1
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Wang H, Chen C, Wang D, Zhu Y, Chen P. Correlation of clinicopathological and prognostic characteristics between endometriosis-associated and primary ovarian cancer. BMC Cancer 2023; 23:1210. [PMID: 38066448 PMCID: PMC10704787 DOI: 10.1186/s12885-023-11641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The main aim of this study was to establish the clinicopathological and prognostic correlations between endometriosis-associated and non-endometriosis-associated primary ovarian cancer, with a view to providing a reference guide for revision of diagnostic criteria for malignant transformation of endometriosis. METHODS Clinicopathological and follow-up data of 174 patients with clear cell and endometrial ovarian cancer were retrospectively extracted. Cases were divided into endometriosis-associated and non-endometriosis-associated primary ovarian cancer for comparative analysis of clinicopathological characteristics and prognosis. RESULTS Average age and post-menopausal rate in the endometriosis-associated ovarian cancer group were lower relative to the primary ovarian cancer group (P < 0.05). Body mass index, age at menopause, operation history, dysmenorrhea, complications, tumor size, tumor side, ascites, CA125, HE4, CA19.9, stage, differentiation, expression of ER, PR, P53, P16, Ki67, MMR, HNF-1β and Napsin A were not significantly different between the groups (P > 0.05). Furthermore, rates of resistance to platinum chemotherapy, relapse, progression-free survival and overall survival were comparable between the two groups (P > 0.05). CONCLUSION Endometriosis-associated and primary ovarian cancers of the same pathological type are speculated to be homologous in terms of origin from malignant transformation of endometriosis. It may therefore be necessary to revise the diagnostic criteria for ovarian endometriosis malignancy.
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Affiliation(s)
- Huimin Wang
- Department of Gynecology, Liaoning Cancer Hospital & Institute, 44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110004, China
| | - Cong Chen
- Department of Gynecology, Liaoning Cancer Hospital & Institute, 44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110004, China
| | - Danbo Wang
- Department of Gynecology, Liaoning Cancer Hospital & Institute, 44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110004, China.
| | - Yanmei Zhu
- Department of Pathology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, China.
| | - Peng Chen
- Department of Gynecology, Liaoning Cancer Hospital & Institute, 44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110004, China
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2
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Hong YS, Park J, Kim H. Association of endometriosis with genital human papillomavirus infection in US women: a national population-based study. Sci Rep 2023; 13:8020. [PMID: 37198431 DOI: 10.1038/s41598-023-35153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 05/13/2023] [Indexed: 05/19/2023] Open
Abstract
The prevalence of genital human papillomavirus (HPV) in women with endometriosis has never been reported in a national representative survey. We aimed to investigate the association of endometriosis with the prevalence of HPV. We analyzed the data on 1768 women (representing 43,824,157 women) in the United States aged 20-54 years from the National Health and Nutrition Examination Survey in the prevaccination era (2003-2006). The diagnosis of endometriosis was based on a self-report. The prevalence of any HPV in women with endometriosis did not differ from that in women without endometriosis after controlling for potential confounders such as age, ethnicity, family income, marital status, and the number of deliveries (adjusted prevalence ratio (aPR) 0.84, 95% confidence interval (CI) 0.61-1.15). No significant association was found between the prevalence of high-risk HPV and the diagnosis of endometriosis (aPR 0.71, 95% CI 0.44-1.14). If the participants were not covered by health insurance, the prevalence of any HPV infection in women with endometriosis was higher than in those without endometriosis (aPR 1.44, 95% CI 0.94-2.20). In contrast, in a subgroup who had health insurance, a lower prevalence of any HPV infection was observed in women with endometriosis (aPR 0.71, 95% CI 0.50-1.03), and P for interaction was statistically significant (P = 0.01). There was no association between endometriosis and HPV infection in this study of HPV vaccine-naïve women of reproductive age. The association was not different by the type of HPV. However, access to healthcare may modify the association between endometriosis and HPV infection.
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Affiliation(s)
- Yun Soo Hong
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 E. Monument St., Baltimore, MD, 21205, USA
| | - Jihwan Park
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 E. Monument St., Baltimore, MD, 21205, USA
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
- Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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3
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Kim H, Kim HJ, Ahn HS. Does endometriosis increase the risks of endometrial hyperplasia and endometrial cancer? Gynecol Oncol 2023; 169:147-153. [PMID: 36357191 DOI: 10.1016/j.ygyno.2022.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The risk of developing endometrial hyperplasia after diagnosis of endometriosis has not been determined. Moreover, the risk of endometrial cancer associated with endometriosis is unclear. This nationwide population-based study investigated the associations of endometrial hyperplasia and endometrial cancer with endometriosis, after adjusting for covariates. METHODS This population-based observational study analyzed data from the Korean National Health Insurance (NHI) database, including 147,869 women who were diagnosed with endometriosis from 2002 to 2017, with each patient matched to 20 control women without endometriosis. Cox proportional hazard regression analyses were performed to estimate the hazard ratios (HRs) of endometrial hyperplasia, endometrial cancer, and mortality from endometrial cancer. RESULTS Among three million women in this population, 16,377 women were diagnosed with endometrial hyperplasia, and 1795 women were diagnosed with endometrial cancer over 19,931,794 person-years of follow-up. Women with endometriosis were at significantly higher risks of endometrial hyperplasia (adjusted hazard ratio [aHR] 1.85, 95% confidence interval [CI] 1.75-1.95), and endometrial cancer (aHR 1.35, 95% CI 1.12-1.63) were compared with control women after adjustment for covariates. A diagnosis of endometriosis did not affect survival in patients with endometrial cancer. CONCLUSION The risks of endometrial hyperplasia and endometrial cancer were found to be significantly higher in women with than without endometriosis. The presence of endometriosis did not affect overall survival in women with endometrial cancer. Additional long-term prospective studies with adequate control of confounders are needed.
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Affiliation(s)
- Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
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4
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Sun Y, Wang Q, Wang M, Sun F, Qiao P, Jiang A, Ren C, Yu Z, Yang T. CHIP induces ubiquitination and degradation of HMGB1 to regulate glycolysis in ovarian endometriosis. Cell Mol Life Sci 2022; 80:13. [PMID: 36536161 PMCID: PMC11073454 DOI: 10.1007/s00018-022-04637-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022]
Abstract
Ovarian endometriosis is a common gynecological condition that can cause infertility in women of childbearing age. However, the pathogenesis is still unknown. We demonstrate that the carboxyl terminus of Hsc70-interacting protein (CHIP) is a negative regulator in the development of endometriosis and reduces HMGB1 expression in endometriotic cells. Meanwhile, CHIP interacts with HMGB1 and promotes its ubiquitinated degradation, thereby inhibiting aerobic glycolysis and the progression of endometriosis. Furthermore, the CHIP agonist YL-109 effectively suppresses the growth of ectopic endometrium in endometriosis mouse model, which could be a potential therapeutic approach for endometriosis. In conclusion, our data suggest that CHIP may inhibit the development of endometriosis by suppressing the HMGB1-related glycolysis.
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Affiliation(s)
- Yujun Sun
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Qian Wang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Mengxue Wang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Fangyuan Sun
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Pengyun Qiao
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Aifang Jiang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Chune Ren
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China.
| | - Zhenhai Yu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China.
| | - Tingting Yang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China.
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5
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Colic E, Patel PU, Kent OA. Aberrant MAPK Signaling Offers Therapeutic Potential for Treatment of Ovarian Carcinoma. Onco Targets Ther 2022; 15:1331-1346. [PMID: 36388156 PMCID: PMC9645123 DOI: 10.2147/ott.s361512] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/01/2022] [Indexed: 08/22/2023] Open
Abstract
Ovarian cancer remains the most lethal gynecological malignancy worldwide due to lack of effective screening, vague early symptoms, poor description of biomarkers, and absence of effective treatment regimes. Epithelial ovarian carcinoma (EOC) is categorized into five distinct disease subtypes which collectively account for ~90% of ovarian carcinomas. Most women present at advanced stages contributing to a poor overall 5-year survival rate. Standard treatment for EOC is cytoreductive surgery and platinum-based chemotherapy; however, most patients suffer from recurrence and platinum-resistant disease, which highlights an urgent need for targeted therapy. The high frequency of molecular alterations affecting gain-of-function signaling through the RAS mitogen-activated protein kinase (MAPK) pathway in EOC has prompted pre-clinical and clinical efforts toward research into the effectiveness of MAPK pathway inhibition as a second-line treatment. The RAS/MAPK pathway is a highly conserved signal transduction cascade, often disrupted in cancer, that regulates tumorigenic phenotypes including cellular proliferation, survival, migration, apoptosis, and differentiation. Herein, the role of the MAPK pathway in EOC with emphasis on targetability of the pathway is described. Pre-clinical and clinical efforts to target MAPK signaling in EOC have identified several MAPK pathway inhibitors that offer efficacious potential for monotherapy and in combination with other compounds. Thus, inhibition of the RAS/MAPK pathway is emerging as a tractable strategy for treatment of ovarian cancer that may permit development of personalized therapy and improved prognosis for women challenged by this disease.
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Affiliation(s)
- Eva Colic
- Department of Pharmacology, adMare BioInnovations, Montreal, Quebec, Canada
| | - Preya U Patel
- Department of Pharmacology, adMare BioInnovations, Montreal, Quebec, Canada
| | - Oliver A Kent
- Department of Pharmacology, adMare BioInnovations, Montreal, Quebec, Canada
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6
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Kacperczyk-Bartnik J, Bartnik P, Goławski K, Sierdziński J, Mańka G, Kiecka M, Lipa M, Warzecha D, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Czajkowski K, Wielgoś M, Koc-Żórawska E, Żórawski M, Laudański P. Plasma and Peritoneal Poly (ADP-Ribose) Polymerase Levels in Patients with Endometriosis. Biomedicines 2022; 10:biomedicines10102451. [PMID: 36289716 PMCID: PMC9599091 DOI: 10.3390/biomedicines10102451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
The evidence of poly (ADP-ribose) polymerase (PARP) association with the immune response could be coherent with the immunological theory of endometriosis and suggests the possibility of a new research direction. The aim of the study was to evaluate the levels of PARP in plasma and peritoneal fluid of patients with and without endometriosis. It was a multicenter, cross-sectional study. Plasma and peritoneal fluid samples were collected from patients with and without endometriosis during planned laparoscopic procedures in eight clinical centers. In total, 84 samples of plasma and 84 samples of the peritoneal fluid were included in the final analyses. Double-antibody sandwich enzyme-linked immunosorbent assay was performed in order to assess levels of PARP in collected samples. No statistically significant differences regarding the detected levels of PARP in plasma and peritoneal fluid comparing patients with and without endometriosis were observed. Patients with a history of infertility had significantly higher plasma PARP concentrations (p = 0.04). We have not observed the potential role of PARP concentration levels in plasma nor peritoneal fluid as an endometriosis biomarker. We have determined an association between a higher plasma PARP concentration and a history of infertility.
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Affiliation(s)
- Joanna Kacperczyk-Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Paweł Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Ksawery Goławski
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-581 Warsaw, Poland
| | | | | | - Michał Lipa
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Damian Warzecha
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Robert Spaczyński
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Artur Jakimiuk
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Center of Reproductive Health, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-330 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-330 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Mirosław Wielgoś
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Ewa Koc-Żórawska
- II Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Marcin Żórawski
- Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Piotr Laudański
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
- Correspondence:
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7
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Ansariniya H, Yavari A, Javaheri A, Zare F. Oxidative stress-related effects on various aspects of endometriosis. Am J Reprod Immunol 2022; 88:e13593. [PMID: 35781369 DOI: 10.1111/aji.13593] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/14/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022] Open
Abstract
Endometriosis is a chronic and relatively common disease in women of childbearing age. Complications of this disease include a wide range of disorders. The cause of this disease is not known for sure, but several hypotheses have been proposed for it. In this disease, the entry of endometrial tissues into the peritoneal cavity causes oxidative stress through the Fenton reaction and inflammation in this site. Oxidative stress can be associated with many complications of endometriosis. In this review, an attempt has been made to discuss the effects of oxidative stress on various complications of this disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hossein Ansariniya
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolfazl Yavari
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Atiyeh Javaheri
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Fateme Zare
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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8
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Kusum K, Raj R, Rai S, Pranjali P, Ashish A, Vicente-Muñoz S, Chaube R, Kumar D. Elevated Circulatory Proline to Glutamine Ratio (PQR) in Endometriosis and Its Potential as a Diagnostic Biomarker. ACS OMEGA 2022; 7:14856-14866. [PMID: 35557708 PMCID: PMC9088897 DOI: 10.1021/acsomega.2c00332] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
Endometriosis (EM) is a hormone-dependent gynecological disease associated with chronic pelvic pain and altered immuno-inflammatory processes. It shares some cancer-like characteristics such as increased proline biosynthesis and activated glutaminolysis. Both proline and glutamine are interconvertible metabolically, and studies have shown their roles in cancer cell metabolic reprogramming, redox homeostasis, occurrence/development of endometrial carcinoma, and its further progression toward the malignant state. So based on this, we hypothesized that the circulatory proline to glutamine ratio (PQR) would be altered in EM and may serve as an indicative biomarker to improve the clinical diagnosis of EM. In present study, the circulatory-PQR levels were estimated for 39 EM patients and 48 age matched healthy female subjects using 800 MHz NMR spectroscopy. Among 39 EM patients, 15 were in the clinical stages I to II and referred to here as moderate EM (MEM) patients and 24 were in the clinical stages III to IV and referred here as severe EM (SEM) patients. The circulatory-PQR levels were significantly increased in EM patients (0.99 ± 0.13 μM in MEM; 1.39 ± 0.22 μM in SEM) compared to normal control (NC) subjects (0.52 ± 0.05 μM in NC). Further, the circulatory PQR levels exhibit the highest diagnostic potential with area under receiver operating characteristic (AUROC) curve values equal to 0.87 ± 0.04 [95%CI = 0.79-0.96] for MEM and 0.89 ± 0.04 [95% CI = 0.82-0.96] for SEM. These results suggested that circulatory-PQR has significant potential to serve as a noninvasive biomarker for diagnostic/prognostic screening of EM and further underscored the importance of these two nonessential amino acids (proline and glutamine) in cancer metabolism.
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Affiliation(s)
- Kusum Kusum
- Department
of Zoology, Institute of Science, Banaras
Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Ritu Raj
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
| | - Sangeeta Rai
- Department
of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Pranjali Pranjali
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
| | - Ashish Ashish
- Department
of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Sara Vicente-Muñoz
- NMR-Metabolomics
Core, Division of Pathology, Cincinnati
Children’s Hospital Medical Center, Cincinnati, Ohio 45229, United States
| | - Radha Chaube
- Department
of Zoology, Institute of Science, Banaras
Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Dinesh Kumar
- Centre
of Biomedical Research (CBMR), SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
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9
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Li X, Xiong W, Long X, Dai X, Peng Y, Xu Y, Zhang Z, Zhang L, Liu Y. Inhibition of METTL3/m6A/miR126 promotes the migration and invasion of endometrial stromal cells in endometriosis. Biol Reprod 2021; 105:1221-1233. [PMID: 34382070 DOI: 10.1093/biolre/ioab152] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/17/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
N6-methyladenosine (m6A), one of the most abundant RNA modifications, is involved in the progression of many diseases, but its role and related molecular mechanisms in endometriosis remain unknown. To address these issues, we detected m6A levels in normal, eutopic and ectopic endometrium and found the m6A levels decreased in eutopic and ectopic endometrium compared with normal endometrium. In addition, we proved that methyltransferase-like 3 (METTL3) downregulation accounted for m6A reduction in endometriosis. Furthermore, we observed that METTL3 knockdown facilitated the migration and invasion of human endometrial stromal cells (HESCs), while METTL3 overexpression exerted opposite effects, suggesting that METTL3 downregulation might contribute to endometriosis development by enhancing cellular migration and invasion. Mechanistically, METTL3-dependent m6A was involved in the DGCR8-mediated maturation of primary microRNA126 (miR126, pri-miR126). Moreover, miR126 inhibitor significantly enhanced the migration and invasion of METTL3-overexpressing HESCs, whereas miR126 mimics attenuated the migration and invasion of METTL3-silenced HESCs. Our study revealed the METTL3/m6A/miR126 pathway, whose inhibition might contribute to endometriosis development by enhancing cellular migration and invasion. It also showed that METTL3 might be a novel diagnostic biomarker and therapeutic target for endometriosis.
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Affiliation(s)
- Xiaoou Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xuefeng Long
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xin Dai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yuan Peng
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Ying Xu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Zhibing Zhang
- Department of Physiology, Wayne State University, 275E Hancock Street, Detroit, 48201, Michigan
| | - Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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10
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Cacciottola L, Donnez J, Dolmans MM. Can Endometriosis-Related Oxidative Stress Pave the Way for New Treatment Targets? Int J Mol Sci 2021; 22:ijms22137138. [PMID: 34281188 PMCID: PMC8267660 DOI: 10.3390/ijms22137138] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/18/2022] Open
Abstract
Endometriosis is a disease of reproductive age characterized by chronic pelvic pain and infertility. Its pathogenesis is complex and still partially unexplained. However, there is increasing evidence of the role of chronic inflammation, immune system dysregulation, and oxidative stress in its development and progression. The latter appears to be involved in multiple aspects of the disease. Indeed, disease progression sustained by a hyperproliferative phenotype can be related to reactive oxygen species (ROS) imbalance, as numerous experiments using drugs to counteract hyperproliferation have shown in recent years. Chronic pelvic pain is also associated with cell function dysregulation favoring chronic inflammation and oxidative stress, specifically involving macrophages and mast cell activation. Moreover, there is increasing evidence of a role for ROS and impaired mitochondrial function not only as deleterious effectors of the ovarian reserve in patients with endometriomas but also in terms of oocyte quality and, hence, embryo development impairment. Targeting oxidative stress looks to be a promising strategy to both curb endometriotic lesion progression and alleviate endometriosis-associated symptoms of chronic pain and infertility. More investigations are nevertheless needed to develop effective therapeutic strategies for clinical application.
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Affiliation(s)
- Luciana Cacciottola
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Jacques Donnez
- Society for Research into Infertility, 1150 Brussels, Belgium;
- Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Marie-Madeleine Dolmans
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium;
- Department of Gynecology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
- Correspondence: ; Tel.: +32-(0)2-764-5287
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11
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Chumduri C, Turco MY. Organoids of the female reproductive tract. J Mol Med (Berl) 2021; 99:531-553. [PMID: 33580825 PMCID: PMC8026429 DOI: 10.1007/s00109-020-02028-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 02/08/2023]
Abstract
Healthy functioning of the female reproductive tract (FRT) depends on balanced and dynamic regulation by hormones during the menstrual cycle, pregnancy and childbirth. The mucosal epithelial lining of different regions of the FRT-ovaries, fallopian tubes, uterus, cervix and vagina-facilitates the selective transport of gametes and successful transfer of the zygote to the uterus where it implants and pregnancy takes place. It also prevents pathogen entry. Recent developments in three-dimensional (3D) organoid systems from the FRT now provide crucial experimental models that recapitulate the cellular heterogeneity and physiological, anatomical and functional properties of the organ in vitro. In this review, we summarise the state of the art on organoids generated from different regions of the FRT. We discuss the potential applications of these powerful in vitro models to study normal physiology, fertility, infections, diseases, drug discovery and personalised medicine.
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Affiliation(s)
- Cindrilla Chumduri
- Department of Microbiology, University of Würzburg, Biocenter, Würzburg, Germany.
- Max Planck Institute for Infection Biology, Berlin, Germany.
| | - Margherita Y Turco
- Department of Pathology, University of Cambridge, Cambridge, UK.
- Centre for Trophoblast Research, Cambridge, UK.
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12
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LncRNA MALAT1 inhibits apoptosis of endometrial stromal cells through miR-126-5p-CREB1 axis by activating PI3K-AKT pathway. Mol Cell Biochem 2020; 475:185-194. [PMID: 32809092 DOI: 10.1007/s11010-020-03871-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/01/2020] [Indexed: 12/13/2022]
Abstract
Endometriosis is a common, chronic and painful disease in women, whose pathogenesis remains not entirely clear. Long non-coding RNA (lncRNA) MALAT1 participates in the development of endometriosis. This study further investigated the regulation of MALAT1-miR-126-5p-CREB1 axis in the pathological process of endometriosis. MALAT1, miR-126-5p, and CREB1 levels in human endometrial stromal cells (HESCs) were detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Protein levels were determined by Western blotting. Cell viability and apoptosis was assessed by MTT assay and annexin V-FITC staining, respectively. The interactivity between miR-126-5p and MALAT1 (or CREB1) was assessed by dual luciferase reporter system. Knockdown of MALAT1 or CREB1 restrained proliferation and induced apoptosis as confirmed by upregulating cleaved caspase-3 and Bax, and down-regulating Bcl-2 in HESCs, while inhibition of miR-126-5p presented the opposite results. Moreover, silencing of MALAT1 triggered apoptosis of HESCs via targeting miR-126-5p. In addition, miR-126-5p directly regulated CREB1 expression via binding to its 3' non-coding region. Finally, miR-126-5p inhibitor-mediated apoptosis inhibition was restrained by CREB1 silencing via inactivation of PI3K-AKT pathway in HESCs. Taken together, our study firstly demonstrates that MALAT1 regulates apoptosis of HESCs through miR-126-5p/CREB1 axis mediated PI3K/AKT pathway. Our findings explained the pathogenesis of endometriosis and offered promising therapeutic option for endometriosis.
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13
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Vallée A, Lecarpentier Y. Curcumin and Endometriosis. Int J Mol Sci 2020; 21:E2440. [PMID: 32244563 PMCID: PMC7177778 DOI: 10.3390/ijms21072440] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022] Open
Abstract
Endometriosis is one of the main common gynecological disorders, which is characterized by the presence of glands and stroma outside the uterine cavity. Some findings have highlighted the main role of inflammation in endometriosis by acting on proliferation, apoptosis and angiogenesis. Oxidative stress, an imbalance between reactive oxygen species and antioxidants, could have a key role in the initiation and progression of endometriosis by resulting in inflammatory responses in the peritoneal cavity. Nevertheless, the mechanisms underlying this disease are still unclear and therapies are not currently efficient. Curcumin is a major anti-inflammatory agent. Several findings have highlighted the anti-oxidant, anti-inflammatory and anti-angiogenic properties of curcumin. The purpose of this review is to summarize the potential action of curcumin in endometriosis by acting on inflammation, oxidative stress, invasion and adhesion, apoptosis and angiogenesis.
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Affiliation(s)
- Alexandre Vallée
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, AP-HP, Paris-Descartes University, 75004 Paris, France
| | - Yves Lecarpentier
- Centre de Recherche Clinique, Grand Hôpital de l’Est Francilien (GHEF), 77100 Meaux, France;
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14
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Moga MA, Bălan A, Dimienescu OG, Burtea V, Dragomir RM, Anastasiu CV. Circulating miRNAs as Biomarkers for Endometriosis and Endometriosis-Related Ovarian Cancer-An Overview. J Clin Med 2019; 8:jcm8050735. [PMID: 31126056 PMCID: PMC6571871 DOI: 10.3390/jcm8050735] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/13/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022] Open
Abstract
Early detection and accurate diagnosis are pivotal in the management of endometriosis and endometriosis-related ovarian neoplasms (ERONs), yet there is no clear common ground regarding their pathogenesis. Endometriosis is a debilitating pathology that profoundly impairs the quality of life. Although the spontaneous resolution of endometriosis is possible, studies suggest that it can be a progressive condition, and ERONs can develop. The gold standard for diagnosis remains as the invasive method of laparoscopy followed by histological confirmation. In recent years, novel biomarkers have been discovered. MicroRNAs (miRNA) represent important epigenetic modulators of gene expression and are very attractive as biomarkers due to their lower complexity, tissue specificity, and stability in bodily fluids. Several studies have advanced the possibility of miRNAs becoming potential biomarkers in endometriosis and ERONs. Our aim is to bring these studies together in order to have a better understanding of whether, how, and when miRNAs might be used as biomarkers for these pathologies. METHODS We selected the reviewed papers from Google Academic, PubMed, and CrossRef. A total of eight studies met the inclusion criteria. RESULTS MiR-200 family, miR-143, 145, miR-20a, and miR199a were the most commonly dysregulated miRNAs in endometriosis, and miR-200 family was found to be dysregulated in both ERONs and endometriosis. CONCLUSIONS No single miRNA was considered as a sole biomarker for this pathology. However, since the prognostic value of biomarkers is generally enhanced if more are assessed at the same time, a panel of miRNAs could be a better indicator of the disease.
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Affiliation(s)
- Marius Alexandru Moga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Andreea Bălan
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Oana Gabriela Dimienescu
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Victoria Burtea
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Roxana Maria Dragomir
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
| | - Costin Vlad Anastasiu
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.
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15
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Zheng R, Zeng D, Wan TT, Guo WB, Guo Y, Liu MJ. Predisposing factors for predicting the therapeutic response of adenomyosis after uterine artery embolization: serum CA125 levels and accompanying endometriosis. ACTA ACUST UNITED AC 2019; 24:364-371. [PMID: 30373724 DOI: 10.5152/dir.2018.17479] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to identify predisposing factors that could help predict the therapeutic response of adenomyosis after uterine artery embolization (UAE). METHODS This was a retrospective, single-center study of patients admitted to the hospital for adenomyosis between 2013 and 2015. Sixty-eight patients with adenomyosis who underwent UAE with tris-acryl gelatin microspheres were divided into two groups based on their therapeutic response (complete or incomplete necrosis of lesions), and pre- and postprocedural pelvic magnetic resonance imaging (MRI) data. Patients were followed up for 12 months after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the symptom relief criteria. Improvement rates in both groups were analyzed and compared. Multivariate logistic regression analysis was used to identify the predisposing factors from retrospectively gathered baseline data that might affect the therapeutic response, including MRI features, clinical symptoms, biochemical index, and accompanying diseases of adenomyosis. Then, a prognostic model was established, and the receiver operating characteristic (ROC) curve of identified factors was drawn to determine their predictive value. RESULTS Following UAE, 46 patients (67.6%) showed complete necrosis, while 22 patients (32.4%) showed incomplete necrosis. At 12-month follow-up, dysmenorrhea symptom improvement was seen in 94.7% of complete necrosis and 50% of incomplete necrosis group (P < 0.001); menorrhagia symptom improvement was seen in 96.2% of complete necrosis and 57.1% of incomplete necrosis groups (P = 0.004). Multivariate logistic regression analysis determined serum cancer antigen 125 (CA125) levels (odds ratio [OR], 1.006; 95% confidence interval [CI], 1.002-1.010; P = 0.005) and accompanying endometriosis (OR, 6.869; 95% CI, 1.881-25.016; P = 0.004) as predisposing factors. The areas under the ROC curve of CA125, endometriosis, and these two indicators combined were 0.785, 0.708, and 0.845, which corresponded to sensitivities of 95.5%, 66.7%, and 68.2% and specificities of 52.2%, 80.0%, and 87.0% at optimal cutoff values, respectively. CONCLUSION Symptom relief of dysmenorrhea and menorrhagia for patients with complete necrosis was significantly better than that for patients with incomplete necrosis. Serum CA125 levels and accompanying endometriosis can effectively distinguish complete necrosis from incomplete necrosis.
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Affiliation(s)
- Rui Zheng
- Department of Interventional Radiology The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dan Zeng
- Department of Radiology, Huangpu Division, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ting-Ting Wan
- Department of Interventional Radiology The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wen-Bo Guo
- Department of Interventional Radiology The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ming-Juan Liu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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16
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Gandini S, Lazzeroni M, Peccatori FA, Bendinelli B, Saieva C, Palli D, Masala G, Caini S. The risk of extra-ovarian malignancies among women with endometriosis: A systematic literature review and meta-analysis. Crit Rev Oncol Hematol 2019; 134:72-81. [PMID: 30771877 DOI: 10.1016/j.critrevonc.2018.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/29/2018] [Accepted: 12/30/2018] [Indexed: 01/23/2023] Open
Abstract
We conducted a meta-analysis of studies reporting on the risk of extra-ovarian malignancies among women with endometriosis. Summary relative risk (SRR) and 95% confidence intervals (CI) were calculated through random effect models. We explored causes of between-studies heterogeneity and assessed the presence of publication bias. We included 32 studies published between 1989 and 2018. We found an increased risk of endometrial (SRR 1.38, 95%CI 1.10-1.74) and thyroid cancer (SRR 1.38, 95%CI 1.17-1.63), and inverse association with cervical cancer (SRR 0.78, 95%CI 0.60-0.95). No association emerged for breast cancer (SRR 1.04, 95%CI 0.99-1.09) and melanoma (SRR 1.31, 95%CI 0.86-1.96). Between-study heterogeneity was large for breast and endometrial cancer and melanoma. Associations were generally stronger in case-control, cross-sectional, and cohort studies with internal control group, compared to cohort studies with external control group. No indication for publication bias was found. Our conclusions need to be confirmed in properly designed cohort studies with clinical confirmation of endometriosis.
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Affiliation(s)
- S Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - M Lazzeroni
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, Milan, Italy
| | - F A Peccatori
- Division of Gynecology Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - B Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - C Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - D Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - G Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
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17
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Bakhtiarizadeh MR, Hosseinpour B, Shahhoseini M, Korte A, Gifani P. Weighted Gene Co-expression Network Analysis of Endometriosis and Identification of Functional Modules Associated With Its Main Hallmarks. Front Genet 2018; 9:453. [PMID: 30369943 PMCID: PMC6194152 DOI: 10.3389/fgene.2018.00453] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/18/2018] [Indexed: 12/21/2022] Open
Abstract
Although many genes have been identified using high throughput technologies in endometriosis (ES), only a small number of individual genes have been analyzed functionally. This is due to the complexity of the disease that has different stages and is affected by various genetic and environmental factors. Many genes are upregulated or downregulated at each stage of the disease, thus making it difficult to identify key genes. In addition, little is known about the differences between the different stages of the disease. We assumed that the study of the identified genes in ES at a system-level can help to better understand the molecular mechanism of the disease at different stages of the development. We used publicly available microarray data containing archived endometrial samples from women with minimal/mild endometriosis (MMES), mild/severe endometriosis (MSES) and without endometriosis. Using weighted gene co-expression analysis (WGCNA), functional modules were derived from normal endometrium (NEM) as the reference sample. Subsequently, we tested whether the topology or connectivity pattern of the modules was preserved in MMES and/or MSES. Common and specific hub genes were identified in non-preserved modules. Accordingly, hub genes were detected in the non-preserved modules at each stage. We identified sixteen co-expression modules. Of the 16 modules, nine were non-preserved in both MMES and MSES whereas five were preserved in NEM, MMES, and MSES. Importantly, two non-preserved modules were found in either MMES or MSES, highlighting differences between the two stages of the disease. Analyzing the hub genes in the non-preserved modules showed that they mostly lost or gained their centrality in NEM after developing the disease into MMES and MSES. The same scenario was observed, when the severeness of the disease switched from MMES to MSES. Interestingly, the expression analysis of the new selected gene candidates including CC2D2A, AEBP1, HOXB6, IER3, and STX18 as well as IGF-1, CYP11A1 and MMP-2 could validate such shifts between different stages. The overrepresented gene ontology (GO) terms were enriched in specific modules, such as genetic disposition, estrogen dependence, progesterone resistance and inflammation, which are known as endometriosis hallmarks. Some modules uncovered novel co-expressed gene clusters that were not previously discovered.
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Affiliation(s)
| | - Batool Hosseinpour
- Department of Agriculture, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Maryam Shahhoseini
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Arthur Korte
- Center for Computational and Theoretical Biology, University of Würzburg, Würzburg, Germany
| | - Peyman Gifani
- Cambridge Systems Biology Centre, Department of Genetics, University of Cambridge, Cambridge, United Kingdom.,AI VIVO Ltd., St. John's Innovation Centre, Cambridge, United Kingdom
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18
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Demographic, Clinical, and Prognostic Factors of Ovarian Clear Cell Adenocarcinomas According to Endometriosis Status. Int J Gynecol Cancer 2018; 27:1804-1812. [PMID: 28976447 DOI: 10.1097/igc.0000000000001102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Women with endometriosis carry an increased risk for ovarian clear cell adenocarcinomas (CCCs). Clear cell adenocarcinoma may develop from endometriosis lesions. Few studies have compared clinical and prognostic factors and overall survival in patients diagnosed as having CCC according to endometriosis status. METHODS Population-based prospectively collected data on CCC with coexisting pelvic (including ovarian; n = 80) and ovarian (n = 46) endometriosis or without endometriosis (n = 95) were obtained through the Danish Gynecological Cancer Database. χ Test, independent-samples t test, logistic regression, Kaplan-Meier test, and Cox regression were used. Statistical tests were 2 sided. P values less than 0.05 were considered statistically significant. RESULTS Patients with CCC and pelvic or ovarian endometriosis were significantly younger than CCC patients without endometriosis, and a higher proportion of them were nulliparous (28% and 31% vs 17% (P = 0.07 and P = 0.09). Accordingly, a significantly higher proportion of women without endometriosis had given birth to more than 1 child. Interestingly, a significantly higher proportion of patients with ovarian endometriosis had pure CCCs (97.8% vs 82.1%; P = 0.001) as compared with patients without endometriosis. Overall survival was poorer among CCC patients with concomitant ovarian endometriosis (hazard ratio, 2.56 [95% confidence interval, 1.29-5.02], in the multivariate analysis. CONCLUSIONS Age at CCC diagnosis and parity as well as histology differ between CCC patients with and without concomitant endometriosis. Furthermore, CCC patients with concomitant ovarian endometriosis have a poorer prognosis compared with endometriosis-negative CCC patients. These differences warrant further research to determine whether CCCs with and without concomitant endometriosis develop through distinct pathogenic pathways.
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19
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Zhang T, Zhou J, Man GCW, Leung KT, Liang B, Xiao B, Ma X, Huang S, Huang H, Hegde VL, Zhong Y, Li Y, Kong GWS, Yiu AKW, Kwong J, Ng PC, Lessey BA, Nagarkatti PS, Nagarkatti M, Wang CC. MDSCs drive the process of endometriosis by enhancing angiogenesis and are a new potential therapeutic target. Eur J Immunol 2018; 48:1059-1073. [PMID: 29460338 DOI: 10.1002/eji.201747417] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/20/2018] [Accepted: 02/14/2018] [Indexed: 12/21/2022]
Abstract
Endometriosis affects women of reproductive age via unclear immunological mechanism(s). Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of myeloid cells with potent immunosuppressive and angiogenic properties. Here, we found MDSCs significantly increased in the peripheral blood of patients with endometriosis and in the peritoneal cavity of a mouse model of surgically induced endometriosis. Majority of MDSCs were granulocytic, produced ROS, and arginase, and suppressed T-cell proliferation. Depletion of MDSCs by antiGr-1 antibody dramatically suppressed development of endometrial lesions in mice. The chemokines CXCL1, 2, and 5 were expressed at sites of lesion while MDSCs expressed CXCR-2. These CXC-chemokines promoted MDSC migration toward endometriotic implants both in vitro and in vivo. Also, CXCR2-deficient mice show significantly decreased MDSC induction, endometrial lesions, and angiogenesis. Importantly, adoptive transfer of MDSCs into CXCR2-KO mice restored endometriotic growth and angiogenesis. Together, this study demonstrates that MDSCs play a role in the pathogenesis of endometriosis and identifies a novel CXC-chemokine and receptor for the recruitment of MDSCs, thereby providing a potential target for endometriosis treatment.
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Affiliation(s)
- Tao Zhang
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Juhua Zhou
- Institute for Tumor Immunology, School of Life Sciences, Ludong University, Yantai, Shandong, China
| | - Gene Chi Wai Man
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Kam Tong Leung
- Department of Paediatrics, the Chinese University of Hong Kong, Hong Kong
| | - Bo Liang
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Bo Xiao
- Institute for Tumor Immunology, School of Life Sciences, Ludong University, Yantai, Shandong, China
| | - Xinting Ma
- Institute for Tumor Immunology, School of Life Sciences, Ludong University, Yantai, Shandong, China
| | - Shaoyan Huang
- Department of Oncology, Yantai Mountain Hospital, Yantai, Shandong, China
| | | | - Venkatesh L Hegde
- Department of Obstetrics and Gynecology, Greenville Health Systems, Greenville, South Carolina, SC, USA
| | - Yin Zhong
- Department of Obstetrics and Gynecology, Greenville Health Systems, Greenville, South Carolina, SC, USA
| | - Yanmin Li
- Institute for Tumor Immunology, School of Life Sciences, Ludong University, Yantai, Shandong, China
| | - Grace Wing Shan Kong
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Alice Ka Wah Yiu
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Joseph Kwong
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong
| | - Pak Cheung Ng
- Department of Paediatrics, the Chinese University of Hong Kong, Hong Kong
| | - Bruce A Lessey
- Department of Obstetrics and Gynecology, Greenville Health Systems, Greenville, South Carolina, SC, USA
| | - Prakash S Nagarkatti
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Mitzi Nagarkatti
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong.,Li Ka Shing Institute of Health Sciences, the Chinese University of Hong Kong, Hong Kong.,School of Biomedical Sciences, the Chinese University of Hong Kong, Hong Kong
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20
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Agrawal S, Tapmeier T, Rahmioglu N, Kirtley S, Zondervan K, Becker C. The miRNA Mirage: How Close Are We to Finding a Non-Invasive Diagnostic Biomarker in Endometriosis? A Systematic Review. Int J Mol Sci 2018; 19:ijms19020599. [PMID: 29463003 PMCID: PMC5855821 DOI: 10.3390/ijms19020599] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Endometriosis is a common disorder of the reproductive age group, characterised by the presence of ectopic endometrial tissue. The disease not only causes enormous suffering to the affected women, but also brings a tremendous medical and economic burden to bear on society. There is a long lag phase between the onset and diagnosis of the disease, mainly due to its non-specific symptoms and the lack of a non-invasive test. Endometriosis can only be diagnosed invasively by laparoscopy. A specific, non-invasive test to diagnose endometriosis is an unmet clinical need. The recent discovery of microRNAs (miRNAs) as modulators of gene expression, and their stability and specificity, make them an attractive candidate biomarker. Various studies on miRNAs in endometriosis have identified their cardinal role in the pathogenesis of the disease, and have proposed them as potential biomarkers in endometriosis. Rationale/Objectives: The aims of this review were to study the role of circulatory miRNAs in endometriosis, and bring to light whether circulatory miRNAs could be potential non-invasive biomarkers to diagnose the disease. Search methods: Three databases, PubMed, EMBASE, and BIOSIS were searched, using a combination of Mesh or Emtree headings and free-text terms, to identify literature relating to circulating miRNAs in endometriosis published from 1996 to 31 December 2017. Only peer-reviewed, full-text original research articles in English were included in the current review. The studies meeting the inclusion criteria were critically assessed and checked using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. The dysregulated miRNAs were assessed regarding the concordance between the various studies and their role in the disease. Outcomes: Nine studies were critically analysed, and 42 different miRNAs were found to be dysregulated in them, with only one common miRNA (miR-20a) differentially expressed in more than one study. miR-17-5p/20a, miR-200, miR-199a, miR-143, and miR-145 were explored for their pivotal role in the aetiopathogenesis of endometriosis. Wider implications: It is emerging that miRNAs play a central role in the pathogenesis of endometriosis and have the potential of being promising biomarkers. Circulating miRNAs as a non-invasive diagnostic tool may shorten the delay in the diagnosis of the disease, thus alleviating the suffering of women and reducing the burden on health care systems. However, despite numerous studies on circulating miRNAs in endometriosis, no single miRNA or any panel of them seems to meet the criteria of a diagnostic biomarker. The disagreement between the various studies upholds the demand of larger, well-controlled systematic validation studies with uniformity in the research approaches and involving diverse populations.
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Affiliation(s)
- Swati Agrawal
- Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX1 2JD, UK;.
| | - Thomas Tapmeier
- Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX1 2JD, UK;.
| | - Nilufer Rahmioglu
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX1 2JD, UK.
| | - Shona Kirtley
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford OX1 2JD, UK.
| | - Krina Zondervan
- Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX1 2JD, UK;.
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX1 2JD, UK.
| | - Christian Becker
- Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX1 2JD, UK;.
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Silveira CGT, Rogatto SR, Podgaec S, Abrão MS. Recent Advances in Molecular Genetics of Endometriosis. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/228402650900100103] [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
Endometriosis (MIM 131200) is a prevalent and complex gynecological disease polygenically inherited with multifactorial pathogenesis. It is increasingly recognized as a major women's health issue. Endometriosis is characterized by the presence of endometrial-like tissue in sites outside the uterus, mainly the pelvic peritoneum, ovaries and rectovaginal septum causing severe dysmenorrhoea, dyspareunia, chronic pelvic pain and subfertility. Recent advances in molecular technologies have provided many evidences about the underlying biological events that are likely to be involved in the development of endometriosis. Different chromosomal regions, genes and other molecules, such as microRNAs, have been identified as potentially involved in endometriosis pathogenesis. Moreover, genome-wide analyses of endometriosis have showed novel molecular signatures or individual genes that had not been previously associated with the disease. The goal of these studies is to provide information that might, in turn, lead to new therapies. In this review, some previous studies were updated supporting the polygenic/multifactorial inheritance and the association with malignant neoplasias. We have also emphasized the importance of identifying the causative genes and determining novel diagnostic and predictive biomarkers.
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Affiliation(s)
| | - Silvia Regina Rogatto
- Department of Research, Antonio Prudente Foundation, AC Camargo Hospital, São Paulo and Department of Urology, School of Medicine, UNESP, Botucatu, São Paulo
| | - Sérgio Podgaec
- Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo - Brazil
| | - Mauricio Simões Abrão
- Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo - Brazil
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22
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Halim TA, Attar R, Donfrancesco C, Farooqi AA, Zaman F. From Endometriosis to Cancer: Spotlight on Intracellular Signaling Cascades and MicroRNAs. RECENT TRENDS IN CANCER BIOLOGY: SPOTLIGHT ON SIGNALING CASCADES AND MICRORNAS 2018:1-10. [DOI: 10.1007/978-3-319-71553-7_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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23
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Lai GL, Yeh CC, Yeh CY, Chen RY, Fu CL, Chen CH, Tzeng CR. Decreased zinc and increased lead blood levels are associated with endometriosis in Asian Women. Reprod Toxicol 2017; 74:77-84. [PMID: 28889936 DOI: 10.1016/j.reprotox.2017.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 12/14/2022]
Abstract
Endometriosis is an inflammatory disease associated with multiple pathogenic factors and studies regarding roles of trace metals in endometriosis have been inconsistent and limited. The aim of this cross-sectional study was to compare the blood levels of miscellaneous trace metals measured by inductively coupled plasma mass spectrometry in infertile women with and without endometriosis. Zinc level is associated with declining odds (adjusted OR=0.39, 95% CI=0.18-0.88) of endometriosis. By contrast, lead level is associated with increasing odds (adjusted OR=2.59, 95% CI=1.11-6.06) of endometriosis. The cadmium levels were higher in women with endometriosis, but the aOR was not significant. Zinc has anti-inflammatory characteristics and regulates homeostasis of zinc-containing superoxide dismutase. High lead levels might induce reactive oxygen species and deplete antioxidant defense mechanisms. Further prospective study is needed to test for their causal associations.
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Affiliation(s)
- Guan-Lin Lai
- School of Public Health, College of Public health, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan
| | - Chih-Ching Yeh
- School of Public Health, College of Public health, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan; Department of Public Health, College of Public health, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Ching-Ying Yeh
- School of Public Health, College of Public health, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan
| | - Ruey-Yu Chen
- School of Public Health, College of Public health, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan
| | - Chiung-Lin Fu
- School of Public Health, College of Public health, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan
| | - Chi-Huang Chen
- Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei Medical University, 252 Wu-Hsin Street, Taipei 110, Taiwan
| | - Chii-Ruey Tzeng
- Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan; Center for Reproductive Medicine and Sciences, Taipei Medical University and Hospital, 252 Wu-Hsin Street, Taipei 110, Taiwan.
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24
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Zhang X, Liu Z, Chen M, Cao Q, Huang D. Effects of S100A6 gene silencing on the biological features of eutopic endometrial stromal cells and β‑catenin expression. Mol Med Rep 2017; 15:1279-1285. [PMID: 28075439 PMCID: PMC5367373 DOI: 10.3892/mmr.2017.6105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/25/2016] [Indexed: 11/12/2022] Open
Abstract
Protein expression levels of S100 calcium binding protein A6 (S100A6) are increased in various malignancies and are associated with tumor behavior; however, the association between S100A6 and endometriosis remains to be elucidated. In order to investigate the influence of S100A6 protein, recombinant lentivirus siS100A6 was used to transfect the eutopic endometrial stromal cells. CCK-8 assay was performed to identify the proliferation ability of cell and the cell migration was detected by Transwell assay. Flow cytometry was performed to detect cell apoptosis, and western blotting and reverse transcription-quantitative polymerase chain reaction were performed to identify the expression of β-catenin. The present study investigated the role of S100A6 in endometriosis and its interaction with β-catenin by transfecting eutopic endometrial stromal cells with a recombinant lentivirus containing S100A6-specific small interfering RNA. Inhibition of S100A6 expression had a significant antiproliferative effect and reduced the migratory ability of eutopic endometrial stromal cells, and induced their apoptosis. In addition, inhibition of S100A6 expression suppressed β-catenin expression. These results suggested that inhibition of S100A6 may represent a promising novel approach for the targeted therapy of endometriosis.
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Affiliation(s)
- Xiaoling Zhang
- Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Zequn Liu
- Department of Medicine, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Meihong Chen
- Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Qing Cao
- Jiangxi Province Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Donghua Huang
- Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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25
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Zhang L, Xiong W, Li N, Liu H, He H, Du Y, Zhang Z, Liu Y. Estrogen stabilizes hypoxia-inducible factor 1α through G protein-coupled estrogen receptor 1 in eutopic endometrium of endometriosis. Fertil Steril 2016; 107:439-447. [PMID: 27939762 DOI: 10.1016/j.fertnstert.2016.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/08/2016] [Accepted: 11/08/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether G protein-coupled estrogen receptor (GPER, also known as GPR30 and GPER1) stabilizes hypoxia-inducible factor 1α (HIF-1α) in eutopic endometrium (EuEM) of endometriosis. DESIGN Immunohistochemical analysis and experimental in vitro study. SETTING University hospital. PATIENT(S) Patients with or without endometriosis. INTERVENTION(S) The EuEM and normal control endometrium (CoEM) were obtained by curettage. Primary cultured endometrial stromal cells (ESCs) were treated with 17β-E2, G1, or G15. MAIN OUTCOME MEASURE(S) The EuEM and CoEM were collected for immunohistochemistry. Western blot, polymerase chain reaction, ELISA, and dual luciferase experiments were used to detect expression of GPER, HIF-1α, vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP9) in ESCs. Estradiol and G1 were used as agonists of GPER, G15 as an antagonist. Migration of ESCs and endothelial tube formation of human umbilical vein endothelial cells cultured in medium collected from ESCs were measured. RESULT(S) Protein levels of GPER and HIF-1α were higher in EuEM than in CoEM. Protein levels of HIF-1α but not HIF-1α mRNA levels increased concurrently with GPER after E2 and G1 treatment. Furthermore, expression and activity of VEGF and MMP9 increased under E2 and G1 stimulation. However, these effects disappeared when GPER was blocked. CONCLUSION(S) G protein-coupled estrogen receptor stabilizes HIF-1α and thus promotes HIF-1α-induced VEGF and MMP9 in ESCs, which play critical roles in endometriosis.
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Affiliation(s)
- Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Na Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Hengwei Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Haitang He
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Yu Du
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China
| | - Zhibing Zhang
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, People's Republic of China.
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26
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Thomsen LH, Schnack TH, Buchardi K, Hummelshoj L, Missmer SA, Forman A, Blaakaer J. Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review. Acta Obstet Gynecol Scand 2016; 96:761-778. [DOI: 10.1111/aogs.13010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Line H. Thomsen
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
| | - Tine H. Schnack
- Gynecologic and Obstetric Department; Rigshospitalet University Hospital of Copenhagen; Copenhagen Denmark
| | | | | | - Stacey A. Missmer
- Department of Obstetrics; Gynecology and Reproductive Biology College of Human Medicine; Michigan State University; Boston MA USA
- Department of Epidemiology; Harvard T.H. Chan School of Public Health; Boston MA USA
| | - Axel Forman
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
| | - Jan Blaakaer
- Department of Gynecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
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27
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Omori S, Yoshida S, Kennedy SH, Negoro K, Hamana S, Barlow DH, Maruo T. Polymorphism at Codon 72 of the p53 Gene Is Not associated With Endometriosis in a Japanese Population. ACTA ACUST UNITED AC 2016; 11:232-6. [PMID: 15120697 DOI: 10.1016/j.jsgi.2003.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Endometriosis is inherited as a complex trait, which means that multiple susceptibility genes interact with each other and the environment to produce the phenotype. Previous studies have implicated p53, a tumor suppressor gene, as a factor in the development of the disease. In a Japanese population, we investigated the frequency of the p53 polymorphism in women affected with endometriosis. METHODS We compared the distribution of the p53 codon 72 polymorphism in endometriosis cases (n = 111) and population controls consisting of female neonates (n = 180) by using polymerase chain reaction restriction fragment-length polymorphism analysis in a Japanese population. RESULTS The frequencies of the three p53 genotypes, Arginine (Arg)/Arg, Arg/Proline (Pro), and Pro/Pro in controls were 39.4%, 41.7%, and 18.9 %, respectively. The crude genotype frequencies in the endometriosis cases were similar to those of the controls (35.2%, 48.6%, and 16.2%, respectively). Using the Arg/Arg genotype as the reference, the odds ratios of the Arg/Pro and Pro/Pro genotypes were 1.30 (95% confidence interval [CI] 0.72-1.86, P =.33) and 0.96 (95% CI 0.47-1.94, P =.91), respectively. Thus, there were no significant differences in the frequency of the p53 codon 72 polymorphism between endometriosis cases and controls in this population. The endometriosis cases with severe disease only were also evaluated, but no significant difference was observed in the frequency of the polymorphism between this subgroup and the controls. CONCLUSION Our findings suggest that the p53 codon 72 polymorphism is unlikely to be associated with endometriosis in Japanese women.
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Affiliation(s)
- Shinya Omori
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Japan
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28
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Smith IN, Briggs JM. Structural mutation analysis of PTEN and its genotype-phenotype correlations in endometriosis and cancer. Proteins 2016; 84:1625-1643. [PMID: 27481051 DOI: 10.1002/prot.25105] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 06/17/2016] [Accepted: 07/05/2016] [Indexed: 12/19/2022]
Abstract
The phosphatase and tensin homolog deleted on chromosome ten (PTEN) gene encodes a tumor suppressor phosphatase that has recently been found to be frequently mutated in patients with endometriosis, endometrial cancer and ovarian cancer. Here, we present the first computational analysis of 13 somatic missense PTEN mutations associated with these phenotypes. We found that a majority of the mutations are associated in conserved positions within the active site and are clustered within the signature motif, which contain residues that play a crucial role in loop conformation and are essential for catalysis. In silico analyses were utilized to identify the putative effects of these mutations. In addition, coarse-grained models of both wild-type (WT) PTEN and mutants were constructed using elastic network models to explore the interplay of the structural and global dynamic effects that the mutations have on the relationship between genotype and phenotype. The effects of the mutations reveal that the local structure and interactions affect polarity, protein structure stability, electrostatic surface potential, and global dynamics of the protein. Our results offer new insight into the role in which PTEN missense mutations contribute to the molecular mechanism and genotypic-phenotypic correlation of endometriosis, endometrial cancer, and ovarian cancer. Proteins 2016; 84:1625-1643. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Iris N Smith
- Department of Biology and Biochemistry, University of Houston, Houston, Texas, 77204-5001
| | - James M Briggs
- Department of Biology and Biochemistry, University of Houston, Houston, Texas, 77204-5001.
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29
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Mogensen JB, Kjær SK, Mellemkjær L, Jensen A. Endometriosis and risks for ovarian, endometrial and breast cancers: A nationwide cohort study. Gynecol Oncol 2016; 143:87-92. [PMID: 27430396 DOI: 10.1016/j.ygyno.2016.07.095] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A growing body of evidence suggests that endometriosis increases the risk for ovarian cancer, but it is less well studied whether the excess risk is confined to certain histotypes. Furthermore, it is not fully resolved if endometriosis is associated with endometrial- and breast cancer. The aim was to study overall- and histotype-specific risks for these hormone-dependent cancers in women with endometriosis. METHODS In the Danish National Patient Register, we identified 45,790 women with a clinical diagnosis of endometriosis during 1977-2012. We linked the cohort to the Danish Cancer Register and calculated standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (CIs). RESULTS Endometriosis was associated with increased risks for ovarian cancer (SIR 1.34; 95% CI: 1.16-1.55), due primarily to endometrioid (SIR 1.64; 95% CI: 1.09-2.37) and clear-cell types (SIR 3.64; 95% CI: 2.36-5.38). An excess risk was also observed for endometrial cancer (SIR 1.43; 95% CI: 1.13-1.79), primarily of type 1 (SIR 1.54; 95% CI: 1.20-1.96); and the risk for breast cancer was increased among women aged ≥50years at first diagnosis of endometriosis (SIR 1.27; 95% CI: 1.12-1.42). CONCLUSIONS The results corroborate previous findings of increased risks for endometrioid and clear-cell ovarian cancer in women with endometriosis. As the first cohort study to date, we observed a significantly increased risk for endometrial cancer in women with a diagnosis of endometriosis. The increased breast cancer risk among women with endometriosis diagnosed at ≥50years of age should be studied further.
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Affiliation(s)
- Julie Brøchner Mogensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Gynaecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Lene Mellemkjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
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30
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[Retroperitoneal endometriosis : When a rare form of endometriosis becomes a urological disease]. Urologe A 2016; 55:756-62. [PMID: 27294488 DOI: 10.1007/s00120-016-0119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Retroperitoneal endometriosis is a common benign disease, which requires an interdisciplinary approach. In the clinical practice diagnosis is often delayed for years after onset of the unspecific symptoms so that increased awareness is necessary for detection of the presence of the disease. OBJECTIVE This article provides a description of the disease including the symptoms and pathogenesis, an introduction to the complexity of diagnostic investigations and the current therapy recommendations. MATERIAL AND METHODS Comparison of current therapy recommendations according to the guidelines under consideration of individual studies and background research. Assessment of studies and the accompanying interpretations with the intention of presenting an introduction to the topic with therapy recommendations. RESULTS From a urological point of view retroperitoneal endometriosis is a benign disease affecting the ureters and urinary bladder. Involvement of the ureters leading to hydronephrosis caused by ureteral compression represents an absolute indication for therapy. Recurrent macrohematuria can also necessitate treatment. Treatment includes surgical excision of the focal point of endometriosis as the first line therapy. Various operative procedures and access routes are available but when possible a minimally invasive procedure should be used. A second line drug therapy is also possible. CONCLUSION Surgical excision of a clinically significant focus of endometriosis is the gold standard for therapy. This procedure should take place in a specialized center within an interdisciplinary consensus. Due to the fact that endometriosis is primarily a benign disease, medical clarification for the patient concerning the benefits and risks of therapy is absolutely necessary. An individual therapy concept under consideration of factors, such as the specific clinical relevance and psychological stress is recommended and in close cooperation with the patient.
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31
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Schutz R, Woziwodzki J, Schweppe KW. Diagnostics and Therapy for Malignant (Degenerate) Colon Endometriosis - Three Case Reports. Geburtshilfe Frauenheilkd 2016; 76:417-422. [PMID: 27134299 DOI: 10.1055/s-0041-109769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Malignant degeneration of colon endometriosis is a very rare event. We report here on three cases. A 48-year-old woman with a 10-year history of endometriosis was treated for a rectal adenocarcinoma, a 61-year-old G1P1, who was operated at the age of 40 years for ovarian endometriosis and again at the age of 53 years for an endometriosis-associated endometroid ovarian carcinoma, presented for therapy for a lymph node recurrence of the ovarian cancer and, secondly, due to a malignantly degenerated rectum-sigmoid colon endometriosis; furthermore a 54-year old woman with a 21-year history of endometriosis was operated for malignant colon endometriosis. The tumour occurred during an adjuvant anti-oestrogen treatment with an aromatase inhibitor following surgical and radiotherapy for breast cancer. In all cases a radical cancer operation was followed by adjuvant chemotherapy and in one case with an additional radiotherapy. In the follow-up periods of 18 months, 2 and 5 years, respectively, all women remained free of recurrences. Although this is not a randomised controlled study due to the rare occurrence of such cases, a radical operation followed by individualised adjuvant therapy appears to be the treatment of choice.
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Affiliation(s)
- R Schutz
- Endometriosezentrum Ammerland, Frauenklinik, Ammerland-Klinik GmbH, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Hannover, Westerstede
| | - J Woziwodzki
- Pathologisches Institut Aurich/Westerstede, Westerstede
| | - K-W Schweppe
- Endometriosezentrum Ammerland, Frauenklinik, Ammerland-Klinik GmbH, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Hannover, Westerstede
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32
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Zhang L, Xiong W, Xiong Y, Liu H, Li N, Du Y, Liu Y. Intracellular Wnt/Beta-Catenin Signaling Underlying 17beta-Estradiol-Induced Matrix Metalloproteinase 9 Expression in Human Endometriosis. Biol Reprod 2016; 94:70. [PMID: 26888969 DOI: 10.1095/biolreprod.115.135574] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/02/2016] [Indexed: 12/31/2022] Open
Abstract
Extracellular matrix remodeling is necessary for ectopic endometrium implantation. Many studies have shown an increased expression of matrix metalloproteinase 9 (MMP9) in the ectopic endometrium of endometriosis. However, the signaling pathways and cellular effects related to this process remain incompletely elucidated. The objective of our study was to investigate the association between MMP9 and the Wnt signaling pathway under the regulation of 17beta-estradiol (E2) in endometrial stromal cells. We found that MMP9 was elevated in tissues from women with endometriosis compared with normal women. Furthermore, MMP9 and beta-catenin increased concurrently in a time- and dose-dependent manner after E2 treatment. To clarify the relationship between MMP9 and beta-catenin, we performed luciferase promoter reporter and chromatin immunoprecipitation assays. A beta-catenin/TCF3/LEF1 complex bound to a specific site on the MMP9 promoter that promoted MMP9 gene and protein expression. The promotion of MMP9 by the Wnt signaling pathway under the regulation of E2 may contribute to the pathophysiology of this disease.
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Affiliation(s)
- Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hengwei Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Na Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Du
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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33
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Ulrich UA, Drienko E, Reichert VM, Wunschel A, Noack F. Malignome auf dem Boden einer Endometriose. GYNAKOLOGISCHE ENDOKRINOLOGIE 2016. [DOI: 10.1007/s10304-015-0043-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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34
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Seminal Plasma Promotes Lesion Development in a Xenograft Model of Endometriosis. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 185:1409-22. [PMID: 25907757 DOI: 10.1016/j.ajpath.2015.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/24/2014] [Accepted: 01/20/2015] [Indexed: 12/13/2022]
Abstract
The factors that predispose one-tenth of reproductive-aged women to endometriosis are poorly understood. We determined that genetic deficiency in transforming growth factor β1 impairs endometriosis-like lesion growth in mice. Given that seminal plasma is an abundant source of transforming growth factor β, we evaluated the effect of exposure to seminal plasma on the growth of endometrial lesions. Human endometrial explants were exposed to seminal plasma or to control medium before transfer to Prkdc(scid)-mutant (severe combined immunodeficient) mice. Xenografts exposed to seminal plasma showed an eightfold increase in volume and a 4.3-fold increase in weight after 14 days. These increases were associated with increased proliferation of endometrial epithelial cells and enhanced survival and proliferation of human stromal cells compared with those in control lesions, in which human stromal cell persistence was negligible. Although the distribution of macrophages was altered, their number and activation status did not change in response to seminal plasma. Seminal plasma stimulated the production of a variety of cytokines in endometrial tissue, including growth-regulated oncogene, granulocyte macrophage colony-stimulating factor, and IL-1β. These data suggest that seminal plasma enhances the formation of endometriosis-like lesion via a direct effect on endometrial cell survival and proliferation, rather than via macrophage-mediated mechanisms. These findings raise the possibility that endometrial exposure to seminal plasma could contribute to endometriotic disease progression in women.
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Gharwan H, Bunch KP, Annunziata CM. The role of reproductive hormones in epithelial ovarian carcinogenesis. Endocr Relat Cancer 2015; 22:R339-63. [PMID: 26373571 DOI: 10.1530/erc-14-0550] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 12/12/2022]
Abstract
Epithelial ovarian cancer comprises ∼85% of all ovarian cancer cases. Despite acceptance regarding the influence of reproductive hormones on ovarian cancer risk and considerable advances in the understanding of epithelial ovarian carcinogenesis on a molecular level, complete understanding of the biologic processes underlying malignant transformation of ovarian surface epithelium is lacking. Various hypotheses have been proposed over the past several decades to explain the etiology of the disease. The role of reproductive hormones in epithelial ovarian carcinogenesis remains a key topic of research. Primary questions in the field of ovarian cancer biology center on its developmental cell of origin, the positive and negative effects of each class of hormones on ovarian cancer initiation and progression, and the role of the immune system in the ovarian cancer microenvironment. The development of the female reproductive tract is dictated by the hormonal milieu during embryogenesis. Intensive research efforts have revealed that ovarian cancer is a heterogenous disease that may develop from multiple extra-ovarian tissues, including both Müllerian (fallopian tubes, endometrium) and non-Müllerian structures (gastrointestinal tissue), contributing to its heterogeneity and distinct histologic subtypes. The mechanism underlying ovarian localization, however, remains unclear. Here, we discuss the role of reproductive hormones in influencing the immune system and tipping the balance against or in favor of developing ovarian cancer. We comment on animal models that are critical for experimentally validating existing hypotheses in key areas of endocrine research and useful for preclinical drug development. Finally, we address emerging therapeutic trends directed against ovarian cancer.
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Affiliation(s)
- Helen Gharwan
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Kristen P Bunch
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Christina M Annunziata
- National Cancer InstituteNational Institutes of Health, 10 Center Drive, Building 10, 12N226, Bethesda, Maryland 20892-1906, USAWomen's Malignancies BranchNational Cancer Institute, National Institutes of Health, Center for Cancer Research, Bethesda, Maryland, USADepartment of Gynecologic OncologyWalter Reed National Military Medical Center, Bethesda, Maryland, USA
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Ahmad SF, Akoum A, Horne AW. Selective modulation of the prostaglandin F2α pathway markedly impacts on endometriosis progression in a xenograft mouse model. Mol Hum Reprod 2015; 21:905-16. [PMID: 26472819 DOI: 10.1093/molehr/gav056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/09/2015] [Indexed: 12/11/2022] Open
Abstract
STUDY HYPOTHESIS Selective activation or blockade of the prostaglandin (PG) F2α receptor (FP receptor) affects ectopic endometrial tissue growth and endometriosis development. STUDY FINDING FP receptor antagonists might represent a promising approach for the treatment of peritoneal endometriosis. WHAT IS KNOW ALREADY Eutopic and ectopic endometrium from women with endometriosis exhibit higher expression of key enzymes involved in the PGF2α biosynthetic pathway. It has also been shown that the PGF2α-FP receptor interaction induces angiogenesis in human endometrial adenocarcinoma. STUDY DESIGN, SAMPLES/MATERIALS, METHODS For this study, a mouse model of endometriosis was developed by inoculating human endometrial biopsies into the peritoneal cavity of nude mouse (n = 15). Mice were treated with AL8810 (FP receptor antagonist), Fluprostenol (FP receptor agonist) or PBS. Endometriosis-like lesions were collected and analysed for set of markers for angiogenesis, tissue remodelling, apoptosis, cell proliferation and capillary formation using qPCR and immunohistochemistry. MAIN RESULTS AND THE ROLE OF CHANCE We found that selective inhibition of the FP receptor with a specific antagonist, AL8810, led to a significant decline in the number (P < 0.01) and size of endometriosis-like lesions (P < 0.001), down-regulated the expression of key mediators of tissue remodelling (MMP9, P < 0.05) and angiogenesis (VEGF, P < 0.01) and up-regulated the pro-apoptotic factor (Bax, P < 0.01) as compared with controls. Immunohistochemical analyses further showed a marked decrease in cell proliferation and capillary formation in endometrial implants from AL8810-treated mice, as determined by proliferating cell nuclear antigen (PCNA) and von Willebrand factor (vWF) immunostaining, respectively. Moreover, Fluprostenol, a selective FP receptor agonist, showed the opposite effects. LIMITATIONS, REASONS FOR CAUTION We carried out this study in nude mice, which have low levels of endogenous estrogens which may affect the lesion growth. Caution is required when interpreting these results to women. WIDER IMPLICATIONS OF THE FINDINGS This study extends the role of PG signalling in endometriosis pathogenesis and points towards the possible relevance of selective FP receptor antagonism as a targeted treatment for endometriosis. LARGE SCALE DATA Not Applicable. STUDY FUNDING AND COMPETING INTERESTS This work was supported by grant MOP-123259 to the late Dr Ali Akoum from the Canadian Institutes for Health Research. The authors have no conflict of interest.
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Affiliation(s)
- Syed Furquan Ahmad
- Laboratoire d'Endocrinologie de la Reproduction, Centre de recherche, CHU de Québec-HSFA, Faculté de Médecine, Université Laval, Québec, Canada MRC Centre for Reproductive Health, The University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
| | - Ali Akoum
- Laboratoire d'Endocrinologie de la Reproduction, Centre de recherche, CHU de Québec-HSFA, Faculté de Médecine, Université Laval, Québec, Canada
| | - Andrew W Horne
- MRC Centre for Reproductive Health, The University of Edinburgh, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
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Liao TL, Tzeng CR, Yu CL, Wang YP, Kao SH. Estrogen receptor-β in mitochondria: implications for mitochondrial bioenergetics and tumorigenesis. Ann N Y Acad Sci 2015; 1350:52-60. [PMID: 26301952 DOI: 10.1111/nyas.12872] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Estrogen enhances mitochondrial function by enhancing mitochondrial biogenesis and sustaining mitochondrial energy-transducing capacity. Shifts in mitochondrial bioenergetic pathways from oxidative phosphorylation to glycolysis have been hypothesized to be involved in estrogen-induced tumorigenesis. Studies have shown that mitochondria are an important target of estrogen. Estrogen receptor-β (ERβ) has been shown to localize to mitochondria in a ligand-dependent or -independent manner and can affect mitochondrial bioenergetics and anti-apoptotic signaling. However, the functional role of mitochondrial ERβ in tumorigenesis remains unclear. Clinical studies of ERβ-related tumorigenesis have shown that ERβ stimulates mitochondrial metabolism to meet the high energy demands of processes such as cell proliferation, cell survival, and transformation. Thus, in elucidating the precise role of mitochondrial ERβ in cell transformation and tumorigenesis, it will be particularly valuable to explore new approaches for the development of medical treatments targeting mitochondrial ERβ-mediated mitochondrial function and preventing apoptosis.
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Affiliation(s)
- Tien-Ling Liao
- Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chii-Ruey Tzeng
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan.,Center for Reproductive Medicine and Sciences, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Lan Yu
- Department of Microbiology and Immunology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Yi-Pei Wang
- Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Shu-Huei Kao
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Center for Reproductive Medicine and Sciences, Taipei Medical University Hospital, Taipei, Taiwan
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Abstract
INTRODUCTION Endometriosis affects 10% of women of reproductive age. It is defined as the presence of implanted active endometrial tissue outside the uterine cavity. The exact pathophysiology of endometriosis is still uncertain, although several optional etiological theories have been suggested. Being so common, a novel treatment for endometriosis is widely quested. Recent studies addressing the pathological characteristics of endometriosis have revealed a vicious cycle in which oxidative stress (OS) is generated, which in turn facilitates the implantation of the ectopic endometrium. At the same time, the generation of high amounts of reactive oxygen species further triggers a state of OS. AREAS COVERED The author examined the evidence associating OS and endometriosis. After establishing an association, a search for antioxidant agents that were investigated specifically on endometriosis patients are described including Vitamins C and E, melatonin, resveratrol, xanthohumol and epigallocatechin-3-gallate. A significant effect of all the reviewed antioxidants on endometriosis is reported. EXPERT OPINION Aiming for the reduction of OS as the treatment goal for endometriosis looks promising. However, since most of the studies are either in vitro or are animal based, further studies on human subjects are deemed necessary to elucidate the impact of OS reduction on patients with endometriosis.
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Affiliation(s)
- Avi Harlev
- a 1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland , OH, USA.,b 2 Ben-Gurion University of the Negev, Faculty of Health Sciences, Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics & Gynecology , Israel
| | - Sajal Gupta
- a 1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland , OH, USA
| | - Ashok Agarwal
- c 3 American Center for Reproductive Medicine, Cleveland Clinic , Mail Code: X-11, 10681 Carnegie Avenue, Cleveland, OH 44195, USA +1 216 444 9485 ; +1 216 445 6049;
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Kim HS, Kim MA, Lee M, Suh DH, Kim K, No JH, Chung HH, Kim YB, Song YS. Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis. Ann Surg Oncol 2015; 22:2738-2745. [DOI: 10.1245/s10434-014-4319-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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McKINNON BRETT, MUELLER MICHAELD, NIRGIANAKIS KONSTANTINOS, BERSINGER NICKA. Comparison of ovarian cancer markers in endometriosis favours HE4 over CA125. Mol Med Rep 2015; 12:5179-84. [DOI: 10.3892/mmr.2015.4062] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 06/02/2015] [Indexed: 11/06/2022] Open
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Che XH, Chen YC, Chen CL, Ye XL, Zhu H. Non-hormonal targets underlying endometriosis: A focus on molecular mechanisms. Mol Reprod Dev 2015; 82:410-31. [PMID: 25982890 DOI: 10.1002/mrd.22493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/14/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Xiao-hang Che
- Division of Drugs and Pharmacology; Ningbo Institute of Medical Sciences; Ningbo China
- College of Chemistry and Bio-engineering; Yichun University; Yichun China
- Cancer Institute; Yinzhou People's Hospital; Ningbo China
| | - Yi-chen Chen
- Division of Drugs and Pharmacology; Ningbo Institute of Medical Sciences; Ningbo China
| | - Chun-lin Chen
- College of Chemistry and Bio-engineering; Yichun University; Yichun China
| | - Xiao-lei Ye
- Division of Drugs and Pharmacology; Ningbo Institute of Medical Sciences; Ningbo China
- Cancer Institute; Yinzhou People's Hospital; Ningbo China
| | - Hong Zhu
- Division of Obstetrics and Gynecology; Affiliated Hospital of Ningbo University School of Medicine; Ningbo China
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Chronic lymphocytic leukemia-associated refractory immune thrombocytopenia successfully treated with eltrombopag. TUMORI JOURNAL 2015; 101:e49-50. [PMID: 25702666 DOI: 10.5301/je.5000248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2014] [Indexed: 11/20/2022]
Abstract
Chronic lymphocytic leukemia (CLL) may be associated with immune thrombocytopenia (ITP). The standard treatment for CLL-associated ITP is steroids. For refractory cases, various treatment strategies such as rituximab, splenectomy, and thrombopoietic mimetics are available. We report a patient with CLL who developed recurrent ITP and life-threatening pulmonary hemorrhage. Platelet counts remained extremely low despite massive platelet transfusion and treatment including steroids, immunoglobulin, and single-dose rituximab infusion. The bleeding stopped and platelet counts were increased to normal range 13 days after treatment with eltrombopag 25 mg per day. Our experience suggests that eltrombopag is an effective treatment option in CLL-associated, refractory ITP, especially during major bleeding, which requires relatively rapid improvement of thrombocytopenia.
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Zhang Z, Chen P, Guo C, Meng X, Wang D. Effect of LIM kinase 1 overexpression on behaviour of endometriosis-derived stromal cells. Cell Tissue Res 2014; 359:885-93. [DOI: 10.1007/s00441-014-2068-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 11/10/2014] [Indexed: 01/10/2023]
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Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, Oppelt P, Renner SP, Sillem M, Stummvoll W, De Wilde RL, Schweppe KW. National German Guideline (S2k): Guideline for the Diagnosis and Treatment of Endometriosis: Long Version - AWMF Registry No. 015-045. Geburtshilfe Frauenheilkd 2014; 74:1104-1118. [PMID: 26157194 PMCID: PMC4470398 DOI: 10.1055/s-0034-1383187] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
In this guideline, recommendations and standards for optimum diagnosis and treatment of endometriosis are presented. They are based on the analysis of the available scientific evidence as published in prospective randomized and retrospective studies as well as in systematic reviews. The guideline working group consisted of experts from Austria, Germany, Switzerland, and the Czech Republic.
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Affiliation(s)
- U. Ulrich
- Department of Obstetrics and Gynecology, Martin Luther Hospital,
Berlin
| | - O. Buchweitz
- Gynecological Outpatient Surgery Altonaer Straße, Hamburg
| | - R. Greb
- Center for Reproductive Medicine, Dortmund
| | - J. Keckstein
- Department of Obstetrics and Gynecology, Provincial Hospital,
Villach
| | - I. von Leffern
- Department of Obstetrics and Gynecology, Albertinen Hospital,
Hamburg
| | - P. Oppelt
- Department of Obstetrics and Gynecology, Provincial Womenʼs and
Childrenʼs Hospital, Linz
| | - S. P. Renner
- Department of Obstetrics and Gynecology, University of Erlangen School
of Medicine
| | - M. Sillem
- Gynecological Practice and Clinic Rosengarten, Mannheim
| | - W. Stummvoll
- Departement of Gynecology, Hospital of the Sisters of Mercy,
Linz
| | - R.-L. De Wilde
- Department of Obstetrics, Gynecology, and Gynecologic Oncology, Pius
Hospital Oldenburg, University of Oldenburg School of Medicine
| | - K.-W. Schweppe
- Endometriosis Center Ammerland, Ammerland Clinic,
Westerstede
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Han SJ, O'Malley BW. The dynamics of nuclear receptors and nuclear receptor coregulators in the pathogenesis of endometriosis. Hum Reprod Update 2014; 20:467-84. [PMID: 24634322 DOI: 10.1093/humupd/dmu002] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Endometriosis is defined as the colonization and growth of endometrial tissue at anatomic sites outside the uterine cavity. Up to 15% of reproductive-aged women in the USA suffer from painful symptoms of endometriosis, such as infertility, pelvic pain, menstrual cycle abnormalities and increased risk of certain cancers. However, many of the current clinical treatments for endometriosis are not sufficiently effective and yield unacceptable side effects. There is clearly an urgent need to identify new molecular mechanisms that critically underpin the initiation and progression of endometriosis in order to develop more specific and effective therapeutics which lack the side effects of current therapies. The aim of this review is to discuss how nuclear receptors (NRs) and their coregulators promote the progression of endometriosis. Understanding the pathogenic molecular mechanisms for the genesis and maintenance of endometriosis as modulated by NRs and coregulators can reveal new therapeutic targets for alternative endometriosis treatments. METHODS This review was prepared using published gene expression microarray data sets obtained from patients with endometriosis and published literature on NRs and their coregulators that deal with endometriosis progression. Using the above observations, our current understanding of how NRs and NR coregulators are involved in the progression of endometriosis is summarized. RESULTS Aberrant levels of NRs and NR coregulators in ectopic endometriosis lesions are associated with the progression of endometriosis. As an example, endometriotic cell-specific alterations in gene expression are correlated with a differential methylation status of the genome compared with the normal endometrium. These differential epigenetic regulations can generate favorable cell-specific NR and coregulator milieus for endometriosis progression. Genetic alterations, such as single nucleotide polymorphisms and insertion/deletion polymorphisms of NR and coregulator genes, are frequently detected in ectopic lesions compared with the normal endometrium. These genetic variations impart new molecular properties to NRs and coregulators to increase their capacity to stimulate progression of endometriosis. Finally, post-translational modifications of NR coregulators, such as proteolytic processing, generate endometriosis-specific isoforms. Compared with the unmodified coregulators, these coregulator isoforms have unique functions that enhance the pathogenesis of endometriosis. CONCLUSIONS Epigenetic/genetic variations and posttranslational modifications of NRs and coregulators alter their original function so that they become potent 'drivers' of endometriosis progression.
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Affiliation(s)
- Sang Jun Han
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Bert W O'Malley
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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46
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Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer 2014; 110:1878-90. [PMID: 24518590 PMCID: PMC3974076 DOI: 10.1038/bjc.2014.29] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 12/31/2013] [Accepted: 01/08/2014] [Indexed: 01/06/2023] Open
Abstract
Background: The risk and prognosis of ovarian cancer have not been well established in women with endometriosis. Thus, we investigated the impact of endometriosis on the risk and prognosis for ovarian cancer, and evaluated clinicopathologic characteristics of endometriosis-associated ovarian cancer (EAOC) in comparison with non-EAOC. Methods: After we searched an electronic search to identify relevant studies published online between January 1990 and December 2012, we found 20 case–control and 15 cohort studies including 444 255 patients from 1 625 potentially relevant studies. In the meta-analysis, ovarian cancer risk by endometriosis and clinicopathologic characteristics were evaluated using risk ratio (RR) or standard incidence ratio (SIR), and prognosis was investigated using hazard ratio (HR) with 95% confidence interval (CI). Heterogeneity was evaluated using Higgins I2 to select fixed-effect (I2 ⩽50%) or random effects models (I2>50%), and found no publication bias using funnel plots with Egger's test (P>0.05). Furthermore, we performed subgroup analyses based on study design, assessment of endometriosis, histology, disease status, quality of study and adjustment for potential confounding factors to minimise bias. Results: Endometriosis increased ovarian cancer risk in case–control or two-arm cohort studies (RR, 1.265; 95% CI, 1.214–1.318) and single-arm cohort studies (SIR, 1.797; 95% CI, 1.276–2.531), which were similar in subgroup analyses. Although progression-free survival was not different between EAOC and non-EAOC (HR, 1.023; 95% CI, 0.712–1.470), EAOC was associated with better overall survival than non-EAOC in crude analyses (HR, 0.778; 95% CI, 0.655–0.925). However, progression-free survival and overall survival were not different between the two groups in subgroup analyses. Stage I–II disease, grade 1 disease and nulliparity were more common in EAOC (RRs, 1.959, 1.319 and 1.327; 95% CIs, 1.367–2.807, 1.149–1.514 and 1.245–1.415), whereas probability of optimal debulking surgery was not different between the two groups (RR, 1.403; 95% CI, 0.915–2.152). Furthermore, endometrioid and clear cell carcinomas were more common in EAOC (RRs, 1.759 and 2.606; 95% CIs, 1.551–1.995 and 2.225–3.053), whereas serous carcinoma was less frequent in EAOC than in non-EAOC (RR, 0.733; 95% CI, 0.617–0.871), and there was no difference in the risk of mucinous carcinoma between the two groups (RR, 0.805; 95% CI, 0.584–1.109). These clinicopathologic characteristics were also similar in subgroup analyses. Conclusions: Endometriosis is strongly associated with the increased risk of ovarian cancer, and EAOC shows favourable characteristics including early-stage disease, low-grade disease and a specific histology such as endometrioid or clear cell carcinoma. However, endometriosis may not affect disease progression after the onset of ovarian cancer.
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Affiliation(s)
- H S Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daekak-ro Jongno-gu, Seoul 110-744, Republic of Korea
| | - T H Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daekak-ro Jongno-gu, Seoul 110-744, Republic of Korea
| | - H H Chung
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daekak-ro Jongno-gu, Seoul 110-744, Republic of Korea
| | - Y S Song
- 1] Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daekak-ro Jongno-gu, Seoul 110-744, Republic of Korea [2] Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea [3] Major in Biomodulation, World Class University, Seoul National University, Seoul 151-742, Republic of Korea
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AB S, Srivastava P, Shivaji S. Understanding the pathogenesis of endometriosis through proteomics: Recent advances and future prospects. Proteomics Clin Appl 2013; 8:86-98. [DOI: 10.1002/prca.201200082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 05/31/2013] [Accepted: 06/05/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Siva AB
- Centre for Cellular and Molecular Biology (Council for Scientific and Industrial Research); Hyderabad India
| | - Priyanka Srivastava
- Centre for Cellular and Molecular Biology (Council for Scientific and Industrial Research); Hyderabad India
| | - Sisinthy Shivaji
- Centre for Cellular and Molecular Biology (Council for Scientific and Industrial Research); Hyderabad India
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48
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Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, Oppelt P, Renner SP, Sillem M, Stummvoll W, Schweppe KW. Interdisciplinary S2k Guidelines for the Diagnosis and Treatment of Endometriosis: Short Version - AWMF Registry No. 015-045, August 2013. Geburtshilfe Frauenheilkd 2013; 73:890-898. [PMID: 24771938 PMCID: PMC3975317 DOI: 10.1055/s-0033-1350810] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- U Ulrich
- Klinik für Gynäkologie und Geburtshilfe, Martin-Luther-Krankenhaus, Berlin
| | | | - R Greb
- Kinderwunschzentrum Dortmund, Dortmund
| | - J Keckstein
- Abteilung für Gynäkologie und Geburtshilfe, Landeskrankenhaus, Villach
| | - I von Leffern
- Klinik für Gynäkologie und Geburtshilfe, Albertinen-Krankenhaus, Hamburg
| | - P Oppelt
- Abteilung für Gynäkologie und Geburtshilfe, Landesfrauen- und Kinderklinik, Linz
| | - S P Renner
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - M Sillem
- Praxisklinik am Rosengarten, Mannheim
| | - W Stummvoll
- vormals Abteilung für Gynäkologie, Krankenhaus der Barmherzigen Schwestern, Linz
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Hull ML, Nisenblat V. Tissue and circulating microRNA influence reproductive function in endometrial disease. Reprod Biomed Online 2013; 27:515-29. [PMID: 24055529 DOI: 10.1016/j.rbmo.2013.07.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 07/24/2013] [Accepted: 07/30/2013] [Indexed: 01/15/2023]
Abstract
microRNA (miRNA) have emerged as important epigenetic modulators of gene expression in diverse pathological and physiological processes. In the endometrium, miRNA appear to have a role in the dynamic changes associated with the menstrual cycle, in implantation and in the pathophysiology associated with reproductive disorders such as recurrent miscarriage and endometriosis. This review explores the role of miRNA in endometrial physiology and endometrial disorders of reproduction and also raises the prospect that circulating miRNA may modulate endometrial function or reflect disordered endometrial activity. The clinical potential to use miRNA in diagnostic tests of endometrial function or in the treatment of endometrial disorders will also be discussed.
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Affiliation(s)
- M Louise Hull
- The Robinson Institute, Research Centre for Reproductive Health, University of Adelaide, Australia; The Women's and Children's Hospital, Department of Obstetrics and Gynecology, Adelaide, Australia.
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The 17Beta-Hydroxysteroid Dehydrogenase Type 1 Gene Polymorphism and Endometriosis. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2013. [DOI: 10.5301/je.5000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose Endometriosis is a chronic, painful disease that affects the female genital tract with unknown definite etiology, though there are multiple theories that try to explain its etiology. Genetic causes are suggested in the most widely accepted theories, and this study examined the association between the HSD17B1 gene polymorphism and endometriosis and its severity. Methods Twenty-five patients with clinical suspicion of endometriosis confirmed by laparoscopic examination were admitted to the Gynecology and Obstetrics Department in the Minia University Hospital, and 25 women were enrolled as controls. All subjects underwent genetic analysis for the HSD17B1 gene polymorphism. Results There were significant associations between genotyping analysis of the cases and controls: G/G, A/G and A/A distributions among the cases were 8%, 60% and 32%, respectively, while in controls, they were 60%, 32% and 8%, respectively (p = 0.002, p = 0.05 and p = 0.03, respectively). There were no associations between the HSD17B1 gene polymorphism and severity of endometriosis. Conclusion Genetic analysis of the HSD17B1 gene polymorphism showed it to have an important role in the etiology of endometriosis. Extensive further studies are recommended for further genes that may be associated with endometriosis.
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