1
|
Salmanov AG, Artyomenko VV, Shchedrov AO, Prishchepa AP, Korniyenko SM, Chubatyy AI, Maidannyk IV, Chorna OO, Rud VO, Strakhovetskyi VS, Knyhin MV, Padchenko AS. Adverse pregnancy outcomes associated with endometriosis in Ukraine: results a multicenter study. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1113-1121. [PMID: 39106368 DOI: 10.36740/wlek202406101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVE Aim: To estimate pregnancy outcomes associated with endometriosis in Ukraine. PATIENTS AND METHODS Materials and Methods: We performed the multicentre prospective cohort study during the period from January 1st, 2019 to December 31st, 2021. The study included pregnant women aged ≥18 years hospitalized in 17 hospitals from 15 regions of Ukraine. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). RESULTS Results: Of the 27,558 women, 990 (3,6%) reported a diagnosis of endometriosis before pregnancy. In 990 deliveries, women with endometriosis had a higher risk of hypertension in pregnancy (OR 1.2, 95% CI 1.0-1.3), preeclampsia (OR 1.4, 95% CI 1.3-1.5), severe preeclampsia (OR 1.7, 95% CI 1.5-2.3), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), birth before 34 weeks (OR 3.2, 95% CI 2.8-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). CONCLUSION Conclusions: Pregnant women with endometriosis are at elevated risk for serious and important adverse maternal, fetal and neonatal outcomes. The magnitude of these complications calls for more intensive antenatal care of pregnant women with endometriosis.
Collapse
Affiliation(s)
- Aidyn G Salmanov
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | | | - Andrii O Shchedrov
- SCHOOL OF MEDICINE OF V. N. KARAZIN KHARKIV NATIONAL UNIVERSITY, KHARKIV, UKRAINE
| | | | | | | | | | | | - Victor O Rud
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
| | | | | | | |
Collapse
|
2
|
Salmeri N, Li Piani L, Cavoretto PI, Somigliana E, Viganò P, Candiani M. Endometriosis increases the risk of gestational diabetes: a meta-analysis stratified by mode of conception, disease localization and severity. Sci Rep 2023; 13:8099. [PMID: 37208452 DOI: 10.1038/s41598-023-35236-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
To review the current evidence on the risk of gestational diabetes mellitus (GDM) in women with endometriosis, taking into account relevant confounders such as the higher frequency of Assisted Reproductive Technologies (ART) conceptions. Database searches on PubMed, Medline, Embase and Scopus through June 2022, using combinations of relevant keywords. A total of 18 studies, involving N = 4,600,885 women, were included. The overall risk of GDM in endometriosis patients was significantly higher than in controls (OR, 1.23; 95% CI 1.07-1.51). This significant association persisted in natural pregnancies (OR, 1.08; 95% CI 1.04-1.12) but not in pregnancies conceived through ART (OR, 0.93;95% CI 0.70-1.24). Based on the limited number of studies that examined this association in relation to endometriosis phenotype, an increased risk was found in more severe stages (OR, 3.20; 95% CI 1.20-8.54) but independently from localization of the lesions. Endometriosis increases the risk of GDM, with a possible progressive effect in more advanced stages of the disease. Although the effect magnitude may be limited in some subgroups, this finding has a clinically relevant impact due to both the strong biological plausibility and to the relatively high incidence of both endometriosis and GDM.
Collapse
Affiliation(s)
- Noemi Salmeri
- Gynecology and Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Letizia Li Piani
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122, Milan, Italy
| | - Paolo Ivo Cavoretto
- Gynecology and Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122, Milan, Italy
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy.
| | - Massimo Candiani
- Gynecology and Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| |
Collapse
|
3
|
Harris HR, Korkes KMN, Li T, Kvaskoff M, Cho E, Carvalho LF, Qureshi AA, Abrao M, Missmer SA. Endometriosis, Psoriasis, and Psoriatic Arthritis: A Prospective Cohort Study. Am J Epidemiol 2022; 191:1050-1060. [PMID: 35029650 PMCID: PMC9393059 DOI: 10.1093/aje/kwac009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 01/16/2023] Open
Abstract
Endometriosis, psoriasis, and psoriatic arthritis (PsA) are chronic inflammatory disorders whose etiologies remain poorly understood but may be correlated, as endometriosis has been associated with other inflammatory disorders. We investigated the bidirectional associations between laparoscopically confirmed endometriosis and physician-diagnosed psoriasis and PsA in the Nurses' Health Study II cohort (n = 116,429, United States, 1991-2013). We confirmed 4,112 incident cases of laparoscopically confirmed endometriosis (mean age at diagnosis = 40.3 years) and 697 validated physician-diagnosed cases of psoriasis (mean age at diagnosis = 43.6 years), 110 of which presented with concomitant PsA. A history of psoriasis with concomitant PsA was associated with a 2-fold higher risk of endometriosis (hazard ratio (HR) = 2.01, 95% CI: 1.23, 3.30); however, no association was observed between psoriasis without PsA and endometriosis risk (HR = 0.93, 95% CI: 0.68, 1.26). When endometriosis was the exposure, it was not associated with a risk of subsequent psoriasis (HR = 1.28, 95% CI: 0.95, 1.72). The risk of psoriasis with PsA was notably higher; however, the sample size was small and the confidence intervals wide (HR = 1.77, 95% CI: 0.89, 3.52). Our findings suggest that psoriasis with concomitant PsA is associated with greater risk of laparoscopically confirmed endometriosis. In addition, there was a suggestive association between endometriosis diagnosis and subsequent risk of psoriasis with PsA.
Collapse
Affiliation(s)
- Holly R Harris
- Correspondence to Dr. Holly Harris, Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N., M4-B859, Seattle, WA 98109-1024 (e-mail: )
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Andrieu T, Chicca A, Pellegata D, Bersinger NA, Imboden S, Nirgianakis K, Gertsch J, Mueller MD. Association of endocannabinoids with pain in endometriosis. Pain 2022; 163:193-203. [PMID: 34001768 PMCID: PMC8675052 DOI: 10.1097/j.pain.0000000000002333] [Citation(s) in RCA: 1] [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: 07/24/2020] [Revised: 04/09/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Endocannabinoid (eCB) levels fluctuate in inflammatory conditions and as such may take part in endometriosis-associated pain or even in endometriosis pathogenesis. In this case-control (23 cases and 19 controls) study, targeted lipids were measured in the serum and peritoneal fluid collected during laparoscopy. Endometriosis was confirmed histologically. Dysmenorrhea, abdominal pain, and dyspareunia were assessed using the Numeric Rating Scale for pain. Steroids, eCBs, and related lipids were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Tumor necrosis factor alpha, IL-8, PAPP-A, PP14, RANTES, OPG, MIDKINE, MCP-1, VEGF, leptin, and defensins were quantified by ELISA. We found that eCB levels were significantly influenced by both noncyclic and cyclic abdominal pain. Specifically, women suffering from noncyclic abdominal pain were characterized by a higher 2-AG level in the peritoneal fluid throughout the menstrual cycle, whereas women suffering from dysmenorrhea had higher 2-AG levels and lower AEA levels during the proliferative phase alone. In addition, 2-AG positively correlated with prostaglandin E2 (PGE2), and the ratio AEA/2-AG positively correlated with defensins, suggesting a possible link between endocannabinoids system and inflammatory pain. The results of the current study indicate that the eCB system may play a role in endometriosis-associated pain, but additional studies are needed to investigate the causal relationship.
Collapse
Affiliation(s)
- Thomas Andrieu
- Department of BioMedical Research (DBMR), University of Bern, MEM, Bern, Switzerland
| | - Andrea Chicca
- Institute of Biochemistry and Molecular Medicine (IBMM), NCCR TransCure, University of Bern, Bern, Switzerland
| | - Daniele Pellegata
- Institute of Biochemistry and Molecular Medicine (IBMM), NCCR TransCure, University of Bern, Bern, Switzerland
| | - Nick A. Bersinger
- Department of BioMedical Research (DBMR), University of Bern, MEM, Bern, Switzerland
| | - Sara Imboden
- Department of BioMedical Research (DBMR), University of Bern, MEM, Bern, Switzerland
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Bern, Switzerland
| | - Konstantinos Nirgianakis
- Department of BioMedical Research (DBMR), University of Bern, MEM, Bern, Switzerland
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Bern, Switzerland
| | - Juerg Gertsch
- Institute of Biochemistry and Molecular Medicine (IBMM), NCCR TransCure, University of Bern, Bern, Switzerland
| | - Michael D. Mueller
- Department of BioMedical Research (DBMR), University of Bern, MEM, Bern, Switzerland
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Bern, Switzerland
| |
Collapse
|
5
|
Giacomini E, Minetto S, Li Piani L, Pagliardini L, Somigliana E, Viganò P. Genetics and Inflammation in Endometriosis: Improving Knowledge for Development of New Pharmacological Strategies. Int J Mol Sci 2021; 22:ijms22169033. [PMID: 34445738 PMCID: PMC8396487 DOI: 10.3390/ijms22169033] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/12/2022] Open
Abstract
According to a rich body of literature, immune cell dysfunctions, both locally and systemically, and an inflammatory environment characterize all forms of endometriosis. Alterations in transcripts and proteins involved in the recruitment of immune cells, in the interaction between cytokines and their receptors, cellular adhesion and apoptosis have been demonstrated in endometriotic lesions. The objective of this narrative review is to provide an overview of the components and mechanisms at the intersection between inflammation and genetics that may constitute vanguard therapeutic approaches in endometriosis. The GWAS technology and pathway-based analysis highlighted the role of the MAPK and the WNT/β-catenin cascades in the pathogenesis of endometriosis. These signaling pathways have been suggested to interfere with the disease establishment via several mechanisms, including apoptosis, migration and angiogenesis. Extracellular vesicle-associated molecules may be not only interesting to explain some aspects of endometriosis progression, but they may also serve as therapeutic regimens per se. Immune/inflammatory dysfunctions have always represented attractive therapeutic targets in endometriosis. These would be even more interesting if genetic evidence supported the involvement of functional pathways at the basis of these alterations. Targeting these dysfunctions through next-generation inhibitors can constitute a therapeutic alternative for endometriosis.
Collapse
Affiliation(s)
- Elisa Giacomini
- Reproductive Sciences Laboratory, Obstetrics and Gynecology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (E.G.); (L.P.)
| | - Sabrina Minetto
- Obstetrics and Gynecology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Letizia Li Piani
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy; (L.L.P.); (E.S.)
| | - Luca Pagliardini
- Reproductive Sciences Laboratory, Obstetrics and Gynecology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (E.G.); (L.P.)
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy; (L.L.P.); (E.S.)
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-5503-4302
| |
Collapse
|
6
|
Vanni VS, Villanacci R, Salmeri N, Papaleo E, Delprato D, Ottolina J, Rovere-Querini P, Ferrari S, Viganò P, Candiani M. Concomitant autoimmunity may be a predictor of more severe stages of endometriosis. Sci Rep 2021; 11:15372. [PMID: 34321558 PMCID: PMC8319416 DOI: 10.1038/s41598-021-94877-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 06/25/2021] [Indexed: 12/14/2022] Open
Abstract
Pathogenesis of endometriosis is still unclear and a role of both innate and adaptive immune system has been postulated. Some recent findings have revealed an increased risk to have concomitant autoimmune disease in women with endometriosis, but no study so far has investigated whether this association could affect endometriosis severity and stage. We retrospectively reviewed medical patients' notes of women with a confirmed diagnosis of endometriosis who referred to our endometriosis outpatient clinic between January 2015 and December 2019. Cases (endometriosis and an autoimmune disease) were matched in a 1:3 ratio by age and study period with controls (endometriosis without history of autoimmunity). At univariate logistic analysis, concomitant autoimmunity (OR 2.63, 95% CI 1.64-4.21, p < 0.001) and the number of laparoscopic procedures performed (OR 2.81, 95% CI 1.45-5.43, p = 0.002) emerged as factors significantly associated with the likelihood of stage IV endometriosis. In the multivariate logistic regression model, concomitant autoimmunity remained a significant predictor of stage IV endometriosis (OR 2.54, 95% CI 1.57-4.10, p = 0.004), whereas the association between the number of laparoscopic procedures performed and stage IV endometriosis was found to be of borderline-significance (OR 2.70, 95% 1.37-5.30, p = 0.050). Our findings suggest that endometriosis is more severe in patients who are also affected by autoimmune disturbances after controlling for relevant confounders.
Collapse
Affiliation(s)
- Valeria Stella Vanni
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
- Vita-Salute San Raffaele University, 20132, Milan, Italy.
| | - Roberta Villanacci
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Noemi Salmeri
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Enrico Papaleo
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Diana Delprato
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Jessica Ottolina
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, 20132, Milan, Italy
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Stefano Ferrari
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Paola Viganò
- Reproductive Sciences Lab, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Massimo Candiani
- Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| |
Collapse
|
7
|
AlAshqar A, Reschke L, Kirschen GW, Borahay MA. Role of inflammation in benign gynecologic disorders: from pathogenesis to novel therapies†. Biol Reprod 2021; 105:7-31. [PMID: 33739368 PMCID: PMC8256101 DOI: 10.1093/biolre/ioab054] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022] Open
Abstract
Emerging evidence supports the notion that inflammation fosters the development of common benign gynecologic disorders, including uterine leiomyoma, endometriosis, and adenomyosis. Numerous cytokines, chemokines, and growth and transcription factors have indisputable roles in the establishment and maintenance of benign gynecologic disorders by initiating complex cascades that promote proliferation, angiogenesis, and lesion progression. The interaction between inflammation and benign gynecologic disorders is orchestrated by a plethora of factors, including sex steroids, genetics, epigenetics, extracellular matrix, stem cells, cardiometabolic risk factors, diet, vitamin D, and the immune system. The role of inflammation in these disorders is not limited to local pathobiology but also extends to involve clinical sequelae that range from those confined to the reproductive tract, such as infertility and gynecologic malignancies, to systemic complications such as cardiovascular disease. Enhanced understanding of the intricate mechanisms of this association will introduce us to unvisited pathophysiological perspectives and guide future diagnostic and therapeutic implications aimed at reducing the burden of these disorders. Utilization of inflammatory markers, microRNA, and molecular imaging as diagnostic adjuncts may be valuable, noninvasive techniques for prompt detection of benign gynecologic disorders. Further, use of novel as well as previously established therapeutics, such as immunomodulators, hormonal treatments, cardiometabolic medications, and cyclooxygenase-2 and NF-κB inhibitors, can target inflammatory pathways involved in their pathogenesis. In this comprehensive review, we aim to dissect the existing literature on the role of inflammation in benign gynecologic disorders, including the proposed underlying mechanisms and complex interactions, its contribution to clinical sequelae, and the clinical implications this role entails.
Collapse
Affiliation(s)
- Abdelrahman AlAshqar
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
- Department of Obstetrics and Gynecology, Kuwait University, Kuwait City, Kuwait
| | - Lauren Reschke
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory W Kirschen
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Mostafa A Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
8
|
Villanacci R, Bandini V, Ottolina J, Pagliardini L, Candiani M, Viganò P. The pathogenesis of endometriosis: clues from the immunological evidence. Minerva Obstet Gynecol 2021; 73:275-282. [PMID: 34008382 DOI: 10.23736/s2724-606x.21.04768-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Endometriosis pathogenesis is still a matter of debate. It is now agreed that a complex cooperation of genetic, hormonal, immune and environmental factors is implicated. However, no consensus has been reached yet on what firstly is responsible for the initiation, promotion and survival of endometrial-like tissue outside the uterine cavity. Since consistent evidence have found immunological alterations in women with the disease, the impairment of immune system has been considered for decades one of the possible causes of endometriosis. The aim of this literature review is to summarize the available findings on a particular aspect of this topic represented by the inhibition of natural killer (NK) cell activity in women affected as a paradigmatic example of the complexity in studying the pathogenesis of endometriosis. EVIDENCE ACQUISITION Advanced search of PubMed for English articles published between 1990 and September 2020 using the keywords "endometriosis" or "endometrioma" or "endometriotic" or "ectopic endometrium" in combination with "natural killer cells" (NK). EVIDENCE SYNTHESIS Consistent studies have found an impairment in NK cell activity in women with endometriosis especially in advanced stages of disease (stage III/IV). Reports to explain these findings support the phenomenon as a consequence of the disease establishment. Evidence from genetic studies have questioned the role of these dysfunctions in the pathogenesis of the disease. CONCLUSIONS Immunological dysfunctions and the decreased NK cell cytotoxicity may only represent consequence of endometriosis, although the underlining mechanisms still need to be elucidated.
Collapse
Affiliation(s)
- Roberta Villanacci
- Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy -
| | - Veronica Bandini
- IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Jessica Ottolina
- Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Luca Pagliardini
- Unit of Obstetrics and Gynecology, Reproductive Sciences Lab, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Candiani
- Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Viganò
- Unit of Obstetrics and Gynecology, Reproductive Sciences Lab, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
9
|
Vignali M, Pisoni S, Gentilini D, Spada E, Solima E, Viganò P, Candiani M, Busacca M, DI Blasio AM. Hormonal therapy potentiates the effect of surgery on gene expression profile of peripheral blood mononuclear cells in patients affected by endometriosis. Minerva Endocrinol (Torino) 2020; 46:90-98. [PMID: 33269572 DOI: 10.23736/s2724-6507.20.03298-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Combined oral contraceptives (COCs) represent a common pharmacological approach for endometriosis. They have been demonstrated to mitigate painful symptoms in patients and are considered the first line therapy for symptomatic disease. The goal of this study was to evaluate whether the presence of pelvic endometriotic lesions can exert a systemic effect on PBMC gene expression and to investigate whether hormonal treatment may restore a normal gene expression profile. METHODS Forty women, with endometriosis at stage III-IV, were enrolled in the study. After surgery, 20, randomly chosen, were treated with COC for six months and 20 did not receive hormonal therapy. Blood samples were obtained few days before surgery and six months after surgery. Gene expression profile of PBMC was studied by microarray. Gene expression levels before surgery and post-surgery, in presence and absence of COC, were compared. RESULTS Nine genes previously reported to be overexpressed by endometriosis, were confirmed to be significantly downregulated after surgery. COC treatment lead to a greater down-regulation of these genes and to a significant down-regulation of 3 additional genes. 145 genes resulted downregulated and 28 upregulated by comparing gene expression before surgery with that 6 months after surgery in the presence of COC therapy. CONCLUSIONS Results support the concept that a systemic chronic inflammatory status is among the mechanisms underlying endometriosis. Moreover, they shed light into the mechanisms of action of COCs and strength the rationale for their use to improve quality of life of women affected by the disease.
Collapse
Affiliation(s)
- Michele Vignali
- Department of Biomedical Health Sciences, M. Melloni Hospital, University of Milan, Milan, Italy
| | - Serena Pisoni
- Laboratory of Molecular Biology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Davide Gentilini
- Laboratory of Molecular Biology, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Spada
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Paola Viganò
- Division of Genetics and Cell Biology, Laboratory of Reproductive Sciences, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Candiani
- Unit of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Mauro Busacca
- Department of Biomedical Health Sciences, M. Melloni Hospital, University of Milan, Milan, Italy
| | - Anna M DI Blasio
- Laboratory of Molecular Biology, IRCCS Istituto Auxologico Italiano, Milan, Italy -
| |
Collapse
|
10
|
Yao L, Yang L, Song H, Liu T, Yan H. MicroRNA miR-29c-3p modulates FOS expression to repress EMT and cell proliferation while induces apoptosis in TGF-β2-treated lens epithelial cells regulated by lncRNA KCNQ1OT1. Biomed Pharmacother 2020; 129:110290. [PMID: 32534225 DOI: 10.1016/j.biopha.2020.110290] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/13/2020] [Accepted: 05/16/2020] [Indexed: 10/24/2022] Open
Abstract
Age-related cataract (ARC) is a main cause of blindness for elderly people. MicroRNA hsa_miR-29c-3p (miR-29c-3p) was implicated in many biological processes in complicated diseases. However, the biological mechanism of miR-29c-3p in ARC is still undefined. Quantitative real-time polymerase chain reaction (qRT-PCR) showed that miR-29c-3p was lowly expressed, while FBJ murine osteosarcoma viral oncogene homolog (FOS) and KCNQ1 overlapping transcript 1 (KCNQ1OT1) were highly expressed in cataract tissues and in TGF-β2-treated SRA01/04 cells. Western blot assay indicated that TGF-β2 could promote epithelial-mesenchymal transition (EMT). Moreover, our data suggested that miR-29c-3p overexpression suppressed EMT, cell proliferation and promoted apoptosis in TGF-β2-treated SRA01/04 cells. The dual-luciferase reporter assay verified that FOS was a target of miR-29c-3p and miR-29c-3p was directly targeted by KCNQ1OT1. Furthermore, KCNQ1OT1 could regulate FOS expression by sponging miR-29c-3p. Functional assays revealed that miR-29c-3p regulated FOS to repress EMT, cell proliferation and facilitate apoptosis in TGF-β2-treated SRA01/04 cells mediated by KCNQ1OT1. In conclusion, KCNQ1OT1/miR-29c-3p/FOS axis played a vital role in the progression of ARC.
Collapse
Affiliation(s)
- Ling Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lei Yang
- Tianjin Key Laboratory of Tianjin Nankai Hospital, Tianjin, China
| | - Hui Song
- Department of Ophthalmology, Tianjin Eye Hospital, Tianjin, China
| | - Tiegang Liu
- Department of Ophthalmology, Beijing Capital International Airport Hospital, Beijing, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China.
| |
Collapse
|
11
|
Aboulghar M. Role of adrenomedullin in reproduction and endometriosis. Fertil Steril 2018; 109:1010-1011. [PMID: 29935635 DOI: 10.1016/j.fertnstert.2018.02.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Mohamed Aboulghar
- Faculty of Medicine, Cairo University; and Egyptian IVF Center, Maadi, Cairo, Egypt
| |
Collapse
|
12
|
Jenabi E, Fereidooni B. The association between endometriosis and the risk of LBW: A meta-analysis. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2018. [DOI: 10.1177/2284026518774997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Many observational services have been conducted to evaluate the risk factors of low birth weight, but the results showed no consistency. Therefore, we conducted this meta-analysis to investigate the association between endometriosis (body mass index) and the risk of low birth weight. Methods: Relevant works that were published in major international electronic databases such as PubMed, Scopus, Web of Science, LILACS, SciELO, and Cochrane were systematically searched until February 2018. Begg’s and Egger’s tests were used to determine publication bias in included studies. The random-effects model was carried out to determine the odds ratio. Results: A meta-analysis of the 12 studies proposed a significant association between endometriosis and the risk of low birth weight (odds ratio = 1.34, 95% confidence interval = 1.08–1.60). The subgroup analysis was carried out based on the design, adjusted form, and use of assisted reproductive technology in studies. The pooled results based on subgroup analysis in case–control and cohort studies were 1.46 (0.79–2.12) and 1.32 (1.02–1.62), respectively. There was significant correlation between endometriosis and low birth weight in cohort studies. Also, heterogeneity was not reported among studies in the subgroup based on adjusted form. There was no significant correlation between endometriosis and low birth weight in studies using assisted reproductive technology methods Conclusion: The systematic review and meta-analysis showed that endometriosis increases the risk of low birth weight. Therefore, it is a risk factor for low birth weight.
Collapse
Affiliation(s)
- Ensiyeh Jenabi
- Pediatric Developmental Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | |
Collapse
|
13
|
Leone Roberti Maggiore U, Inversetti A, Schimberni M, Viganò P, Giorgione V, Candiani M. Obstetrical complications of endometriosis, particularly deep endometriosis. Fertil Steril 2017; 108:895-912. [PMID: 29202964 DOI: 10.1016/j.fertnstert.2017.10.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 02/07/2023]
Abstract
Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable. Therefore, the current literature does not support any kind of prophylactic surgery before pregnancy to prevent such complications. Results on the impact of DE on obstetrical outcomes are debatable and characterized by several limitations, including small sample size, lack of adjustment for confounders, lack of adequate control subjects, and other methodologic flaws. For these reasons, it is not possible to draw conclusions on this topic. The strongest evidence shows that DE is associated with higher rates of placenta previa; for other obstetrical outcomes, such as miscarriage, intrauterine growth restriction, preterm birth and hypertensive disorders, results are controversial. Although it is unlikely that surgery of DE may modify the impact of the disease on the course of pregnancy, no study has yet investigated this issue.
Collapse
Affiliation(s)
| | - Annalisa Inversetti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy; Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Schimberni
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy; Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Giorgione
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy; Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy; Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| |
Collapse
|
14
|
Zullo F, Spagnolo E, Saccone G, Acunzo M, Xodo S, Ceccaroni M, Berghella V. Endometriosis and obstetrics complications: a systematic review and meta-analysis. Fertil Steril 2017; 108:667-672.e5. [DOI: 10.1016/j.fertnstert.2017.07.019] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 01/30/2023]
|
15
|
Abstract
Endometriosis is one of the most common gynaecological conditions affecting 6% to 12% of women in the reproductive age group. It can be found in 35% to 45% of women who are trying to conceive and are infertile. Infertility is one of the most common problems associated with endometriosis. This review will look at the evidence that endometriosis may lead to infertility and the data looking at whether surgical correction of endometriosis may improve fertility outcomes.
Collapse
|
16
|
Viganò P, Ottolina J, Sarais V, Rebonato G, Somigliana E, Candiani M. Coagulation Status in Women With Endometriosis. Reprod Sci 2017; 25:559-565. [PMID: 28681683 DOI: 10.1177/1933719117718273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Subtle alterations in coagulation and fibrinolysis have been recently reported in patients with endometriosis supporting a potential hypercoagulable status associated with the disease. This cross-sectional study aimed at evaluating some variables of coagulation status and inflammatory markers in women with endometriosis. A total of 314 women who underwent surgery were considered. The case group (n = 169) included patients with a surgical diagnosis of endometriosis, at any stage of disease. The control group (n = 145) included women with a surgical diagnosis of benign gynecologic pathology. No difference was found for thrombin time, International Normalized Ratio (INR), platelet count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR) between women with endometriosis and controls. Conversely, patients with endometriosis had significantly shortened activated partial thromboplastin time (APTT) when compared to controls (1.08 ± 0.06 and 1.12 ± 0.19, respectively; P < .01). In the subgroup analysis, women with ovarian endometriosis had significantly shortened APTT values in comparison to women without this form and women with stage I to II endometriosis had significantly shorter APTT values and higher PLR than those with stage III to IV disease. In multivariate logistic regression analysis, after controlling for potential confounders, a shortened APTT remained associated with the disease. Activated partial thromboplastin time is shorter in women with endometriosis but still in the normal range. The evidence is insufficient to foresee a possible use of APTT as a diagnostic marker and to claim a crucial role of a systemic hypercoagulable state in the origin of the disease. A role of the local coagulation system in the pathogenesis of the disease cannot be excluded.
Collapse
Affiliation(s)
- Paola Viganò
- 1 Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jessica Ottolina
- 2 Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Sarais
- 2 Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Rebonato
- 2 Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edgardo Somigliana
- 3 Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Candiani
- 2 Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
17
|
The Serum Levels of the Soluble Factors sCD40L and CXCL1 Are Not Indicative of Endometriosis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2857161. [PMID: 27190986 PMCID: PMC4852116 DOI: 10.1155/2016/2857161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/28/2016] [Indexed: 12/12/2022]
Abstract
Endometriosis is a benign but troublesome gynecological condition, characterized by endometrial-like tissue outside the uterine cavity. Lately, the discovery and validation of noninvasive diagnostic biomarkers for endometriosis is one of the main priorities in the field. As the disease elicits a chronic inflammatory reaction, we focused our interest on two factors well known to be involved in inflammation and neoplastic processes, namely, soluble CD40 Ligand and CXCL1, and asked whether differences in the serum levels of sCD40L and CXCL1 in endometriosis patients versus controls can serve as noninvasive disease markers. A total of n = 60 women were included in the study, 31 endometriosis patients and 29 controls, and the serum levels of sCD40L and CXCL1 were measured by enzyme-linked immunosorbent assay. Overall, there were no statistically significant differences in the levels of expression of both sCD40L and CXCL1 between patients and controls. This study adds useful clinical data showing that the serum levels of the soluble factors sCD40L and CXCL1 are not associated with endometriosis and are not suitable as biomarkers for disease diagnosis. However, we found a trend toward lower levels of sCD40L in the deep infiltrating endometriosis subgroup making it a potentially interesting target worth further investigation.
Collapse
|
18
|
Calagna G, Perino A, Chianetta D, Vinti D, Triolo MM, Rimi C, Cucinella G, Agrusa A. Primary umbilical endometrioma: Analyzing the pathogenesis of endometriosis from an unusual localization. Taiwan J Obstet Gynecol 2016; 54:306-12. [PMID: 26166347 DOI: 10.1016/j.tjog.2014.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE This report presents a rare case of symptomatic primary umbilical endometriosis and reviews the literature on the topic with the aim to clarify some questions on the origin of endometriosis. CASE REPORT A 33-year-old woman with cyclic umbilical bleeding was found to have umbilical endometriosis. She had no history of pelvic or abdominal surgery. There was no past history of endometriosis or endometriosis-associated symptoms. An omphalectomy was performed after explorative laparoscopy to carefully inspect the abdominopelvic cavity and assess any coexisting pelvic endometriotic lesions. Histological examination confirmed the diagnosis of umbilical endometriosis. CONCLUSION Umbilical endometriosis is a rare but under-recognized phenomenon. Primary lesions are difficult to recognize, but probably represent an independent nosological entity. The possibility of endometriosis must be considered during the evaluation of an umbilical mass despite the absence of previous surgery. Complete excision and successive histology are highly recommended.
Collapse
Affiliation(s)
- Gloria Calagna
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy.
| | - Antonino Perino
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Daniela Chianetta
- Department of General Surgery, Emergency and Organ Transplantation, University Hospital "P. Giaccone", Palermo, Italy
| | - Daniele Vinti
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| | | | - Carlo Rimi
- Department of Pathological Anatomy, University Hospital "P. Giaccone", Palermo, Italy
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Antonino Agrusa
- Department of General Surgery, Emergency and Organ Transplantation, University Hospital "P. Giaccone", Palermo, Italy
| |
Collapse
|
19
|
Sanchez AM, Somigliana E, Vercellini P, Pagliardini L, Candiani M, Vigano P. Endometriosis as a detrimental condition for granulosa cell steroidogenesis and development: From molecular alterations to clinical impact. J Steroid Biochem Mol Biol 2016; 155:35-46. [PMID: 26407755 DOI: 10.1016/j.jsbmb.2015.07.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period. Alterations in ovarian follicle morphology and function have been documented in affected women. The local intrafollicular environment has been as well examined by various groups. In the present review, we aimed to summarize the molecular evidence supporting the idea that endometriosis can negatively influence growth, steroidogenesis and the function of the granulosa cells (GCs). Reduced P450 aromatase expression, increased intracellular ROS generation and altered WNT signaling characterize the GCs of women with endometriosis. Clear evidence for an increased level of GC apoptosis has been provided in association with the downregulation of pro-survival factors. Other potentially negative effects include decreased progesterone production, locally decreased AMH production and lower inflammatory cytokine expression, although these have been only partially clarified. The possibility that endometriosis per se may influence IVF clinical results as a consequence of the detrimental impact on the local intrafollicular environment is also discussed.
Collapse
Affiliation(s)
- Ana Maria Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Edgardo Somigliana
- Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Paolo Vercellini
- Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Luca Pagliardini
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Candiani
- Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milano, Italy
| | - Paola Vigano
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy.
| |
Collapse
|
20
|
Aceto GM, Fantini F, De Iure S, Di Nicola M, Palka G, Valanzano R, Di Gregorio P, Stigliano V, Genuardi M, Battista P, Cama A, Curia MC. Correlation between mutations and mRNA expression of APC and MUTYH genes: new insight into hereditary colorectal polyposis predisposition. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2015; 34:131. [PMID: 26511139 PMCID: PMC4625907 DOI: 10.1186/s13046-015-0244-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/19/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Transcript dosage imbalance may influence the transcriptome. To gain insight into the role of altered gene expression in hereditary colorectal polyposis predisposition, in the present study we analyzed absolute and allele-specific expression (ASE) of adenomatous polyposis coli (APC) and mutY Homolog (MUTYH) genes. METHODS We analyzed DNA and RNA extracted from peripheral blood mononuclear cells (PBMC) of 49 familial polyposis patients and 42 healthy blood donors selected according similar gender and age. Patients were studied for germline alterations in both genes using dHPLC, MLPA and automated sequencing. APC and MUTYH mRNA expression levels were investigated by quantitative Real-Time PCR (qRT-PCR) analysis using TaqMan assay and by ASE assays using dHPLC-based primer extension. RESULTS Twenty out of 49 patients showed germline mutations: 14 in APC gene and six in MUTYH gene. Twenty-nine patients did not show mutations in both genes. Results from qRT-PCR indicated that gene expression of both APC and MUTYH was reduced in patients analyzed. In particular, a significant reduction in APC expression was observed in patients without APC germline mutation vs control group (P < 0.05) while APC expression in the mutation carrier patients, although lower compared to control individuals, did not show statistical significance. On the other hand a significant reduced MUTYH expression was detected in patients with MUTYH mutations vs control group (P < 0.05). Altered ASE of APC was detected in four out of eight APC mutation carriers. In particular one case showed a complete loss of one allele. Among APC mutation negative cases, 4 out of 13 showed a moderate ASE. ASE of MUTYH did not show any altered expression in the cases analyzed. Spearman's Rho Test analysis showed a positive and significant correlation between APC and MUTYH genes both in cases and in controls (P = 0.020 and P < 0.001). CONCLUSIONS APC and MUTYH showed a reduced germline expression, not always corresponding to gene mutation. Expression of APC is decreased in mutation negative cases and this appears to be a promising indicator of FAP predisposition, while for MUTYH gene, mutation is associated to reduced mRNA expression. This study could improve the predictive genetic diagnosis of at-risk individuals belonging to families with reduced mRNA expression regardless of presence of mutation.
Collapse
Affiliation(s)
- Gitana Maria Aceto
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Fabiana Fantini
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Sabrina De Iure
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Giandomenico Palka
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Rosa Valanzano
- Department of Clinical Physiopathology, University of Florence, Florence, Italy.
| | - Patrizia Di Gregorio
- Immunohaematology and Transfusional Medicine Service, "SS. Annunziata" Hospital, Chieti, Italy.
| | - Vittoria Stigliano
- Division of Gastroenterology and Digestive Endoscopy, Regina Elena National Cancer Institute, Rome, Italy.
| | - Maurizio Genuardi
- Institute of Medical Genetics, "A. Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
| | - Pasquale Battista
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| | - Alessandro Cama
- Department of Pharmacy, "G. d'Annunzio" University, Chieti, Italy.
| | - Maria Cristina Curia
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
| |
Collapse
|
21
|
Leone Roberti Maggiore U, Ferrero S, Mangili G, Bergamini A, Inversetti A, Giorgione V, Viganò P, Candiani M. A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Hum Reprod Update 2015; 22:70-103. [PMID: 26450609 DOI: 10.1093/humupd/dmv045] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/14/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Traditionally, pregnancy was considered to have a positive effect on endometriosis and its painful symptoms due not only to blockage of ovulation preventing bleeding of endometriotic tissue but also to different metabolic, hormonal, immune and angiogenesis changes related to pregnancy. However, a growing literature is emerging on the role of endometriosis in affecting the development of pregnancy and its outcomes and also on the impact of pregnancy on endometriosis. The present article aims to underline the difficulty in diagnosing endometriotic lesions during pregnancy and discuss the options for the treatment of decidualized endometriosis in relation to imaging and symptomatology; to describe all the possible acute complications of pregnancy caused by pre-existing endometriosis and evaluate potential treatments of these complications; to assess whether endometriosis affects pregnancy outcome and hypothesize mechanisms to explain the underlying relationships. METHODS This systematic review is based on material searched and obtained via Pubmed and Medline between January 1950 and March 2015. Peer-reviewed, English-language journal articles examining the impact of endometriosis on pregnancy and vice versa were included in this article. RESULTS Changes of the endometriotic lesions may occur during pregnancy caused by the modifications of the hormonal milieu, posing a clinical dilemma due to their atypical appearance. The management of these events is actually challenging as only few cases have been described and the review of available literature evidenced a lack of formal estimates of their incidence. Acute complications of endometriosis during pregnancy, such as spontaneous hemoperitoneum, bowel and ovarian complications, represent rare but life-threatening conditions that require, in most of the cases, surgical operations to be managed. Due to the unpredictability of these complications, no specific recommendation for additional interventions to the routinely monitoring of pregnancy of women with known history of endometriosis is advisable. Even if the results of the published studies are controversial, some evidence is suggestive of an association of endometriosis with spontaneous miscarriage, preterm birth and small for gestational age babies. A correlation of endometriosis with placenta previa (odds ratio from 1.67 to 15.1 according to various studies) has been demonstrated, possibly linked to the abnormal frequency and amplitude of uterine contractions observed in women affected. Finally, there is no evidence that prophylactic surgery would prevent the negative impact of endometriosis itself on pregnancy outcome. CONCLUSIONS Complications of endometriosis during pregnancy are rare and there is no evidence that the disease has a major detrimental effect on pregnancy outcome. Therefore, pregnant women with endometriosis can be reassured on the course of their pregnancies although the physicians should be aware of the potential increased risk of placenta previa. Current evidence does not support any modification of conventional monitoring of pregnancy in patients with endometriosis.
Collapse
Affiliation(s)
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino - IST, Largo R. Benzi 10, 16132 Genova, Italy Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Genova, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Annalisa Inversetti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Veronica Giorgione
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Via Olgettina 58, 20132 Milano, Italy
| |
Collapse
|
22
|
The immune response in the CNS in Theiler's virus induced demyelinating disease switches from an early adaptive response to a chronic innate-like response. J Neurovirol 2015; 22:66-79. [PMID: 26260496 DOI: 10.1007/s13365-015-0369-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 12/14/2022]
Abstract
Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD) is an important model of the progressive disability caused by irreversible CNS tissue injury, and provides an example of how a CNS pathogen can cause inflammation, demyelination, and neuronal damage. We were interested in which molecules, especially inflammatory mediators, might be upregulated in the CNS throughout TMEV-IDD. We quantitated by a real-time RT-PCR multi-gene system the expression of a pathway-focused panel of genes at 30 and 165 days post infection, characterizing both the early inflammatory and the late neurodegenerative stages of TMEV-IDD. Also, we measured 32 cytokines/chemokines by multiplex Luminex analysis in CSF specimens from early and late TMEV-IDD as well as sham-treated mice. Results indicate that, in the later stage of TMEV-IDD, activation of the innate immune response is most prominent: TLRs, type I IFN response genes, and innate immunity-associated cytokines were highly expressed in late TMEV-IDD compared to sham (p ≤ 0.0001) and early TMEV-IDD (p < 0.05). Conversely, several molecular mediators of adaptive immune response were highly expressed in early TMEV-IDD (all p ≤ 0.001). Protein detection in the CSF was broadly concordant with mRNA abundance of the corresponding gene measured by real-time RT-PCR in the spinal cord, since several cytokines/chemokines were increased in the CSF of TMEV-IDD mice. Results show a clear shift from adaptive to innate immunity from early to late TMEV-IDD, indicating that adaptive and innate immune pathways are likely involved in the development and progression of the disease to different extents. CSF provides an optimal source of biomarkers of CNS neuroinflammation.
Collapse
|
23
|
Granese R, Perino A, Calagna G, Saitta S, De Franciscis P, Colacurci N, Triolo O, Cucinella G. Gonadotrophin-releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: a multi-center randomized trial. Acta Obstet Gynecol Scand 2015; 94:637-45. [PMID: 25761587 DOI: 10.1111/aogs.12633] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the efficacy of dienogest + estradiol valerate (E2V) and gonadotrophin-releasing hormone analogue (GnRH-a) in reducing recurrence of pain in patients with chronic pelvic pain due to laparoscopically diagnosed and treated endometriosis. DESIGN Multi-center, prospective, randomized study. SETTING Three university departments of obstetrics and gynecology in Italy. POPULATION Seventy-eight women who underwent laparoscopic surgery for endometriosis combined with chronic pelvic pain. METHODS Post-operative administration of dienogest + E2V for 9 months (group 1) or GnRH-a monthly for 6 months (group 2). MAIN OUTCOME MEASURES A visual analogue scale was used to test intensity of pain before laparoscopic surgery at 3, 6 and 9 months of follow up. A questionnaire to investigate quality of life was administered before surgery and at 9 months of follow up. RESULTS The visual analogue scale score did not show any significant differences between the two groups (p = 0.417). The questionnaire showed an increase of scores for all women compared with pre-surgery values, demonstrating a marked improvement in quality of life and health-related satisfaction with both treatments. No significant differences were found between the groups. The rate of apparent endometriosis recurrence was 10.8% in group 1 and 13.7% in group 2 (p = 0.962). CONCLUSION Both therapies seemed equally efficacious in preventing endometriosis-related chronic pelvic pain recurrence in the first 9 months of follow-up.
Collapse
Affiliation(s)
- Roberta Granese
- Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University Hospital "G. Martino", Messina, Italy
| | - Antonino Perino
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Gloria Calagna
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Salvatore Saitta
- Department of Clinical and Experimental Medicine Human Pathology, University Hospital "G. Martino", Messina, Italy
| | | | - Nicola Colacurci
- Department of Obstetrics and Gynecology, II University, Naples, Italy
| | - Onofrio Triolo
- Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University Hospital "G. Martino", Messina, Italy
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, University Hospital "P. Giaccone", Palermo, Italy
| |
Collapse
|
24
|
Identification of crucial genes in intracranial aneurysm based on weighted gene coexpression network analysis. Cancer Gene Ther 2015; 22:238-45. [DOI: 10.1038/cgt.2015.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 01/17/2023]
|
25
|
Alabiso G, Alio L, Arena S, di Prun AB, Bergamini V, Berlanda N, Busacca M, Candiani M, Centini G, Di Cello A, Exacoustos C, Fedele L, Gabbi L, Geraci E, Lavarini E, Incandela D, Lazzeri L, Luisi S, Maiorana A, Maneschi F, Mattei A, Muzii L, Pagliardini L, Perandini A, Perelli F, Pinzauti S, Remorgida V, Sanchez AM, Seracchioli R, Somigliana E, Tosti C, Venturella R, Vercellini P, Viganò P, Vignali M, Zullo F, Zupi E. How to Manage Bowel Endometriosis: The ETIC Approach. J Minim Invasive Gynecol 2015; 22:517-29. [PMID: 25678420 DOI: 10.1016/j.jmig.2015.01.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 01/07/2023]
Abstract
A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and various clinical scenarios are discussed. A decision algorithm derived from this discussion is proposed as well.
Collapse
Affiliation(s)
- Giulia Alabiso
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital, University of Milan, Milan, Italy
| | - Luigi Alio
- Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy
| | - Saverio Arena
- Department of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Valentino Bergamini
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | - Nicola Berlanda
- Department of Obstetrics and Gynecology, Isituto Luigi Mangiagalli, University of Milan, Milan, Italy
| | - Mauro Busacca
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital, University of Milan, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Milan, Italy
| | - Gabriele Centini
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Annalisa Di Cello
- Department of Obstetrics and Gynecology, University of Magna Graecia, Catanzaro, Italy
| | | | - Luigi Fedele
- Department of Obstetrics and Gynecology, Isituto Luigi Mangiagalli, University of Milan, Milan, Italy
| | - Laura Gabbi
- Department of Obstetrics and Gynecology, University of Genova, Genova, Italy
| | - Elisa Geraci
- Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy
| | - Elena Lavarini
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | - Domenico Incandela
- Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy
| | - Lucia Lazzeri
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Stefano Luisi
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Antonio Maiorana
- Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy
| | - Francesco Maneschi
- Department of Obstetrics and Gynecology, Santa Maria Goretti Hospital, Latina, Italy
| | - Alberto Mattei
- Department of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - Ludovico Muzii
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Luca Pagliardini
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Milan, Italy
| | - Alessio Perandini
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | - Federica Perelli
- Department of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - Serena Pinzauti
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Valentino Remorgida
- Department of Obstetrics and Gynecology, University of Genova, Genova, Italy
| | - Ana Maria Sanchez
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Milan, Italy
| | - Renato Seracchioli
- Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Tosti
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Roberta Venturella
- Department of Obstetrics and Gynecology, University of Magna Graecia, Catanzaro, Italy
| | - Paolo Vercellini
- Department of Obstetrics and Gynecology, Isituto Luigi Mangiagalli, University of Milan, Milan, Italy
| | - Paola Viganò
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Milan, Italy
| | - Michele Vignali
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital, University of Milan, Milan, Italy
| | - Fulvio Zullo
- Department of Obstetrics and Gynecology, University of Magna Graecia, Catanzaro, Italy
| | - Errico Zupi
- Department of Obstetrics and Gynecology, University of Siena, Siena, Italy.
| |
Collapse
|
26
|
Bravi F, Parazzini F, Cipriani S, Chiaffarino F, Ricci E, Chiantera V, Viganò P, La Vecchia C. Tobacco smoking and risk of endometriosis: a systematic review and meta-analysis. BMJ Open 2014; 4:e006325. [PMID: 25534211 PMCID: PMC4275697 DOI: 10.1136/bmjopen-2014-006325] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Since conflicting results have been published on the role of tobacco smoking on the risk of endometriosis, we provide an up-to-date summary quantification of this potential association. DESIGN We performed a PubMed/MEDLINE search of the relevant publications up to September 2014, considering studies on humans published in English. We searched the reference list of the identified papers to find other relevant publications. Case-control as well as cohort studies have been included reporting risk estimates on the association between tobacco smoking and endometriosis. 38 of the 1758 screened papers met the inclusion criteria. The selected studies included a total of 13,129 women diagnosed with endometriosis. SETTING Academic hospitals. MAIN OUTCOME MEASURE Risk of endometriosis in tobacco smokers. RESULTS We obtained the summary estimates of the relative risk (RR) using the random effect model, and assessed the heterogeneity among studies using the χ(2) test and quantified it using the I(2) statistic. As compared to never-smokers, the summary RR were 0.96 (95% CI 0.86 to 1.08) for ever smokers, 0.95 (95% CI 0.81 to 1.11) for former smokers, 0.92 (95% CI 0.82 to 1.04) for current smokers, 0.87 (95% CI 0.70 to 1.07) for moderate smokers and 0.93 (95% CI 0.69 to 1.26) for heavy smokers. CONCLUSIONS The present meta-analysis provided no evidence for an association between tobacco smoking and the risk of endometriosis. The results were consistent considering ever, former, current, moderate and heavy smokers, and across type of endometriosis and study design.
Collapse
Affiliation(s)
- Francesca Bravi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sonia Cipriani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Chiaffarino
- Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Ricci
- Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Vito Chiantera
- Department of Gynecology, Charitè Universitätsmedizin, Berlin, Germany
| | - Paola Viganò
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
27
|
Sanchez AM, Viganò P, Quattrone F, Pagliardini L, Papaleo E, Candiani M, Panina-Bordignon P. The WNT/β-catenin signaling pathway and expression of survival promoting genes in luteinized granulosa cells: endometriosis as a paradigm for a dysregulated apoptosis pathway. Fertil Steril 2014; 101:1688-96. [PMID: 24661731 DOI: 10.1016/j.fertnstert.2014.02.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 02/17/2014] [Accepted: 02/20/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To analyze the WNT/β-catenin signaling pathway in luteinized granulosa cells from women with and without endometriosis in relation to cellular apoptosis. DESIGN Basic. SETTING University hospital. PATIENT(S) Patients with a laparoscopic diagnosis of endometriosis (n = 30) and women undergoing intracytoplasmic sperm injection for male infertility (control group n = 39). INTERVENTION(S) Isolation of luteinized granulosa cells. MAIN OUTCOME MEASURE(S) Gene expression analysis of components of the WNT/β-catenin pathway, protein expression levels of β-catenin, and cell cycle studies in luteinized granulosa cells. RESULT(S) Compared with luteinized granulosa cells from control women, cells derived from endometriosis patients had significantly higher transcript levels of the β-catenin-independent molecules WNT4 and WNT5a and lower levels of the β-catenin-dependent molecule WNT1. A decrease of total β-catenin as well as of its dephosphorylated active form, together with an aberrant gene expression of the downstream targets survivin and BMP4, was detected in cells from affected women. Flow cytometry analysis confirmed an enhanced apoptosis of luteinized granulosa cells from patients with endometriosis. CONCLUSION(S) The concomitant dysregulation of specific members of the WNT pathway and of its pivot molecule β-catenin in granulosa cells characterized by an increased apoptosis suggests that the WNT/β-catenin signaling pathway might be involved in leading to granulosa cell atresia.
Collapse
Affiliation(s)
- Ana M Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Paola Viganò
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy.
| | - Federica Quattrone
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Pagliardini
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Paola Panina-Bordignon
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
28
|
Chiaffarino F, Bravi F, Cipriani S, Parazzini F, Ricci E, Viganò P, La Vecchia C. Coffee and caffeine intake and risk of endometriosis: a meta-analysis. Eur J Nutr 2014; 53:1573-9. [PMID: 24481690 DOI: 10.1007/s00394-014-0662-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 01/17/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The potential association between endometriosis and coffee/caffeine consumption has been analysed in several epidemiological studies. In order to establish whether caffeine influences the risk of endometriosis, we provide to summarize the evidence from published studies on this issue. METHODS We performed a meta-analysis of epidemiological studies published up to January 2013. We computed summary relative risks (RR) of endometriosis for any, high and low versus no coffee/caffeine consumption. RESULTS We identified a total eight studies, six case-control and two cohort studies, including a total of 1,407 women with endometriosis. The summary RR for any versus non-consumption were 1.26 [95% confidence interval (CI) 0.95-1.66] for caffeine and 1.13 (95% CI 0.46-2.76) for coffee consumption; the overall estimate was 1.18 (95% CI 0.92-1.49). The summary RR were 1.09 (95% CI 0.84-1.42) and 1.09 (95% CI 0.89-1.33) for high and low caffeine consumption as compared to no consumption, respectively. CONCLUSION The present meta-analysis provided no evidence for an association between coffee/caffeine consumption and the risk of endometriosis. Coffee/caffeine consumption, as currently used in diet, does not carry a health risk.
Collapse
Affiliation(s)
- Francesca Chiaffarino
- Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
29
|
Mahalingaiah S, Hart JE, Laden F, Aschengrau A, Missmer SA. Air pollution exposures during adulthood and risk of endometriosis in the Nurses' Health Study II. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:58-64. [PMID: 24225723 PMCID: PMC3888567 DOI: 10.1289/ehp.1306627] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 11/08/2013] [Indexed: 05/05/2023]
Abstract
BACKGROUND Particulate matter and proximity to large roadways may promote disease mechanisms, including systemic inflammation, hormonal alteration, and vascular proliferation, that may contribute to the development and severity of endometriosis. OBJECTIVE Our goal was to determine the association of air pollution exposures during adulthood, including distance to road, particulate matter<2.5 μm, between 2.5 and 10 μm, and <10 μm, (PM2.5, PM10-2.5, PM10), and timing of exposure with risk of endometriosis in the Nurses' Health Study II. METHODS Proximity to major roadways and outdoor levels of PM2.5, PM10-2.5, and PM10 were determined for all residential addresses from 1993 to 2007. Multivariable-adjusted time-varying Cox proportional hazard models were used to estimate the relation between these air pollution exposures and endometriosis risk. RESULTS Among 84,060 women, 2,486 incident cases of surgically confirmed endometriosis were identified over 710,230 person-years of follow-up. There was no evidence of an association between endometriosis risk and distance to road or exposure to PM2.5, PM10-2.5, or PM10 averaged over follow-up or during the previous 2- or 4-year period. CONCLUSIONS Traffic and air pollution exposures during adulthood were not associated with incident endometriosis in this cohort of women.
Collapse
Affiliation(s)
- Shruthi Mahalingaiah
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | | | | | | |
Collapse
|
30
|
Chen X, Yan Y, Li P, Yang Z, Qin L, Mo W. Association of GSTP1 −313A/G polymorphisms and endometriosis risk: a meta-analysis of case–control studies. Eur J Obstet Gynecol Reprod Biol 2013; 171:362-7. [DOI: 10.1016/j.ejogrb.2013.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 08/12/2013] [Accepted: 10/02/2013] [Indexed: 02/06/2023]
|
31
|
Zhou L, Conceicao V, Gupta P, Saksena NK. Why are the neurodegenerative disease-related pathways overrepresented in primary HIV-infected peripheral blood mononuclear cells: a genome-wide perspective. Virol J 2012; 9:308. [PMID: 23241427 PMCID: PMC3546955 DOI: 10.1186/1743-422x-9-308] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 12/04/2012] [Indexed: 01/07/2023] Open
Abstract
We demonstrate for the first time that the genome-wide profiling of HIV-infected peripheral blood mononuclear cells (PBMCs) from HIV-patients free of neurologic disease show overrepresentation of neurodegenerative pathways (Alzheimer’s, Parkinson’s, ALS, Huntington’s and Prion Disease, etc.) in genome-wide microarray analysis, which suggests that this genome-wide representation of neurodegenerative diseases-related pathways in PBMCs could possibly be a subcellular manifestation of neurologic interference by HIV. Further, the cell-tagging analysis attested this belief showing the large majority of genes tagged with cells of monocyte and macrophage lineage, which are implicated in neuronal dysfunction in both viral and non-viral neurodegenerative diseases. Together, these findings suggest that the genomic interference of HIV with neurodegenerative pathways is not by chance, but may be an early sign of HIV-mediated sub-genomic and sub-cellular manifestation of neurologic disease. Moreover, these findings signify the utility of PBMC and genome-wide mapping of the host gene expression as a powerful tool in predicting possible early events in neurologic deterioration in HIV patients.
Collapse
Affiliation(s)
- Li Zhou
- Retroviral Genetics Division, Center for Virus Research, Westmead Millennium Institute, Westmead Hospital, the University of Sydney, Westmead, Sydney, 2145, NSW, Australia
| | | | | | | |
Collapse
|
32
|
Herington JL, Glore DR, Lucas JA, Osteen KG, Bruner-Tran KL. Dietary fish oil supplementation inhibits formation of endometriosis-associated adhesions in a chimeric mouse model. Fertil Steril 2012; 99:543-50. [PMID: 23103017 DOI: 10.1016/j.fertnstert.2012.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine whether dietary fish oil supplementation reduces development of spontaneous endometriosis-associated adhesions using an established model. DESIGN Laboratory-based study. SETTING Medical center research laboratory. PATIENT(S)/ANIMAL(S): Disease-free women of reproductive age and nude mice. INTERVENTION(S) Women were not provided any intervention. Mice were randomized to receive fish oil supplementation or control diet. MAIN OUTCOME MEASURE(S) Experimental endometriosis was established in mice via injection of human endometrial tissue within 16 hours of ovariectomy. Mice were provided standard or menhaden fish oil-supplemented diets for ≥ 2 weeks before initiation of experimental endometriosis and until killing them 1 week later. At necropsy, mice were examined for the presence and extent of adhesions and endometriotic-like lesions. Tissues were excised and morphologically characterized. RESULT(S) Adhesions/lesions were reduced in mice provided with dietary fish oil compared with control animals. Leukocytes were more numerous within the adhesions/lesions of the mice maintained on the standard diet compared with animals provided with fish oil. As indicated by staining intensity, collagen deposition was greater at adhesion sites within control mice compared with fish oil-supplemented animals. CONCLUSION(S) Wound-healing associated with surgery created an inflammatory peritoneal microenvironment that promoted the development of both experimental endometriosis and adhesions in a murine model. Targeting excessive inflammation with fish oil may be an effective adjuvant therapy to reduce the development of postsurgical adhesions related to endometriosis.
Collapse
Affiliation(s)
- Jennifer L Herington
- Women's Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
| | | | | | | | | |
Collapse
|
33
|
Vigano P, Rabellotti E, Pagliardini L, Somigliana E, Candiani M, Vercellini P. Progesterone Resistance, Aromatase, and Inflammation: The Important Relationships Between Hormones and Inflammation. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2012. [DOI: 10.1007/s13669-012-0013-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
34
|
Sanchez AM, Vigano P, Mugione A, Panina-Bordignon P, Candiani M. The molecular connections between the cannabinoid system and endometriosis. Mol Hum Reprod 2012; 18:563-71. [DOI: 10.1093/molehr/gas037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|
35
|
|