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Lin T, Allaire C, As-Sanie S, Stratton P, Vincent K, Adamson GD, Arendt-Nielsen L, Bush D, Jansen F, Longpre J, Rombauts L, Shah J, Toussaint A, Hummelshoj L, Missmer SA, Yong PJ. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project: V. Physical examination standards in endometriosis research. Fertil Steril 2024; 122:304-315. [PMID: 38508508 DOI: 10.1016/j.fertnstert.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE The World Endometriosis Research Foundation established the Endometriosis Phenome and Biobanking Harmonisation Project (EPHect) to create standardized documentation tools (with common data elements) to facilitate the comparison and combination of data across different research sites and studies. In 2014, 4 data research standards were published: clinician-reported surgical data, patient-reported clinical data, and fluid and tissue biospecimen collection. Our current objective is to create an EPHect standard for the clinician-reported physical examination (EPHect-PE) for research studies. DESIGN An international consortium involving 26 clinical and academic experts and patient partners from 11 countries representing 25 institutions and organizations. Two virtual workshops, followed by the development of the physical examination standards underwent multiple rounds of iterations and revisions. SUBJECTS N/A MAIN OUTCOME MEASURE(S): N/A RESULT(S): The EPHect-PE tool provides standardized assessment of physical examination characteristics and pain phenotyping. Data elements involve examination of back and pelvic girdle; abdomen including allodynia and trigger points; vulva including provoked vestibulodynia; pelvic floor muscle tone and tenderness; tenderness on unidigital pelvic examination; presence of pelvic nodularity; uterine size and mobility; presence of adnexal masses; presence of incisional masses; speculum examination; tenderness and allodynia at an extra-pelvic site (e.g., forearm); and recording of anthropometrics. CONCLUSION(S) The EPHect-PE standards will facilitate the standardized documentation of the physical examination, including the assessment and documentation of examination phenotyping of endometriosis-associated pelvic pain.
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Affiliation(s)
- Tinya Lin
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine Allaire
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | - Katy Vincent
- Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - G David Adamson
- World Endometriosis Research Foundation (WERF); Department of Obstetrics & Gynecology, Stanford University, Palo Alto, California
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Aalborg University Hospital, Mech-Sense, Aalborg, Denmark
| | | | - Femke Jansen
- World Endometriosis Organisations (WEO); EndoHome - Endometriosis Association Belgium, Belgium
| | - Jennifer Longpre
- Department of Obstetrics and Gynecology, Université de Montreal, Montreal, Quebec, Canada
| | - Luk Rombauts
- World Endometriosis Research Foundation (WERF); Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Jay Shah
- National Institutes of Health, Bethesda, Maryland
| | - Abeesha Toussaint
- World Endometriosis Organisations (WEO); Trinidad and Tobago Endometriosis Association, Port of Spain, Trinidad and Tobago
| | | | - Stacey A Missmer
- World Endometriosis Research Foundation (WERF); Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, Michigan
| | - Paul J Yong
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
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Donnez J, Dolmans MM. Endometriosis: from iron and macrophages to exosomes. Is the sky clearing? Hum Reprod Open 2024; 2024:hoae034. [PMID: 38905003 PMCID: PMC11189659 DOI: 10.1093/hropen/hoae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Indexed: 06/23/2024] Open
Affiliation(s)
- Jacques Donnez
- Department of Gynecology, Université Catholique de Louvain,
Brussels, Belgium
- Société de Recherche pour l’Infertilité (SRI), Infertility Research
Department, Brussels, Belgium
| | - Marie-Madeleine Dolmans
- Gynecology Research Department, Institut de Recherche Expérimentale et
Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint-Luc,
Brussels, Belgium
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3
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Huang E, Wang X, Chen L. Regulated Cell Death in Endometriosis. Biomolecules 2024; 14:142. [PMID: 38397379 PMCID: PMC10886833 DOI: 10.3390/biom14020142] [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: 11/25/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024] Open
Abstract
Regulated cell death (RCD) represents a distinct mode of cell demise, differing from accidental cell death (ACD), characterized by specific signaling cascades orchestrated by diverse biomolecules. The regular process of cell death plays a crucial role in upholding internal homeostasis, acting as a safeguard against biological or chemical damage. Nonetheless, specific programmed cell deaths have the potential to activate an immune-inflammatory response, potentially contributing to diseases by enlisting immune cells and releasing pro-inflammatory factors. Endometriosis, a prevalent gynecological ailment, remains incompletely understood despite substantial progress in unraveling associated signaling pathways. Its complexity is intricately tied to the dysregulation of inflammatory immune responses, with various RCD processes such as apoptosis, autophagic cell death, pyroptosis, and ferroptosis implicated in its development. Notably, limited research explores the association between endometriosis and specific RCD pathways like pyroptosis and cuproptosis. The exploration of regulated cell death in the context of endometriosis holds tremendous potential for further advancements. This article thoroughly reviews the molecular mechanisms governed by regulated cell death and their implications for endometriosis. A comprehensive understanding of the regulated cell death mechanism in endometriosis has the potential to catalyze the development of promising therapeutic strategies and chart the course for future research directions in the field.
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Affiliation(s)
| | | | - Lijuan Chen
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (E.H.)
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Yen CF, Hamdan M, Hengrasmee P, Huang Z, Jeong K, Dao LA, Lertvikool S, Mogan S, Pal B, Sumapradja K, Wu MH, Yap-Garcia MIM, Donovan C, Christopher S, Kim MR. Improving the diagnosis of endometriosis in Asia-Pacific: Consensus from the Asia-Pacific Endometriosis Expert Panel for Endometriosis. Int J Gynaecol Obstet 2023; 163:720-732. [PMID: 37837343 DOI: 10.1002/ijgo.15142] [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: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 10/16/2023]
Abstract
Endometriosis should be diagnosed as early as possible in the continuum of care; but substantial delays of approximately 6-8 years between symptom onset and endometriosis diagnosis have been widely reported. With the purpose of improving the prompt diagnosis of endometriosis, the Asia-Pacific Endometriosis Expert Panel (APEX) sought to address the reasons for diagnostic delays across the region, and formulate a multi-pronged approach to overcoming these challenges. In the first instance, clinical diagnosis is preferable to surgical diagnosis, in order to facilitate earlier empirical treatment and minimize the negative sequelae of undiagnosed/untreated disease. There should be a high clinical index of suspicion in women presenting with cyclical symptoms, including those involving extrapelvic organs. Diagnostic delays in Asia-Pacific countries are attributable to a variety of patient, physician, and healthcare factors, including poor awareness, normalization/trivialization of pain, individual/cultural attitudes toward menstruation, default use of symptom-suppressing treatments, misdiagnosis, and a lack of diagnostic resourcing or adequate referral pathways in some areas. Suggested initiatives to reduce diagnostic delays are geared toward improving public awareness, improving clinical diagnostic skills, streamlining multidisciplinary care pathways for timely referral, updating and implementing diagnostic guidelines, lobbying policymakers and insurance companies for endometriosis support, and increasing efforts to bridge data gaps and perform further research in this field. Formulating specific action plans and gathering traction are the responsibility of individual countries within local parameters. The APEX group advocates for any initiatives and policies that support the unmet needs of women with endometriosis, to improve patient experience and outcomes.
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Affiliation(s)
- Chih-Feng Yen
- Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | | | | | - Zhongwei Huang
- NUS Bia Echo Centre for Reproductive Longevity and Equality (ACRLE), Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Kyungah Jeong
- Ewha Womans University, Mokdong Hospital, Seoul, South Korea
| | - Le Anh Dao
- Hanoi Obstetrics & Gynecology Hospital, Hanoi, Vietnam
| | | | - Surita Mogan
- Endometriosis Association of Malaysia (MyEndosis), Petaling Jaya, Malaysia
| | - Bhaskar Pal
- Apollo Multispecialty Hospital, Kolkata, India
| | | | - Meng-Hsing Wu
- National Cheng Kung University Hospital, Tainan, Taiwan
| | | | | | | | - Mee-Ran Kim
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Menzhinskaya IV, Pavlovich SV, Melkumyan AG, Chuprynin VD, Yarotskaya EL, Sukhikh GT. Potential Significance of Serum Autoantibodies to Endometrial Antigens, α-Enolase and Hormones in Non-Invasive Diagnosis and Pathogenesis of Endometriosis. Int J Mol Sci 2023; 24:15578. [PMID: 37958566 PMCID: PMC10649774 DOI: 10.3390/ijms242115578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
The objective of the study was to evaluate the profile of serum autoantibodies and their diagnostic and pathogenetic significance in ovarian endometrioma (OEM) and deep infiltrative endometriosis (DIE). The study enrolled 74 patients with endometriosis (Group 1), including 53 patients with OEM (Subgroup 1a); 21 patients with DIE without ovarian lesions (Subgroup 1b); and 27 patients without endometriosis (Group 2). The diagnosis was confirmed by laparoscopic surgery and histologic examination of resected tissues. Antibodies (M, G) to tropomyosin 3 (TPM), tropomodulin 3 (TMOD), α-enolase (ENO), estradiol (E2), progesterone (PG), and human chorionic gonadotropin (hCG) were identified in blood serum using modified ELISA. In endometriosis, antibodies to endometrial antigens, hormones, and ENO were detected more often than antiphospholipid and antinuclear antibodies. Higher levels of IgM to TPM, hCG, E2, and PG and IgG to TMOD, ENO, E2, and hCG were found in Subgroup 1a compared to Group 2. IgM to TPM, hCG, E2, PG, and IgG to E2 and ENO had a high diagnostic value for OEM (AUC > 0.7), with antibodies to TPM having the highest sensitivity and specificity (73.6% and 81.5%). In Subgroup 1b, only the levels of IgM to TPM and hCG were higher than in Group 2. These antibodies had a high diagnostic value for DIE. Thus, endometriosis is associated with autoantibodies to endometrial antigens, α-enolase, steroid, and gonadotropic hormones. A wider spectrum of antibodies is detected in OEM than in DIE. These antibodies have a high diagnostic value for OEM and DIE and potential pathogenetic significance for endometriosis and associated infertility.
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Affiliation(s)
- Irina V. Menzhinskaya
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
| | - Stanislav V. Pavlovich
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119048 Moscow, Russia
| | - Arika G. Melkumyan
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
| | - Vladimir D. Chuprynin
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
| | - Ekaterina L. Yarotskaya
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
| | - Gennady T. Sukhikh
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation, 117997 Moscow, Russia
- Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119048 Moscow, Russia
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Szukiewicz D. Insight into the Potential Mechanisms of Endocrine Disruption by Dietary Phytoestrogens in the Context of the Etiopathogenesis of Endometriosis. Int J Mol Sci 2023; 24:12195. [PMID: 37569571 PMCID: PMC10418522 DOI: 10.3390/ijms241512195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Phytoestrogens (PEs) are estrogen-like nonsteroidal compounds derived from plants (e.g., nuts, seeds, fruits, and vegetables) and fungi that are structurally similar to 17β-estradiol. PEs bind to all types of estrogen receptors, including ERα and ERβ receptors, nuclear receptors, and a membrane-bound estrogen receptor known as the G protein-coupled estrogen receptor (GPER). As endocrine-disrupting chemicals (EDCs) with pro- or antiestrogenic properties, PEs can potentially disrupt the hormonal regulation of homeostasis, resulting in developmental and reproductive abnormalities. However, a lack of PEs in the diet does not result in the development of deficiency symptoms. To properly assess the benefits and risks associated with the use of a PE-rich diet, it is necessary to distinguish between endocrine disruption (endocrine-mediated adverse effects) and nonspecific effects on the endocrine system. Endometriosis is an estrogen-dependent disease of unknown etiopathogenesis, in which tissue similar to the lining of the uterus (the endometrium) grows outside of the uterus with subsequent complications being manifested as a result of local inflammatory reactions. Endometriosis affects 10-15% of women of reproductive age and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. In this review, the endocrine-disruptive actions of PEs are reviewed in the context of endometriosis to determine whether a PE-rich diet has a positive or negative effect on the risk and course of endometriosis.
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Affiliation(s)
- Dariusz Szukiewicz
- Department of Biophysics, Physiology & Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, 02-004 Warsaw, Poland
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Chen J, Wang D, Xu R, Yao T, Guo Y, Liu Q, Yang E, Wu Z, Xu Z. SLP-2 regulates the generation of reactive oxygen species and the ERK pathway to promote papillary thyroid carcinoma motility and angiogenesis. Tissue Cell 2023; 80:101997. [PMID: 36527788 DOI: 10.1016/j.tice.2022.101997] [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: 09/16/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
Although papillary thyroid cancer (PTC) has a generally decent prognosis, approximately 10% of patients experience recurrence, which is frequently associated with distant metastasis. Stomatin-like protein 2 (SLP-2), a protein located in the mitochondrial intermembrane space, is thought to be a possible cancer promoter. This study aimed to discover the involvement of SLP-2 in PTC motility and angiogenesis, and to initially explore its mechanism. According to the CCLE database, SLP-2 was universally increased in various cancers. Then SLP-2 expression in PTC cell lines was evaluated. Thereafter the influences of SLP-2 knockdown on cell migration, invasion, epithelial-mesenchymal transition (EMT), and angiogenesis were assessed, respectively. The mediated roles of reactive oxygen species (ROS) and MAPKs in the SLP-2 regulation were likewise determined. SLP-2 was discovered to be upregulated in PTC cells, and its knockdown could suppress cell migration, invasion, EMT, and angiogenesis. Declined SLP-2 expression also facilitated ROS generation and inhibited phosphorylation of MAPKs. Moreover, ERK agonist and ROS scavenger treatment partially reversed the impacts of SLP-2 knockdown on cells, indicating SLP-2 regulated generation of ROS and ERK pathway to promote PTC motility and angiogenesis. Generally, SLP-2 appears to be one of the major genes in the pathogenesis of PTC. Silencing its expression may have an impact on the onset and evolution of PTC. The fact that SLP-2 has a considerable influence on ROS levels implies that PTC can be treated by boosting ROS levels.
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Affiliation(s)
- Jianping Chen
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Duting Wang
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Rui Xu
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Ting Yao
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Yu Guo
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Qi Liu
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Erlong Yang
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Zhengqing Wu
- Department of Breast and Thyroid Surgery, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Zhenyu Xu
- Precision Medicine Centre, Yijishan Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
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Madan T, Modi D, Sharma JB, Raut M, Sharma RS. Special issue: Clinical reproductive immunology: Indian perspective. Am J Reprod Immunol 2023; 89:e13681. [PMID: 36655282 DOI: 10.1111/aji.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 01/20/2023] Open
Affiliation(s)
- Taruna Madan
- Department of Innate Immunity, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Deepak Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | - Mohan Raut
- Dr. Raut's Centre for Reproductive Immunology, Dr. Raut's Women's Hospital, Mumbai, India
| | - Radhey Shyam Sharma
- Formerly, Scientist Emeritus, Indian Council of Medical Research, New Delhi, India
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