development of genital cancer. Recently, certain components of the microbiota have been identified as potentially promoting a high level of estrogen in the blood. Many environmental factors are also suspected of increasing the estrogen concentration, especially prenatal exposure to estrogen-like endocrine disruptors such as DES and bisphenol A. Phthalates are also suspected of promoting endometriosis but throughmeans other than binding to estradiol receptors. The impact of dioxin or tobacco seems to be more controversial.
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Affiliation(s)
- Nicolas Monnin
- Majorelle Clinic, Atoutbio Laboratory, Laboratory of Biology of Reproduction, 54000 Nancy, France
| | - Anne Julie Fattet
- Majorelle Clinic, Atoutbio Laboratory, Laboratory of Biology of Reproduction, 54000 Nancy, France
| | - Isabelle Koscinski
- Laboratory of Biology of Reproduction, Hospital Saint Joseph, 13008 Marseille, France
- NGERE Inserm 1256, 54505 Vandoeuvre les Nancy, France
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The Role of Dietary Fats in the Development and Treatment of Endometriosis. Life (Basel) 2023; 13:life13030654. [PMID: 36983810 PMCID: PMC10058497 DOI: 10.3390/life13030654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023] Open
Abstract
Endometriosis is an estrogen-dependent disease in women of childbearing age that affects approximately 5–15% of the female population. The etiology of endometriosis is complex, multifaceted, and not fully understood. In endometriosis, which is an estrogen-related chronic inflammatory condition, estrogen plays a major role in endometrial cellular growth. High estrogen levels could be another risk factor for developing endometriosis. The aim of this review is to update knowledge on the impact of dietary fats on the development of endometriosis and chronic inflammation in women with endometriosis and diet therapy. Dietary fat may be linked with the progression and development of endometriosis, but studies have been contradictory due to various issues including sample size, different study designs, and different methodological aspects. Results have shown that the risk of endometriosis may increase with a higher consumption of products rich in saturated fats, especially palmitic acid and trans-unsaturated fatty acids. Monounsaturated fats and omega-3 polyunsaturated fatty acids may likely be connected with a lower risk of developing endometriosis and with reductions in the severity of disease. Monounsaturated fats, omega-3 polyunsaturated fatty acids, and a suitable eicosapentaenoic acid to arachidonic acid ratio can be used in diet therapy to improve quality of life by reducing pain and inflammation. Further research is needed in order to fully understand the influence of dietary fats on the risk of development of this disease.
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Gonadotropin-Releasing Hormone Antagonists-A New Hope in Endometriosis Treatment? J Clin Med 2023; 12:jcm12031008. [PMID: 36769656 PMCID: PMC9918258 DOI: 10.3390/jcm12031008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Endometriosis is a chronic disease, in which endometrial-like tissue is found outside the uterine cavity. Lesions are typically located in the true pelvis but can be found, in addition to extragenital endometriosis, in the respiratory system, the diaphragm, the pleura or the pericardium. As the extrauterine endometrial lesions undergo the menstrual cycle, they cause many symptoms, including pain, and besides infertility, they all mostly affect the quality of the patient's life. Pharmacological management of endometriosis significantly increases in importance either as a first-line treatment or as a complementary therapy after surgery. Yet, current research on antagonists of the gonadotropin-releasing hormone (GnRH) has revealed their potential benefits in endometriosis treatment. Their mechanism of action is to down-regulate the hypothalamic-pituitary-gonadal axis and therefore induce a hypoestrogenic state. The resulting reduction of estrogen levels prevents disease progression and diminishes the recurrence rate after surgical removal of endometriosis. The present review summarizes recent reports of the role oral GnRH antagonists have as a significant treatment option for pain reduction in endometriosis patients.
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12
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Dutta S, Banu SK, Arosh JA. Endocrine disruptors and endometriosis. Reprod Toxicol 2023; 115:56-73. [PMID: 36436816 DOI: 10.1016/j.reprotox.2022.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Endometriosis is a hormone-dependent inflammatory gynecological disease of reproductive-age women. It is clinically and pathologically characterized by the presence of functional endometrium as heterogeneous lesions outside the uterine cavity. The two major symptoms are chronic pelvic pain and infertility, which profoundly affect women's reproductive health and quality of life. This significant individual and public health concerns underscore the importance of understanding the pathogenesis of endometriosis. The environmental endocrine-disrupting chemicals (EDCs) are exogenous agents that interfere with the synthesis, secretion, transport, signaling, or metabolism of hormones responsible for homeostasis, reproduction, and developmental processes. Endometriosis has been potentially linked to exposure to EDCs. In this review, based on the robust literature search, we have selected four endocrine disruptors (i) polychlorinated biphenyls (PCB)s (ii) dioxins (TCDD) (iii) bisphenol A (BPA) and its analogs and (iv) phthalates to elucidate their critical role in the etiopathogenesis of endometriosis. The epidemiological and experimental data discussed in this review indicate that these four EDCs activate multiple intracellular signaling pathways associated with proinflammation, estrogen, progesterone, prostaglandins, cell survival, apoptosis, migration, invasion, and growth of endometriosis. The available information strongly indicates that environmental exposure to EDCs such as PCBs, dioxins, BPA, and phthalates individually or collectively contribute to the pathophysiology of endometriosis. Further understanding of the molecular mechanisms of how these EDCs establish endometriosis and therapeutic strategies to mitigate the effects of these EDCs in the pathogenesis of endometriosis are timely needed. Moreover, understanding the interactive roles of these EDCs in the pathogenesis of endometriosis will help regulate the exposure to these EDCs in reproductive age women.
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Affiliation(s)
- Sudipta Dutta
- Reproductive Endocrinology and Cell Signaling Laboratory, Department of Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 77843 College Station, TX, USA
| | - Sakhila K Banu
- Reproductive Endocrinology and Cell Signaling Laboratory, Department of Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 77843 College Station, TX, USA.
| | - Joe A Arosh
- Reproductive Endocrinology and Cell Signaling Laboratory, Department of Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 77843 College Station, TX, USA.
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Bonavina G, Taylor HS. Endometriosis-associated infertility: From pathophysiology to tailored treatment. Front Endocrinol (Lausanne) 2022; 13:1020827. [PMID: 36387918 PMCID: PMC9643365 DOI: 10.3389/fendo.2022.1020827] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the clinically recognized association between endometriosis and infertility, the mechanisms implicated in endometriosis-associated infertility are not fully understood. Endometriosis is a multifactorial and systemic disease that has pleiotropic direct and indirect effects on reproduction. A complex interaction between endometriosis subtype, pain, inflammation, altered pelvic anatomy, adhesions, disrupted ovarian reserve/function, and compromised endometrial receptivity as well as systemic effects of the disease define endometriosis-associated infertility. The population of infertile women with endometriosis is heterogeneous, and diverse patients' phenotypes can be observed in the clinical setting, thus making difficult to establish a precise diagnosis and a single mechanism of endometriosis related infertility. Moreover, clinical management of infertility associated with endometriosis can be challenging due to this heterogeneity. Innovative non-invasive diagnostic tools are on the horizon that may allow us to target the specific dysfunctional alteration in the reproduction process. Currently the treatment should be individualized according to the clinical situation and to the suspected level of impairment. Here we review the etiology of endometriosis related infertility as well as current treatment options, including the roles of surgery and assisted reproductive technologies.
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Affiliation(s)
- Giulia Bonavina
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
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14
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Senocak GNC, Yapca OE, Yılmaz EPT, Ozturk N, Ozdes S, Kumtepe Y. May endocan be a new biomarker in the diagnosis of endometriosis? J Gynecol Obstet Hum Reprod 2022; 51:102423. [DOI: 10.1016/j.jogoh.2022.102423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/27/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022]
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15
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The role of dynamic thiol/disulfide homeostasis for the evaluation of oxidative stress in endometriosis patients. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1120611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Kusum K, Raj R, Rai S, Pranjali P, Ashish A, Vicente-Muñoz S, Chaube R, Kumar D. Elevated Circulatory Proline to Glutamine Ratio (PQR) in Endometriosis and Its Potential as a Diagnostic Biomarker. ACS OMEGA 2022; 7:14856-14866. [PMID: 35557708 PMCID: PMC9088897 DOI: 10.1021/acsomega.2c00332] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
Endometriosis (EM) is a hormone-dependent gynecological disease associated with chronic pelvic pain and altered immuno-inflammatory processes. It shares some cancer-like characteristics such as increased proline biosynthesis and activated glutaminolysis. Both proline and glutamine are interconvertible metabolically, and studies have shown their roles in cancer cell metabolic reprogramming, redox homeostasis, occurrence/development of endometrial carcinoma, and its further progression toward the malignant state. So based on this, we hypothesized that the circulatory proline to glutamine ratio (PQR) would be altered in EM and may serve as an indicative biomarker to improve the clinical diagnosis of EM. In present study, the circulatory-PQR levels were estimated for 39 EM patients and 48 age matched healthy female subjects using 800 MHz NMR spectroscopy. Among 39 EM patients, 15 were in the clinical stages I to II and referred to here as moderate EM (MEM) patients and 24 were in the clinical stages III to IV and referred here as severe EM (SEM) patients. The circulatory-PQR levels were significantly increased in EM patients (0.99 ± 0.13 μM in MEM; 1.39 ± 0.22 μM in SEM) compared to normal control (NC) subjects (0.52 ± 0.05 μM in NC). Further, the circulatory PQR levels exhibit the highest diagnostic potential with area under receiver operating characteristic (AUROC) curve values equal to 0.87 ± 0.04 [95%CI = 0.79-0.96] for MEM and 0.89 ± 0.04 [95% CI = 0.82-0.96] for SEM. These results suggested that circulatory-PQR has significant potential to serve as a noninvasive biomarker for diagnostic/prognostic screening of EM and further underscored the importance of these two nonessential amino acids (proline and glutamine) in cancer metabolism.
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Affiliation(s)
- Kusum Kusum
- Department
of Zoology, Institute of Science, Banaras
Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Ritu Raj
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
| | - Sangeeta Rai
- Department
of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Pranjali Pranjali
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
| | - Ashish Ashish
- Department
of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Sara Vicente-Muñoz
- NMR-Metabolomics
Core, Division of Pathology, Cincinnati
Children’s Hospital Medical Center, Cincinnati, Ohio 45229, United States
| | - Radha Chaube
- Department
of Zoology, Institute of Science, Banaras
Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Dinesh Kumar
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
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17
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Comparison of Isolated Sciatic Nerve and Sacral Nerve Root Endometriosis: A Review of the Literature. J Minim Invasive Gynecol 2022; 29:943-951. [DOI: 10.1016/j.jmig.2022.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
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18
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Méar L, Com E, Fathallah K, Guillot L, Lavigne R, Guével B, Fauconnier A, Vialard F, Pineau C. The Eutopic Endometrium Proteome in Endometriosis Reveals Candidate Markers and Molecular Mechanisms of Physiopathology. Diagnostics (Basel) 2022; 12:diagnostics12020419. [PMID: 35204508 PMCID: PMC8870972 DOI: 10.3390/diagnostics12020419] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 12/29/2022] Open
Abstract
Endometriosis is a common chronic gynaecological disease causing various symptoms, such as infertility and chronic pain. The gold standard for its diagnosis is still laparoscopy and the biopsy of endometriotic lesions. Here, we aimed to compare the eutopic endometrium from women with or without endometriosis to identify proteins that may be considered as potential biomarker candidates. Eutopic endometrium was collected from patients with endometriosis (n = 4) and women without endometriosis (n = 5) during a laparoscopy surgery during the mid-secretory phase of their menstrual cycle. Total proteins from tissues were extracted and digested before LC-MS-MS analysis. Among the 5301 proteins identified, 543 were differentially expressed and enriched in two specific KEGG pathways: focal adhesion and PI3K/AKT signaling. Integration of our data with a large-scale proteomics dataset allowed us to highlight 11 proteins that share the same trend of dysregulation in eutopic endometrium, regardless of the phase of the menstrual cycle. Our results constitute the first step towards the identification of potential promising endometrial diagnostic biomarkers. They provide new insights into the mechanisms underlying endometriosis and its etiology. Our results await further confirmation on a larger sample cohort.
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Affiliation(s)
- Loren Méar
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
- UVSQ, INRAE, BREED, Université Paris-Saclay, 78350 Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d’Alfort, BREED, 94700 Maisons-Alfort, France
| | - Emmanuelle Com
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
| | - Khadija Fathallah
- Department of Obstetrics and Gynecology, CHI de Poissy, St. Germain en Laye, 78303 Poissy, France; (K.F.); (A.F.)
| | - Laetitia Guillot
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
| | - Régis Lavigne
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
| | - Blandine Guével
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
| | - Arnaud Fauconnier
- Department of Obstetrics and Gynecology, CHI de Poissy, St. Germain en Laye, 78303 Poissy, France; (K.F.); (A.F.)
- EA7325-RISQ, UFR des Sciences de la Santé Simone Veil, 78180 Montigny le Bretonneux, France
| | - François Vialard
- UVSQ, INRAE, BREED, Université Paris-Saclay, 78350 Jouy-en-Josas, France
- Ecole Nationale Vétérinaire d’Alfort, BREED, 94700 Maisons-Alfort, France
- Genetics Federation, CHI de Poissy, St. Germain en Laye, 78303 Poissy, France
- Correspondence: (F.V.); (C.P.)
| | - Charles Pineau
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, CEDEX, 35042 Rennes, France; (L.M.); (E.C.); (L.G.); (R.L.); (B.G.)
- Protim, Univ Rennes, Biosit–UMS 3480, US-S 018, CEDEX, 35042 Rennes, France
- Correspondence: (F.V.); (C.P.)
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Gupta V, Noh KW, Maschek H, Thal S, Welter S. A unique case of thoracic endometriosis syndrome and pulmonary Langerhans’ cell histiocytosis: Six recurrent pneumothoraces. Respir Med Case Rep 2022; 36:101603. [PMID: 35242517 PMCID: PMC8866092 DOI: 10.1016/j.rmcr.2022.101603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 02/15/2022] [Indexed: 11/18/2022] Open
Abstract
Spontaneous pneumothorax (SP) in women of reproductive age with causes such as thoracic endometriosis syndrome (TES) presents a diagnostic and therapeutic challenge. A 33-year-old women was treated conservatively with chest tube insertion for a first occurrence of a right-sided pneumothorax in September 2015. In January 2016, a right-sided video-assisted thoracoscopic surgery (VATS) wedge resection and partial parietal pleurectomy was performed due to a recurrence. A right-sided VATS was again performed in December 2016 with multiple wedge resections and a total pleurectomy revealing a pulmonary Langerhans’ cell histiocytosis (PLCH) in the histological and immunohistochemical examinations. The patient was recommended an abstinence of smoking and further course was unremarkable until May 2019, when due to a recurrent pneumothorax, she received a talc pleurodesis via right-sided VATS. Due to yet another recurrence, she underwent a talc slurry pleurodesis over a right sided chest drain. In March 2020 due to recurrence, a right-sided VATS was performed and a blueish nodular lesion was resected from the diaphragm. The histological examination revealed an endometriosis with a diagnosis of TES. Since the patient did not exhibit a temporal relationship between her periods and the onset of pneumothorax symptoms, a final diagnosis of non-catamenial endometriosis-related pneumothorax was made. The patient is currently continuing smoking abstinence and is under hormone therapy. She has not presented with a recurrence. In clinical practice, it is important not to just relay on the information available to us, but to reevaluate the patient history to uncover new clues leading to a new diagnosis. A rare combination of two rare diagnoses, PLHC and TES, only recognized through multiple hospital stays and operations. Symptoms of endometriosis-related pneumothorax are not always directly related to the menstrual cycle. As clinicians, we should remember that it is not impossible to suffer from two rare disorders. A thorough history taking and a precise intraoperative evaluation might reveal clues towards diagnosis and correct treatment.
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Lamrabet S, Bekhouche A, Wanpouille C, Rousset P, Thomassin-Naggara I. Classification dPEI : une nouvelle classification IRM de l’endométriose pelvienne profonde. IMAGERIE DE LA FEMME 2021. [DOI: 10.1016/j.femme.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Osuchowska-Grochowska I, Blicharska E, Gogacz M, Nogalska A, Winkler I, Szopa A, Ekiert H, Tymczyna-Borowicz B, Rahnama-Hezavah M, Grochowski C. Brief Review of Endometriosis and the Role of Trace Elements. Int J Mol Sci 2021; 22:11098. [PMID: 34681755 PMCID: PMC8540211 DOI: 10.3390/ijms222011098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 12/13/2022] Open
Abstract
Endometriosis is a chronic, estrogen-dependent, inflammatory condition that is defined as the presence of endometrial glands and stroma outside the uterine cavity. Despite the progress in research into the mechanisms leading to the development of endometriosis, its cause has not yet been established. It seems to be possible that the formation of oxidative stress may be one of the main causes of the development of endometriosis. There is much research that studies the potential role of trace elements in the appearance of endometrial-like lesions. Most studies focus on assessing the content of selected trace elements in the blood, urine, or peritoneal fluid in women with endometriosis. Meanwhile, little is known about the content of these elements in endometrial-like implants, which may be helpful in developing the theory of endometriosis. Investigations that are more comprehensive are needed to confirm a hypothesis that some trace elements play a role in the pathomechanism of endometriosis.
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Affiliation(s)
| | - Eliza Blicharska
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland;
| | - Marek Gogacz
- 2nd Department of Gynecology, Lublin Medical University, 20-954 Lublin, Poland;
| | - Agata Nogalska
- Department of Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland;
| | - Izabela Winkler
- 2nd Department of Gynecology, St John’s Center Oncology, 20-090 Lublin, Poland;
| | - Agnieszka Szopa
- Department of Pharmaceutical Botany, Jagielonian University, Collegium Medicum, 30-688 Kraków, Poland; (A.S.); (H.E.)
| | - Halina Ekiert
- Department of Pharmaceutical Botany, Jagielonian University, Collegium Medicum, 30-688 Kraków, Poland; (A.S.); (H.E.)
| | - Barbara Tymczyna-Borowicz
- Department of Conservative Dentistry with Endodontics, Medical University of Lublin, 20-439 Lublin, Poland;
| | | | - Cezary Grochowski
- Laboratory of Virtual Man, Medical University of Lublin, 20-439 Lublin, Poland;
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22
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The Role of miRNAs 340-5p, 92a-3p, and 381-3p in Patients with Endometriosis: A Plasma and Mesenchymal Stem-Like Cell Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5298006. [PMID: 34631883 PMCID: PMC8494557 DOI: 10.1155/2021/5298006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/05/2021] [Accepted: 09/09/2021] [Indexed: 01/07/2023]
Abstract
Background Endometriosis is the most prevalent gynecological disease with elusive etiology. The mysterious entity and the lack of noninvasive diagnostic methods affect women's lives negatively. This study is aimed at finding the relationship between miR-340-5p, 92a-3p, and miR-381-3p and the pathogenesis of endometriosis in endometrial mesenchymal stem-like cells (eMSCs) of endometriosis and assessing their potential as a noninvasive biomarker in plasma. Methods Peripheral blood and eMSC specimens were collected from suspected women of endometriosis before laparoscopy. Total RNA was isolated from plasma and cultured eMSCs to synthesize complementary DNA. The expression of miR-340-5p, miR-92a-3p, and miR-381-3p was analyzed by RT-qPCR. To understand these miRNAs' role, we also did a bioinformatic analysis. Results There was a downregulation of miR-340-5p, miR-92a-3p, and miR-381-3p in plasma, and the upregulation of miR-340-5p and the downregulation of miR-92a-3p and miR-381-3p in eMSCs of women with endometriosis. There was a positive concordance between the expression of miR-92a-3p and miR-381-3p in plasma and eMSCs. Our study also showed three genes, Solute Carrier Family 6 Member 8 (SLC6A8), Zinc Finger Protein 264 (ZNF264), and mouse double minute 2 (MDM2), as common targets of these miRNAs. Conclusions This study has been one of the first attempts to examine the expression of miR-340-5p, miR-92a-3p, and miR-381-3p in both plasma and eMSCs and revealed their possible role in endometriosis based on in silico analysis. Biomarkers pave the way to develop a new therapeutic approach to the management or treatment of endometriosis patients. Our result as a first report shows that combined levels of miRNAs 340-5p and 381-3p may have the potential to be utilized as diagnostic biomarkers for endometriosis.
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23
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Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int J Mol Sci 2021; 22:ijms221910554. [PMID: 34638893 PMCID: PMC8508982 DOI: 10.3390/ijms221910554] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is a “mysterious” disease and its exact cause has not yet been established. Among the etiological factors, congenital, environmental, epigenetic, autoimmune and allergic factors are listed. It is believed that the primary mechanism of the formation of endometriosis foci is retrograde menstruation, i.e., the passage of menstrual blood through the fallopian tubes into the peritoneal cavity and implantation of exfoliated endometrial cells. However, since this mechanism is also observed in healthy women, other factors must also be involved in the formation of endometriosis foci. Endometriosis is in many women the cause of infertility, chronic pain and the deterioration of the quality of life. It also represents a significant financial burden on health systems. The article presents a review of the literature on endometriosis—a disease affecting women throughout the world.
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Balasubramanian V, Saravanan R, Joseph LD, Dev B, Gouthaman S, Srinivasan B, Dharmarajan A, Rayala SK, Venkatraman G. Molecular dysregulations underlying the pathogenesis of endometriosis. Cell Signal 2021; 88:110139. [PMID: 34464692 DOI: 10.1016/j.cellsig.2021.110139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/07/2023]
Abstract
Endometriosis is a crippling disease characterized by the presence of endometrium-like tissue or scar outside the uterine cavity, commonly confined to the peritoneal and serosal surfaces of the pelvic organs. 10-15% of women in reproductive age are estimated to be affected by endometriosis. Most of these patients present with infertility and suffer from pelvic pain. The benign disease rarely progresses to malignancy. Regardless of its high prevalence, the pathogenesis of the disease is not fully understood. Treatment options for endometriosis are limited and are often based on a symptomatic approach. The unavailability of proper diagnostic approaches, fewer therapeutic options, and sparse understanding of molecular alterations are responsible for the continued disease burden. Exploring the molecular elements causing the pathogenesis of endometriosis may lead to a number of breakthroughs in the treatment of the illness, such as the discovery of new biomarkers for diagnosis and therapeutic targets that can be a guide to better prognosis and reduced recurrence. The goal of this review is to provide the reader a critical understanding of the disease by summarizing the genetic, immunological, hormonal, and epigenetic deregulations that support the molecular basis for development of endometriotic cyst, with a special focus on the study models needed to analyze these changes in the endometriotic microenvironment.
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Affiliation(s)
- Vaishnavi Balasubramanian
- Department of Human Genetics, Faculty of Biomedical Sciences, Technology and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Roshni Saravanan
- Department of Human Genetics, Faculty of Biomedical Sciences, Technology and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Leena Dennis Joseph
- Department of Pathology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Bhawna Dev
- Department of Radiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Shanmugasundaram Gouthaman
- Department of Surgical Oncology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Bhuvana Srinivasan
- Department of Obstetrics and Gynecology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Arun Dharmarajan
- Department of Biomedical Sciences, Faculty of Biomedical Sciences, Technology and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Suresh Kumar Rayala
- Department of Biotechnology, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
| | - Ganesh Venkatraman
- Department of Human Genetics, Faculty of Biomedical Sciences, Technology and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
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25
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Qi X, Zhang W, Ge M, Sun Q, Peng L, Cheng W, Li X. Relationship Between Dairy Products Intake and Risk of Endometriosis: A Systematic Review and Dose-Response Meta-Analysis. Front Nutr 2021; 8:701860. [PMID: 34368211 PMCID: PMC8339299 DOI: 10.3389/fnut.2021.701860] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: Diet lifestyle can influence the risk of endometriosis. Therefore, we conducted a systematic meta-analysis to investigate the association between dairy products and the risk of endometriosis. Besides, we performed a dose-response meta-analysis to evaluate the amount of dairy intake affecting the risk of endometriosis. Methods: Relevant studies were searched from Pubmed, Embase databases, Cochrane Library, and Web of Science from the inception to November 6th, 2020. Also, the dose-response meta-analysis was conducted. All the pooled results were performed by risk ratios (RRs). Results: Finally, seven high-quality studies were included in the present meta-analysis. Total dairy intake was inversely associated with the risk of endometriosis, and the risk of endometriosis tended to decrease with a decrease in the risk of endometriosis when dairy products intake was over 21 servings/week (RR 0.87, 95% CI 0.76–1.00; pnon−linearity = 0.04). Similarly, people who consumed more than 18 servings of high-fat dairy products per week had a reduced risk of endometriosis (RR 0.86, 95% CI 0.76–0.96). When stratified-analyses were conducted based on specific dairy product categories, it indicated that people with high cheese intake might have a reduced risk of endometriosis (RR 0.86, 95% CI 0.74–1.00). Other specific dairy products such as whole milk (RR 0.90, 95% CI 0.72–1.12), reduced-fat/skim milk (RR 0.83, 95% CI 0.50–1.73), ice cream (RR 0.83, 95% CI 0.50–1.73), and yogurt (RR 0.83, 95% CI 0.62–1.11) have not shown significant evidence of an association with the risk of endometriosis. However, there is a higher risk of endometriosis in the females with high butter intake compared to females with low butter intake (1.27, 95% CI 1.03–1.55). Conclusions: Overall, dairy products intake was associated with a reduction in endometriosis, with significant effects when the average daily intake ≥3 servings. When analyzed according to the specific type of dairy product, it was shown that females with higher high-fat dairy and cheese intake might have a reduced risk of endometriosis. However, high butter intake might be associated to the increased risk of endometriosis. More future studies are needed to validate and add to this finding.
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Affiliation(s)
- Xiangying Qi
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Wenyan Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Mingxiu Ge
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Qiang Sun
- Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Lei Peng
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shandong University, Jinan, China
| | - Wenke Cheng
- Department of Cardiology, Heart Center Leipzig at University Leipzig, Leipzig, Germany
| | - Xuepeng Li
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Zaozhuang Municipal Hospital, Zaozhuang, China
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Network Pharmacology-Based Prediction of Bioactive Compounds and Potential Targets of Wenjing Decoction for Treatment of Endometriosis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:4521843. [PMID: 34257679 PMCID: PMC8253647 DOI: 10.1155/2021/4521843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/14/2021] [Indexed: 12/20/2022]
Abstract
Endometriosis is a chronic estrogen-dependent inflammatory disorder that negatively affects the quality of life in women. The Wenjing decoction (WJD) is a traditional Chinese medicine that has been shown to have a therapeutic effect on endometriosis. Our study systematically explored the mechanism of WJD against endometriosis using a network pharmacology approach. Potentially bioactive compounds of WJD and their possible targets were retrieved from the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. The protein-protein interaction network and herbs-compounds-genes multinetwork were constructed using Cytoscape for visualization. Subsequently, the signaling pathways of common targets were retrieved from the Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, and molecular docking was performed using PyRx software. In total, 48 common targets were screened, such as IL6 and ESR1, which were related to inflammation and the endocrine system. The top five bioactive compounds were quercetin, kaempferol, wogonin, beta-sitosterol, and stigmasterol. KEGG enrichment analysis revealed 65 pathways containing inflammatory- and endocrine-related signaling pathways, such as the "TNF signaling pathway" and the "estrogen signaling pathway." Taken together, the results of our network pharmacology analysis predicted that certain active ingredients of WJD might treat endometriosis by regulating inflammation and/or endocrine, which provided references for further understanding and exploration of WJD on endometriosis.
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Chen FY, Chen SW, Chen X, Huang JY, Ye Z, Wei JCC. Hydroxychloroquine might reduce risk of incident endometriosis in patients with systemic lupus erythematosus: A retrospective population-based cohort study. Lupus 2021; 30:1609-1616. [PMID: 34259057 DOI: 10.1177/09612033211031009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND SLE, which is common in women, is commonly treated with HCQ, an anti-inflammation medication. Reproductive-age women with SLE are prone to be impacted by endometriosis. This study analyzes the relationship between HCQ and endometriosis patients with SLE in order to determine whether HCQ is effective for treating the latter. METHODS This population-based, retrospective cohort study analyzed the SLE risk in a cohort of newly diagnosed SLE patients with endometriosis during 2000 through 2013. Controls were selected at a 1:2 ratio through age-matching using the greedy algorithm. The Cox proportional hazard model was used to analyze the association between HCQ use and endometriosis incidence. Four different Cox regression models were used. Lastly, sensitivity analysis with PSOW and IPW was implemented to evaluate the hazard ratio (HR) of endometriosis after exposure with HCQ. RESULTS In the cohort where age and sex matched high and low HCQ dosage, the average follow-up time was about 1 year. The cohort's overall incidence rates of endometriosis were 44.54 and 90.03 per 100000 person-month for high and low dosage respectively. The high dose group's conditional hazard ratio (aHR) for incidental endometriosis was 0.482 (CI = 0.191 to 1.213). The incidence rate and Kaplan-Meir curves of endometriosis were consistent with the results for the cohort. CONCLUSION This study demonstrated that SLE patients continuously treated with HCQ have a lower risk of developing endometriosis. Clinically, HCQ can be beneficial for endometriosis patients with SLE.
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Affiliation(s)
- Fang-Yu Chen
- Institute of Medicine, 34899Chung Shan Medical University, Chung Shan Medical University, Taichung, Taiwan
| | - Shuo-Wei Chen
- Institute of Medicine, 34899Chung Shan Medical University, Chung Shan Medical University, Taichung, Taiwan
| | - Xinpeng Chen
- Department of Rheumatology, 74550Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, Guangdong, China
| | - Jing-Yang Huang
- Department of Medical Research, 63276Chung Shan Medical University Hospital, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Zhizhong Ye
- Department of Rheumatology, 74550Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, Guangdong, China
| | - James Cheng-Chung Wei
- Institute of Medicine, 34899Chung Shan Medical University, Chung Shan Medical University, Taichung, Taiwan.,Department of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Upregulation of fibroblast growth factor 2 contributes to endometriosis through SPRYs/DUSP6/ERK signaling pathway. Acta Histochem 2021; 123:151749. [PMID: 34224989 DOI: 10.1016/j.acthis.2021.151749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022]
Abstract
Previous studies report that fibroblast growth factor 2 (FGF2) modulates Sproutys (SPRYs)/dual specificity phosphatase 6 (DUSP6)/extracellular signal-regulated kinase (ERK) signaling pathway in endometrial glandular epithelial cells. However, its role in endometriosis remains unclear. The expression patterns and localization of related proteins in endometrium patients' samples were determined using quantitative reverse transcription PCR, Western blotting, and immunohistochemistry, respectively. Human endometrial stromal cells (HESCs) were isolated and transfected with small interfering RNA (siRNA) targeting FGF2 (FGF2-siRNA). Cell viability was determined using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. It was found that FGF2 mRNA and protein levels were increased in the ectopic endometrium, whilst the mRNA and protein levels of SPRYs/DUSP6/ERK signaling pathway related-genes were dysregulated. Spearman's rank correlation analysis revealed a negative correlation between FGF2 and SPRYs/DUSP6 signaling pathway-related proteins. In vitro study demonstrated that FGF2 silencing suppressed cell proliferation. Our results suggest that FGF2 upregulation might contribute to endometriosis via the regulation of the SPRYs/DUSP6/ERK signaling pathway.
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Abstract
Pyroptosis, an inflammatory form of programmed cell death, takes an essential part in a wide variety of physiological activities, for instance, implantation, placentation and the body's defense against infection. However, once excessively activated, pyroptosis mediated by the activation of inflammasomes can be highly pathological. It can cause inflammatory and autoimmune diseases including a variety of obstetrical and gynecological diseases, such as endometriosis, gestational diabetes mellitus, insulin resistance in polycystic ovary syndrome, and multiple obstetric complications including preeclampsia. Although the role of pyroptosis in the pathogenesis of the above mentioned diseases has not been fully elucidated, we try to tap its therapeutic potential by targeting pyroptosis signaling and inflammasome formation. Pyroptosis and inflammasomes are confirmed to be involved in endometriosis and gynecological malignant tumors, therefore, medical approachs inducing pyroptosis of the ectopic endometrium and tumor cells can be feasible treatments for endometriosis and gynecological cancers. On the maternal-fetal interface, although a certain level of the innate immune response activation is required for a successful implantation and placentation, maternal and fetal injury may occur once the inflammasomes are over-activated. Besides, since gestational diabetes mellitus and insulin resistance in polycystic ovary syndrome share common pathogenesis with metabolic diseases, this domain research sheds light on future study of some obstetrical and gynecological diseases.
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Affiliation(s)
- Shu-Yue Yu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University,, Shanghai, P.R. China
| | - Xue-Lian Li
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University,, Shanghai, P.R. China
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RASULOVA K, PEHLİVAN M, AKBEROVA A, KIZILDAĞ S. Endometriozisli hastaların ektopik ve ötopik dokularında glycodelin A mRNA ekspresyonlarının belirlenmesi. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.795826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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31
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Matei AM, Draghici-Ionescu AM, Cioplea M, Zurac SA, Boda D, Serban I, Caruntu C, Ilie MA, Fekete GL. Skin endometriosis: A case report and review of the literature. Exp Ther Med 2021; 21:532. [PMID: 33815605 DOI: 10.3892/etm.2021.9964] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/18/2020] [Indexed: 12/11/2022] Open
Abstract
Skin endometriosis is a rare disease with variable clinical and histopathological characteristics that depend on hormonal stimuli. The skin is not a common location, as most cases of endometriosis involve pelvic sites, such as the ovaries, peritoneum and bowel. However, the most common extrapelvic site affected is the abdominal wall and this location of the disease is frequently associated with obstetric and gynecologic surgery. Here we report a case of skin endometriosis emerged as a painful subcutaneous nodule located near to the left side of an obstetrical surgery procedure scar. The patient affected was a woman in her reproductive age, with a history of right ovary endometriotic cyst laparoscopically removed and histologically confirmed as a primary endometriosis. Dermatologists should be aware of this condition in any woman with a painful lump located in the proximity of a pelvic surgery-induced scar. Its non-specific clinical appearance may confuse the clinician and may delay the diagnosis and management.
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Affiliation(s)
- Andreea-Mariana Matei
- Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania.,Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Mirela Cioplea
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Sabina Andrada Zurac
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniel Boda
- Department of Dermatology, 'Prof. N.C. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.,Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ioana Serban
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N.C. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Mihaela Adriana Ilie
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Gyula László Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania
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32
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Verhulst E, Bafort C, Tomassetti C, Wolthuis A, Bielen D, Coolen J, Weynand B, Platteeuw L, Meuleman C, Van Raemdonck D. Endometriotic lung cyst causing catamenial hemoptysis; a case report and review of literature. Acta Chir Belg 2021; 122:432-437. [PMID: 33657969 DOI: 10.1080/00015458.2021.1887556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We report a rare case of an endometriotic lung cyst in a 47-year woman with recurrent catamenial hemoptysis. Chest computed tomography (CT) obtained outside the menstruation in October 2019 revealed a cystic lesion (2.5 cm) located in the right inferior lobe near the distal esophagus and the inferior pulmonary vein. Compared to CT abdomen in May 2019, this lesion had increased with a larger volume and a thicker wall. An endometrial lung cyst was suspected as episodes of hemoptysis no longer occurred after initiating hormonal treatment with nomegestrol acetate. Exploratory video-assisted thoracoscopic surgery with wedge resection of the cyst was performed. Histopathologic examination confirmed the diagnosis of an endometriotic cystic lesion. Postoperative course was uneventful with no further symptoms since then.
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Affiliation(s)
- Evelyne Verhulst
- Faculty of Medicine, Catholic University Leuven, Leuven, Belgium
| | - Celine Bafort
- Doctoral School, Biomedical Sciences, Catholic University Leuven, Leuven, Belgium
| | - Carla Tomassetti
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Didier Bielen
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Johan Coolen
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Birgit Weynand
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Christel Meuleman
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
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Helbig M, Vesper AS, Beyer I, Fehm T. Does Nutrition Affect Endometriosis? Geburtshilfe Frauenheilkd 2021; 81:191-199. [PMID: 33574623 PMCID: PMC7870287 DOI: 10.1055/a-1207-0557] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/24/2020] [Indexed: 02/08/2023] Open
Abstract
Endometriosis is a hormone-related, chronic inflammation in women of childbearing age. The aetiology and pathogenesis of endometriosis are not yet fully understood. For other illnesses classed as lifestyle diseases, the link between nutrition and pathogenesis has already been researched and proven. With regard to these findings, the question continues to arise as to whether and how a specific diet and lifestyle could also influence pathogenesis and the progression of endometriosis. The aim of this review is to examine the data and determine what influence nutrition has on the development of endometriosis or on existing disease. The study results currently available do not permit a clear, scientific recommendation or indicate a detailed diet. In summary, it can be said that fish oil capsules in combination with vitamin B 12 have been associated with a positive effect on endometriosis symptoms (particularly of dysmenorrhoea). Alcohol and increased consumption of red meat and trans fats are associated with a negative effect. The results of the studies listed with regard to fruit and vegetables, dairy products, unsaturated fats, fibre, soy products and coffee are not clear. Therefore, the general recommendations for a balanced and varied diet in line with the guidelines of the Deutsche Gesellschaft für Ernährung e. V. [German Nutrition Society] apply, along with the recommendation to cut out alcohol. In order to be able to derive more concrete recommendations, we require further studies to investigate the influence of nutrition on endometriosis.
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Affiliation(s)
- Martina Helbig
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Anne-Sophie Vesper
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ines Beyer
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- Klinik für Geburtshilfe und Frauenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Kim HI, Seo SK, Chon SJ, Kim GH, Lee I, Yun BH. Changes in the Expression of TBP-2 in Response to Histone Deacetylase Inhibitor Treatment in Human Endometrial Cells. Int J Mol Sci 2021; 22:ijms22031427. [PMID: 33572677 PMCID: PMC7866992 DOI: 10.3390/ijms22031427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Histone deacetylase inhibitors (HDACi) induce apoptosis preferentially in cancer cells by caspase pathway activation and reactive oxygen species (ROS) accumulation. Suberoylanilide hydroxamic acid (SAHA), a HDACi, increases apoptosis via altering intracellular oxidative stress through thioredoxin (TRX) and TRX binding protein-2 (TBP-2). Because ROS accumulation, as well as the redox status determined by TBP-2 and TRX, are suggested as possible mechanisms for endometriosis, we queried whether SAHA induces apoptosis of human endometrial cells via the TRX–TBP-2 system in endometriosis. Eutopic endometrium from participants without endometriosis, and ectopic endometrium from patients with endometriosis, was obtained surgically. Human endometrial stromal cells (HESCs) and Ishikawa cells were treated with SAHA and cell proliferation was assessed using the CCK-8 assay. Real-time PCR and Western blotting were used to quantify TRX and TBP-2 mRNA and protein expression. After inducing oxidative stress, SAHA was applied. Short-interfering TRX (SiTRX) transfection was performed to see the changes after TRX inhibition. The mRNA and protein expression of TBP-2 was increased with SAHA concentrations in HESCs significantly. The mRNA TBP-2 expression was decreased after oxidative stress, upregulated by adding 2.5 μM of SAHA. The TRX/TBP-2 ratio decreased, apoptosis increased significantly, and SiTRX transfection decreased with SAHA. In conclusion, SAHA induces apoptosis by modulating the TRX/TBP-2 system, suggesting its potential as a therapeutic agent for endometriosis.
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Affiliation(s)
- Hye In Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.I.K.); (S.K.S.); (I.L.)
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.I.K.); (S.K.S.); (I.L.)
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Seung Joo Chon
- Department of Obstetrics and Gynecology, Gil Hospital, Gachon University College of Medicine, Inchon 21565, Korea;
| | - Ga Hee Kim
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Inha Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.I.K.); (S.K.S.); (I.L.)
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Bo Hyon Yun
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (H.I.K.); (S.K.S.); (I.L.)
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea;
- Correspondence: ; Tel.: +82-2-2228-2230
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Brunty S, Mitchell B, Bou-Zgheib N, Santanam N. Endometriosis and ovarian cancer risk, an epigenetic connection. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1715. [PMID: 33490227 PMCID: PMC7812227 DOI: 10.21037/atm-20-2449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Endometriosis is a gynecological disorder that affects 176 million women worldwide and 1 in 10 females in the United States. Endometriosis most often affects women of child-bearing age, with most going undiagnosed. Endometriosis also shares many characteristics common to invasive cancer and has been known to be associated with epithelial ovarian cancer. Ovarian cancer is the 11th most common cancer among women and over 22,000 new cases will be diagnosed within the next year. Women most commonly diagnosed with this cancer are between the ages of 55–64 years, outside the range of the age of women affected with endometriosis. While no known cause of either disease has been established, epigenetic regulation is thought to play a major role in both. This review focuses on epigenetic changes that occur within each individual disease as well as those that are similar in both, suggesting a possible etiological link between the two diseases.
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Affiliation(s)
- Sarah Brunty
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Brenda Mitchell
- Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Nadim Bou-Zgheib
- Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Nalini Santanam
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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Muraoka A, Osuka S, Kiyono T, Suzuki M, Yokoi A, Murase T, Nishino K, Niimi K, Nakamura T, Goto M, Kajiyama H, Kondo Y, Kikkawa F. Establishment and characterization of cell lines from human endometrial epithelial and mesenchymal cells from patients with endometriosis. F&S SCIENCE 2020; 1:195-205. [PMID: 35559928 DOI: 10.1016/j.xfss.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To establish and characterize cell lines derived from human endometrial epithelial cells (ECs) and mesenchymal cells (MCs) from patients with and without endometriosis. DESIGN In vitro experimental study. SETTING University and national cancer center research institute. PATIENT(S) Two women with endometriosis and two women without endometriosis. INTERVENTION(S) Sampling of endometrial ECs and MCs. MAIN OUTCOME MEASURE(S) Establishing immortalized endometrial ECs and MCs with quantitative reverse transcription-polymerase chain reaction (qRT-PCR), immunocytochemical analysis, and RNA sequence profiling performed to characterize the immortalized cells and a cell proliferation assay, three-dimensional culture, and assays for hormone responses performed to characterize the features of ECs. RESULT(S) The qRT-PCR, immunocytochemical analysis, and Western blot analysis revealed that the ECs and MCs maintained their original features. Moreover, the immortalized cells were found to retain responsiveness to sex steroid hormones. The ECs formed a gland-like structure in three-dimensional culture, indicating the maintenance of normal EC phenotypes. The RNA sequence profiling, principal component analysis, and clustering analysis showed that the gene expression patterns of the immortalized cells were different from those of cancer cells. Several signaling pathways that were statistically significantly enriched in ECs and MCs with endometriosis were revealed. CONCLUSION(S) We successfully obtained four paired immortalized endometrial ECs and MCs from patients with and without endometriosis. Using these cells could help identify diagnostic and therapeutic targets for endometriosis. The cell lines established in this study will thus serve as powerful experimental tools in the study of endometriosis.
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Affiliation(s)
- Ayako Muraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan; Division of Cancer Biology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Satoko Osuka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
| | - Tohru Kiyono
- Project for Prevention of HPV-related Cancer, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa City, Japan.
| | - Miho Suzuki
- Division of Cancer Biology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Akira Yokoi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Tomohiko Murase
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kimihiro Nishino
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Tomoko Nakamura
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Maki Goto
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yutaka Kondo
- Division of Cancer Biology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Belok S, Herbst N, Billatos E. A chocolate effusion - An unusual cause of elevated adenosine deaminase in the pleural fluid. Respir Med Case Rep 2020; 31:101260. [PMID: 33117649 PMCID: PMC7582089 DOI: 10.1016/j.rmcr.2020.101260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/12/2020] [Accepted: 10/10/2020] [Indexed: 11/06/2022] Open
Abstract
Background Thoracic Endometriosis Syndrome (TES) is a rare diagnosis characterized by ectopic endometrial tissue in the chest. Pleural fluid adenosine deaminase (ADA) is thought to be highly specific for tuberculous pleural effusions, particularly when >40 IU/L (international units/liter). Results A 36-year-old woman from Cameroon (immigrated 10 years ago) with no past medical history presented to the emergency department with increasing abdominal swelling over months found to have on imaging ascites, a left adnexal lesion, a large right-sided pleural effusion and peritoneal studding. Sampling of the pleural fluid revealed dark brown fluid which on analysis was a non-specific exudate with an adenosine deaminase >100. Exploratory laparotomy by gynecology-oncology revealed a large amount of hemorrhagic ascites, multiple endometriotic implants, and a right ovarian endometrioma. Ultimately the patient was taken for video-assisted thoracoscopy (VATS) and decortication. The VATS revealed a diaphragmatic tear was seen suggesting the etiology of the pleural fluid was trans-diaphragmatic passage of blood through the defect. There was no evidence of malignancy or granulomas. Stains and subsequent cultures were negative on all specimens for Mycobacterium tuberculosis. Discussion Our case demonstrates a rarity of an ADA >100 IU/L due to TES rather than tuberculosis. In conclusion, ADA analysis, as with any lab test, should be interpreted within clinical context as false positives may occur. Several weeks following presentation the patient was discharged without any intrapleural catheter and near complete expansion of the lung. She was started on leuprolide and medroxyprogesterone and has no recurrent effusion or ascites in over two years since initial presentation.
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Affiliation(s)
- Samuel Belok
- Boston University School of Medicine, Department of Medicine, Section of Pulmonary and Critical Care, USA
| | - Nicole Herbst
- Emory University School of Medicine, Division of Pulmonary and Critical Critical Care, Georgia
| | - Ehab Billatos
- Boston University School of Medicine, Department of Medicine, Section of Pulmonary and Critical Care, USA
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El-Zayadi AA, Mohamed SA, Arafa M, Mohammed SM, Zayed A, Abdelhafez MS, Badawy AM. Anti-IL-6 receptor monoclonal antibody as a new treatment of endometriosis. Immunol Res 2020; 68:389-397. [PMID: 32939649 DOI: 10.1007/s12026-020-09153-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/11/2020] [Indexed: 12/24/2022]
Abstract
Many pro-inflammatory cytokines especially tumor necrotic factor alpha (TNFα), interleukin (IL)-1β, and IL-6 have crucial role in the pathogenesis of endometriosis. In this study, we investigated the immune-modulatory role of humanized anti-IL-6 receptor monoclonal antibodies in the treatment of endometriosis. This is a prospective, randomized, controlled, blinded study in which Sprague Dawley rats were used as animal model of endometriosis. Animals were randomly divided into two groups, a test group which received tocilizumab (Actemra; Roche, Switzerland) and a control group which received saline. Afterwards, a comparison was done between the eutopic and ectopic endometrium that was excised from both groups, histopathologically and immune-histochemically. Histopathologic assessment and immune-histochemical staining were performed using antibodies against IL-6. Tocilizumab significantly suppressed the volume of endometriotic lesions compared with non-treated rats (P = 0.006) and atrophied the ectopic endometrial-like epithelium (in 42.8% of treated rats vs 0% in the control group). Tocilizumab also decreased the anti-IL-6 receptor immune-histochemical staining intensity in ectopic endometrium (from non to +++ in the test group vs ++ or more in the control group), with no apparent difference in the eutopic one reflecting the down-regulation of IL-6-producing cells in ectopic endometriotic lesions. In rats with induced endometriosis, anti-IL-6 receptor monoclonal antibodies could offer a new horizon of usage of this immune-modulatory biologic drug, used in other autoimmune diseases, in treatment of endometriosis.
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Affiliation(s)
- Ahmed A El-Zayadi
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt
| | - Sara A Mohamed
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt
| | - Mohammad Arafa
- Department of Pathology, Mansoura University, Mansoura, Egypt
| | - Shereen M Mohammed
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt
| | - Abdelhady Zayed
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt
| | - Mohamed S Abdelhafez
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt
| | - Ahmed M Badawy
- Department of Obstetrics and Gynecology, Mansoura University Hospitals, El Gomhouria St., Mansoura City, Dakahlia, 35111, Egypt.
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Zheng Q, Wang J, Li W, Chen X, Chen S, Chen L. Emodin Reverses the Epithelial-Mesenchymal Transition of Human Endometrial Stromal Cells by Inhibiting ILK/GSK-3β Pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:3663-3672. [PMID: 32982173 PMCID: PMC7490435 DOI: 10.2147/dddt.s262816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
Abstract
Purpose To explore the exact mechanism through which emodin down-regulates the migration and invasion abilities of endometrial stromal cells. Moreover, to explore the theoretical basis of emodin in the treatment of endometriosis. Patients and Methods Endometriosis endometrial stromal cells (EESs) were cultured from 15 women with endometriosis and control endometrial stromal cells (CESs) were cultured from 12 women without endometriosis. The levels of proteins were evaluated by Western blot. The migration and invasion abilities of cells were detected by transwell assays. Results The abilities of migration and invasion of EESs were much stronger than those of CESs. After treated with emodin, the migration and invasion abilities of EESs and CESs were significantly down-regulated, and the levels of integrin-linked kinase (ILK) and p-GSK-3β were statistically down-regulated in EESs. Besides that, the expression of keratin was up-regulated while the expression of vimentin, β-catenin and slug were all down-regulated by emodin in a dose- and time-dependent manner. Silencing of ILK gene in EESs also achieved the above effects, which were strengthened by emodin. Conversely, exogenous expression of ILK in CESs increased the expression of p-GSK-3β, which were abrogated by emodin. Furthermore, SB216763 increased migration and invasion abilities of CESs by facilitating the epithelial-mesenchymal transition (EMT) through up-regulating levels of p-GSK-3β, β-catenin and slug, which were also abrogated by emodin. Conclusion Emodin inhibits the migration and invasion abilities of human endometrial stromal cells by reversing the EMT via ILK/GSK-3β pathway. So, emodin may be considered as a promising targeted therapy for endometriosis.
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Affiliation(s)
- Qiaomei Zheng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
| | - Jinhua Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
| | - Wenwen Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
| | - Xiaoyun Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
| | - Shaozhan Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
| | - Lihong Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China
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Naem A, Shamandi A, Al-Shiekh A, Alsaid B. Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report. BMC Womens Health 2020; 20:190. [PMID: 32883302 PMCID: PMC7469317 DOI: 10.1186/s12905-020-01054-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Endometriosis is an estrogen-dependent disease defined by the presence of endometrial glands and stroma out of the uterine cavity. Its prevalence is estimated to be 2-10% in reproductive aged women. Endometriosis occurrence is estimated to be 2.55% in postmenopausal patients due to the decreased levels of estrogen. Endometriosis can present in three different forms: superficial peritoneal implants, ovarian endometriomas, and deep infiltrating endometriosis. Ovarian endometriomas are the most common form of endometriosis. Even though endometriomas have been encountered in various localizations, a free abdominal endometrioma was only reported once in a premenopausal patient. Here, we are reporting the first case of a free large endometrioma in a postmenopausal patient. CASE PRESENTATION A 67-year-old woman presented to the emergency department at our university hospital complaining of constipation and right flank pain. She suffered from uncontrolled primary hypertension and type 2 diabetes mellitus. On presentation, she was afebrile, hypertensive, and tachycardic. An abdominal CT scan revealed a large cystic mass measuring 17 × 26 cm in the anterior-posterior and transverse diameters respectively. The cyst caused bowel obstruction and right sided hydronephrosis. The patient underwent laparotomy and during the surgical exploration a large abdominal cyst adhered to the greater omentum was found. The cyst received plenteous blood supply from the greater omentum. The uterus and both ovaries were completely normal and didn't have any connection to the cyst. An en-bloc cystectomy was performed successfully. The final histopathology report confirmed an abdominal endometrioma. The patient had an uneventful postoperative recovery. CONCLUSIONS Endometriomas might reach large sizes regardless of their location or the patient's age. The close relation of free abdominal endometriomas with the greater omentum suggests that these were developed from endometriotic omental implants. Endometrioma is rare in postmenopausal women. However, it should be considered as a possible differential diagnosis at any age.
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Affiliation(s)
- Antoine Naem
- Faculty of medicine of Damascus university, Damascus, Syria.
| | - Anwar Shamandi
- Faculty of medicine of Damascus university, Damascus, Syria
| | - Ali Al-Shiekh
- Faculty of medicine of Damascus university, Damascus, Syria
- Al-Mouassat University Hospital, Damascus, Syria
| | - Bayan Alsaid
- Faculty of medicine of Damascus university, Damascus, Syria
- Al-Assad University hospital, Damascus, Syria
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Méar L, Herr M, Fauconnier A, Pineau C, Vialard F. Polymorphisms and endometriosis: a systematic review and meta-analyses. Hum Reprod Update 2020; 26:73-102. [PMID: 31821471 DOI: 10.1093/humupd/dmz034] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Endometriosis is an estrogen-dependent gynecological disorder that affects at least 10% of women of reproductive age. It may lead to infertility and non-specific symptoms such as chronic pelvic pain. Endometriosis screening and diagnosis are difficult and time-consuming. Late diagnosis (with a delay ranging from 3.3 to 10.7 years) is a major problem and may contribute to disease progression and a worse response to treatment once initiated. Efficient screening tests might reduce this diagnostic delay. As endometriosis is presumed to be a complex disease with several genetic and non-genetic pathogenic factors, many researchers have sought to identify polymorphisms that predispose to this condition. OBJECTIVE AND RATIONALE We performed a systematic review and meta-analysis of the most regularly reported polymorphisms in order to identify those that might predispose to endometriosis and might thus be of value in screening. SEARCH METHODS The MEDLINE database was searched for English-language publications on DNA polymorphisms in endometriosis, with no date restriction. The PubTator text mining tool was used to extract gene names from the selected publications' abstracts. We only selected polymorphisms reported by at least three studies, having applied strict inclusion and exclusion criteria to their control populations. No stratification based on ethnicity was performed. All steps were carried out according to PRISMA guidelines. OUTCOMES The initial selection of 395 publications cited 242 different genes. Sixty-two genes (corresponding to 265 different polymorphisms) were cited at least in three publications. After the application of our other selection criteria (an original case-control study of endometriosis, a reported association between endometriosis and at least one polymorphism, data on women of reproductive age and a diagnosis of endometriosis in the cases established by surgery and/or MRI and confirmed by histology), 28 polymorphisms were eligible for meta-analysis. Only five of the 28 polymorphisms were found to be significantly associated with endometriosis: interferon gamma (IFNG) (CA) repeat, glutathione S-transferase mu 1 (GSTM1) null genotype, glutathione S-transferase pi 1 (GSTP1) rs1695 and wingless-type MMTV integration site family member 4 (WNT4) rs16826658 and rs2235529. Six others showed a significant trend towards an association: progesterone receptor (PGR) PROGINS, interCellular adhesion molecule 1 (ICAM1) rs1799969, aryl-hydrocarbon receptor repressor (AHRR) rs2292596, cytochrome family 17 subfamily A polypeptide 1 (CYP17A1) rs743572, CYP2C19 rs4244285 and peroxisome proliferator-activated receptor gamma (PPARG) rs1801282), and 12 showed a significant trend towards the lack of an association: tumor necrosis factor (TNF) rs1799964, interleukin 6 (IL6) rs1800796, transforming growth factor beta 1 (TGFB1) rs1800469, estrogen receptor 1 (ESR1) rs2234693, PGR rs10895068, FSH receptor (FSHR) rs6166, ICAM1 rs5498, CYP1A1 rs4646903, CYP19A1 rs10046, tumor protein 53 (TP53) rs1042522, X-ray repair complementing defective repair in Chinese hamster cells 1 (XRCC1) rs25487 and serpin peptidase inhibitor clade E member 1 (SERPINE1) rs1799889; however, for the 18 polymorphisms identified in the latter two groups, further studies of the potential association with the endometriosis risk are needed. The remaining five of the 28 polymorphisms were not associated with endometriosis: glutathione S-transferase theta 1 (GSTT1) null genotype, vascular endothelial growth factor alpha (VEGFA) rs699947, rs833061, rs2010963 and rs3025039. WIDER IMPLICATIONS By carefully taking account of how the control populations were defined, we identified polymorphisms that might be candidates for use in endometriosis screening and polymorphisms not associated with endometriosis. This might constitute the first step towards identifying polymorphism combinations that predispose to endometriosis (IFNG (CA) repeat, GSTM1 null genotype, GSTP1 rs1695, WNT4 rs16826658 and WNT4 rs2235529) in a large cohort of patients with well-defined inclusion criteria. In turn, these results might improve the diagnosis of endometriosis in primary care. Lastly, our present findings may enable a better understanding of endometriosis and improve the management of patients with this disease.
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Affiliation(s)
- Loren Méar
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, F-78180 Montigny le Bretonneux, France.,Univ Rennes, Inserm, EHESP, Irset, UMR_S 1085, F-35042 Rennes cedex, France.,Protim, Univ Rennes, F-35042 Rennes cedex, France
| | - Marie Herr
- INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France.,UMR-S 1168, UFR des Sciences de la Santé Simone Veil, UVSQ, F-78180 Montigny le Bretonneux, France.,Département Hospitalier d'Epidémiologie et Santé Publique, Hôpitaux Universitaires Paris Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, F-75000 Paris, France
| | - Arnaud Fauconnier
- EA7325-RISQ, UFR des Sciences de la Santé Simone Veil, UVSQ, F-78180 Montigny le Bretonneux, France.,Department of Gyneacology and Obstetrics, CHI de Poissy St Germain en Laye, F-78303 Poissy, France
| | - Charles Pineau
- Univ Rennes, Inserm, EHESP, Irset, UMR_S 1085, F-35042 Rennes cedex, France.,Protim, Univ Rennes, F-35042 Rennes cedex, France
| | - François Vialard
- EA7404-GIG, UFR des Sciences de la Santé Simone Veil, UVSQ, F-78180 Montigny le Bretonneux, France.,Genetics Federation, CHI de Poissy St Germain en Laye, F-78303 Poissy, France
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Méar L, Pineau C, Vialard F, Velez de la Calle JF. Endometriosis screening in patients attending an IVF clinic: a proof-of-concept retrospective cohort study. HUM FERTIL 2020; 25:313-322. [PMID: 32684058 DOI: 10.1080/14647273.2020.1795731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given that (i) endometriosis affects approximately 40% of women diagnosed with fertility problems and (ii) this condition may be an underestimated cause of idiopathic infertility, it is essential to identify high-risk patients for laparoscopic screening and reduce the diagnostic delay. We performed a retrospective analysis of 312 women (208 diagnosed with endometriosis and 104 controls) admitted to an in vitro fertilisation (IVF) unit in the city of Brest (France) between June 2007 and July 2014. As part of the women's infertility treatment, levels of cancer antigen 125 (CA-125) were assayed in blood samples collected on the day of oocyte retrieval. Surplus serum was used to set up a new sperm agglutination test. It was observed that sperm agglutination was significantly correlated with endometriosis and CA-125 levels (p < 0.01 for both). By building a decision tree, we identified a subpopulation of patients with low CA-125 levels and a high risk of endometriosis. This proof-of-concept study constitutes a first step towards a high-quality, controlled, multi-centre trial. If our preliminary results are confirmed, the decision tree should improve the medical care given to women in IVF programmes by identifying potential endometriosis sufferers for laparoscopic examination and enabling them to be counselled about precautionary measures.
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Affiliation(s)
- Loren Méar
- Univ Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes Cedex, France.,GIG-EA7404, Université de Versailles Saint-Quentin-en-Yvelines - Paris Saclay, UFR Sciences de la Santé-Simone Veil, Montigny-le Bretonneux, France.,Protim, Univ Rennes, Rennes Cedex, France
| | - Charles Pineau
- Univ Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes Cedex, France.,Protim, Univ Rennes, Rennes Cedex, France
| | - François Vialard
- GIG-EA7404, Université de Versailles Saint-Quentin-en-Yvelines - Paris Saclay, UFR Sciences de la Santé-Simone Veil, Montigny-le Bretonneux, France.,Department of Biology of Reproduction, Cytogenetics and Genetics, Centre Hospitalier de Poissy-Saint Germain, CS 73082, Poissy, France
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Barberic M, Pavicic Baldani D, Rogic D, Kralik S. Serum concentrations of neuropilin-1 in women with endometriosis. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:271-276. [PMID: 32069143 DOI: 10.1080/00365513.2020.1728785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective of this work is to investigate, for the first time, serum concentration of neuropilin-1 (NRP-1), aiming to evaluate its diagnostic performance in endometriosis and usability as a potential non-invasive serum marker of endometriosis. Two hundred women were treated laparoscopically. After laparoscopic surgery women were divided into two groups: 120 women diagnosed with endometriosis and 80 healthy women (control group). Blood samples were taken from all women undergoing laparoscopy half an hour before the induction of anesthesia, for the purpose of collection of serum. The level of NRP-1 in serum was assayed by a standardised sandwich enzyme-linked immunosorbent assay. Differences between endometriosis and healthy control group in NRP-1 levels were significant. All values were significantly and several times higher in patients group, p < .001. After receiver operating characteristic analysis, the area under curve was 0.97 (95% confidence interval: 0.941 to 0.989, p < .0001) at 11 µg/L cut-off level for NRP-1. Preliminary threshold values for NRP-1 in serum were assumed to serve as diagnostic parameters with sensitivity of 99.3% and specificity of 97.8%. Serum concentration of NRP-1 can be considered as a potentially good laboratory diagnostic, non-invasive marker for endometriosis.
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Affiliation(s)
- Monika Barberic
- Department of Medical Laboratory Diagnostic, Ivanic Grad, Croatia
| | - Dinka Pavicic Baldani
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dunja Rogic
- Department of Medical Biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Sasa Kralik
- Clinical Institute of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
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Naem A, Kouba L, Al-Kurdy B. An unusual appearance of a serous ovarian cyst coexisting with endometriosis: A case report. Int J Surg Case Rep 2020; 67:130-133. [PMID: 32062117 PMCID: PMC7021526 DOI: 10.1016/j.ijscr.2020.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/19/2020] [Accepted: 01/22/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Endometriosis is an estrogen-dependent disease that can provoke fibrosis through the elevated concentration of TGF-β. Endometriosis-related fibrosis often manifests as pelvic adhesions, and it is almost always observed microscopically when examining the endometriotic lesions. Here we are reporting, for the first time in literature, an unusual gross appearance of a serous ovarian cyst that coexisted with endometriosis. PRESENTATION OF CASE A 32-year-old G1P2 woman presented to our hospital complaining of the inability to conceive. She was scheduled to have an exploratory laparoscopy. Upon reaching the abdominal cavity, several islands of endometriosis and a left ovarian mass were spotted. The ovarian mass was resected by an excisional biopsy and the pathologic examination showed a benign ovarian cyst with extreme fibrosis in its wall. DISCUSSION Endometriosis often induces a chronic pelvic inflammation, mediated mainly by the over-activated macrophages. These cells secrete many cytokines and growth factors that alter the normal pelvic milieu. TGF-β levels are often elevated within the peritoneal fluid, which stimulate fibroblasts and provoke tissue fibrosis. One study suggested that ovarian stromal fibrosis can induce infertility by impairing folliculogenesis. LH-inhibiting regimens can reverse the stromal fibrosis, and improve the fertility outcomes. CONCLUSION The mural fibrosis seen in the cystic wall reflects unrecognized ovarian stromal fibrosis induced by the fibrogenic effects of endometriosis. This process may play a potential role in provoking infertility in patients with endometriosis, and could be reversed by administrating the LH-inhibiting regimens.
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Affiliation(s)
- Antoine Naem
- Faculty of Medicine of Damascus University, Damascus, Syria.
| | - Lamia Kouba
- Faculty of Medicine of Damascus University, Damascus, Syria.
| | - Bashar Al-Kurdy
- Faculty of Medicine of Damascus University, Damascus, Syria; University Hospital of Obstetrics and Gynecology in Damascus, Syria.
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Transcriptome meta-analysis reveals differences of immune profile between eutopic endometrium from stage I-II and III-IV endometriosis independently of hormonal milieu. Sci Rep 2020; 10:313. [PMID: 31941945 PMCID: PMC6962450 DOI: 10.1038/s41598-019-57207-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
Eutopic endometrium appears to be crucial for endometriosis development. Despite of the evident importance, data regarding the cellular microenvironment remain unclear. Our objective was to explore the tissue microenvironment heterogeneity, transcripts, and pathways that are enriched in all phases of the menstrual cycle by analysing publicly deposited data derived from whole transcriptome microarrays of eutopic endometria of women with and without endometriosis. A meta-analysis of the transcriptome microarrays was performed using raw data available from a public database. Eligibility criteria included eutopic endometrium samples from women with endometriosis and healthy controls without any pathological condition reported the presence of an adequately reported normal menstrual phase, and samples containing both glandular and stromal components. Raw data were processed using a robust multiarray average method to provide background correction, normalisation, and summarisation. The batch effect was estimated by principal variant component analysis and removed using an empirical Bayes method. Cellular tissue heterogeneity was inferred using the xCell package. Differentially expressed genes were identified based on a 5% adjusted p value and a 2.0-fold change. Pathways were identified by functional enrichment based on the Molecular Signatures Database, a p value of < 5%, and an FDR q value of ≤ 25%. Genes that were more frequently found in pathways were identified using leading edge analysis. In a manner independent of cycle phase, the subpopulations of activated dendritic cells, CD4 T effector memory phenotype cells, eosinophils, macrophages M1, and natural killer T cells (NKT) were all higher in stage I-II endometriosis compared to those in healthy controls. The subpopulations of M2 macrophages and natural killer T cells were elevated in eutopic endometriums from women with stage III-IV endometriosis, and smooth muscle cells were always more prevalent in healthy eutopic endometriums. Among the differently expressed genes, FOS, FOSB, JUNB, and EGR1 were the most frequently mapped within the interaction networks, and this was independent of stage and cycle phase. The enriched pathways were directly related to immune surveillance, stem cell self-renewal, and epithelial mesenchymal transition. PI3K AKT mTOR, TGF signalling, and interferon alpha/gamma responses were enriched exclusively in stage III-IV endometriosis. The cellular microenvironments and immune cell profiles were different between eutopic endometriums from women with stage I-II and stage III-IV endometriosis, and these differences were independent of the hormonal milieu. Specifically, a pro-inflammatory profile was predominant in stage I-II endometriosis, and M1-M2 polarization into eutopic endometrium may be crucial for the progression of the disease. The higher prevalence of NKT cells in eutopic endometriums from women with endometriosis that was independent of cycle phase or staging suggested a sustained stress and/or damage to these eutopic endometriums. Based on this, the results of this meta-analysis are important for identifying challenges and opportunities for future research.
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Endometriosis and Pregnancy: A Single Institution Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020401. [PMID: 31936225 PMCID: PMC7014217 DOI: 10.3390/ijerph17020401] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 12/17/2022]
Abstract
Endometriosis may compromise the physiological course of pregnancy. The aim of this prospective observational study was to evaluate whether endometriosis causes a higher prevalence of obstetric and neonatal complications as well as a higher risk of caesarean section and to detect a possible correlation between the presence, type, and location of endometriosis and obstetric complications, previous surgery, and pregnancy outcome, as well as the influence of pregnancy on the course of the disease. We compared two cohorts of women with spontaneous pregnancy, with and without endometriosis. Obstetric and neonatal outcomes, mode of delivery, presence, type, and location of endometriotic lesions and the effect of pregnancy on the disease were analyzed. A total of 425 pregnancies were evaluated: 145 cases and 280 controls. Patients with endometriosis showed a higher incidence of miscarriage, threatened miscarriage, threatened preterm labor, preterm delivery, placental abruption, and a higher incidence of caesarean section. A significant correlation with pregnancy-induced hypertension and preeclampsia was found in the presence of adenomyosis. No difference in fetal outcome was found. One case of hemoperitoneum during pregnancy was observed. Pregnancy in women with endometriosis carries a higher risk of obstetric complications, such as miscarriage, threatened miscarriage, preterm labor, preterm birth, and a higher caesarean section rate. Endometriosis does not seem to influence fetal well-being.
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Dogra N, Luthra A, Chauhan R, Bajaj R, Gourav KP. Recurrent unilateral hemorrhagic pleural effusion: A rare manifestation of thoracic endometriosis syndrome. Ann Card Anaesth 2020; 23:521-523. [PMID: 33109818 PMCID: PMC7879902 DOI: 10.4103/aca.aca_17_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Unilateral recurrent pleural effusions are commonly encountered in critical care practice. Relevant clinical history, physical examination, radiology, and diagnostic thoracentesis usually identify the cause of pleural effusion in most cases. Thoracoscopy or video-assisted thoracic surgery may be required in selective cases. We report a case of 32-year-old female with recurrent unilateral hemorrhagic pleural effusion that was the presenting feature of thoracic endometriosis syndrome.
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Affiliation(s)
- Neeti Dogra
- Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India
| | - Ankur Luthra
- Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India
| | - Rajiv Chauhan
- Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India
| | - Ritika Bajaj
- Department of Obstetrics and Gynaecology, Jindal IVF and Sant Memorial Nursing Home, Chandigarh, India
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Effect of endometriosis on the fecal bacteriota composition of mice during the acute phase of lesion formation. PLoS One 2019; 14:e0226835. [PMID: 31887116 PMCID: PMC6936831 DOI: 10.1371/journal.pone.0226835] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022] Open
Abstract
Accumulating evidence indicates that there is an interaction between the gut microbiota and endometriotic lesions. The new formation of these lesions is associated with stem cell recruitment, angiogenesis and inflammation, which may affect the composition of the gut microbiota. To test this hypothesis, we herein induced endometriotic lesions by transplantation of uterine tissue fragments from green fluorescent protein (GFP)+ donor mice into the peritoneal cavity of GFP- C57BL/6 wild-type mice. Sham-transplanted animals served as controls. Fecal pellets of the animals were collected 3 days before as well as 7 and 21 days after the induction of endometriosis to analyze the composition of the gut microbiota by means of 16S ribosomal RNA gene sequencing. The transplantation of uterine tissue fragments resulted in the establishment of endometriotic lesions in all analyzed mice. These lesions exhibited a typical histomorphology with endometrial glands surrounded by a vascularized stroma. Due to their bright GFP signal, they could be easily differentiated from the surrounding GFP- host tissue. Bacterial 16S rRNA genes were successfully PCR-amplified from the DNA extracts of all obtained mice fecal samples. However, no significant effect of endometriosis induction on the composition of the bacterial microbiota was detected with our experimental setup. Our findings allow careful speculation that endometriosis in mice does not induce pronounced dysbiosis during the acute phase of lesion formation.
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Nezhat C, Lindheim SR, Backhus L, Vu M, Vang N, Nezhat A, Nezhat C. Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management. JSLS 2019; 23:JSLS.2019.00029. [PMID: 31427853 PMCID: PMC6684338 DOI: 10.4293/jsls.2019.00029] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Endometriosis is characterized by the presence of endometrial-like glands and stroma outside the uterine cavity and is believed to affect 6%–10% of reproductive-age women. Endometriosis within the lung parenchyma or on the diaphragm and pleural surfaces produces a range of clinical and radiological manifestations. This includes catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules, resulting in an entity known as thoracic endometriosis syndrome (TES). Database: Computerized searches of MEDLINE and PubMed were conducted using the key words “thoracic endometriosis,” “catamenial pneumothorax,” “catamenial hemothorax,” and “catamenial hemoptysis.” References from identified sources were manually searched to allow for a thorough review. Conclusion: TES can produce incapacitating symptoms for some patients. Symptoms of TES are nonspecific, so a high degree of clinical suspicion is warranted. Medical management represents the first-line treatment approach. When this fails or is contraindicated, definitive surgical treatment for cases of suspected TES uses a combined video laparoscopy performed by a gynecologic surgeon and video-assisted thoracoscopic surgery performed by a thoracic surgeon. Postoperative hormonal suppression may further reduce disease recurrence.
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Affiliation(s)
- Camran Nezhat
- Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Steven R Lindheim
- Department of Obstetrics and Gynecology, Wright State University, Dayton, Ohio, USA
| | - Leah Backhus
- Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Mailinh Vu
- Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Nataliya Vang
- Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Azadeh Nezhat
- Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
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Kotronis K, Zafrakas M, Papasozomenou P, Timologou A, Miliaras D, Tarlatzis BC, Grimbizis G. Protein expression pattern of tissue inhibitor of metalloproteinase-3 (TIMP3) in endometriosis and normal endometrium. Gynecol Endocrinol 2019; 35:1103-1106. [PMID: 31185764 DOI: 10.1080/09513590.2019.1625880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Given the involvement of different extracellular matrix (ECM) metalloproteinases (MMPs) in endometriosis, the protein expression pattern of tissue inhibitor of metalloproteinase-3 (TIMP3) was analyzed in this study in endometriosis and normal endometrium. Tissue samples were collected prospectively from 64 premenopausal patients undergoing operative laparoscopy. Protein expression of TIMP3 was analyzed immunohistochemically in endometriotic lesions (n = 30) and normal eutopic endometrium from patients with (n = 35) and without (n = 29) endometriosis. Comparison between the three different groups of tissue samples showed that TIMP3 was differentially expressed between the three groups (p = .04). Pair-wise comparisons showed that TIMP3 expression was lower in endometriotic lesions as compared with normal eutopic endometrium from controls (p = .006); the same non-significant trend was found, in the comparison between endometriosis lesions and matched eutopic endometrium. There were no differences in TIMP3 expression in the normal eutopic endometrium between patients with and without endometriosis. In conclusion, TIMP3 seems to be involved in the pathogenesis, pathophysiology, and maintenance of endometriosis and it might be useful as a diagnostic and prognostic marker of endometriosis. Future studies should further investigate this issue, as well as the interplay between TIMPs and different extracellular MMPs in endometriosis.
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Affiliation(s)
- Konstantinos Kotronis
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Menelaos Zafrakas
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- School of Health and Medical Care, αlexander τechnological εducational ιnstitute of Thessaloniki, Thessaloniki, Greece
| | - Panayiota Papasozomenou
- School of Health and Medical Care, αlexander τechnological εducational ιnstitute of Thessaloniki, Thessaloniki, Greece
| | - Anna Timologou
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimosthenis Miliaras
- Laboratory of Histology & Embryology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Basil C Tarlatzis
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigorios Grimbizis
- First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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