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Sharifi Razavi A, Mohajerani F, Niksolat F, Karimi N. Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:327-333. [PMID: 38281082 DOI: 10.1093/pm/pnae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/29/2024]
Abstract
OBJECTIVES Recently, there has been a renewed interest in traditional medicine for carpal tunnel syndrome (CTS). Curcumin has been reported as an agent with antioxidant, anti-inflammatory, analgesic, and neuroprotective attributes. This study is one of the first investigations to assess the effect of curcumin gel on CTS. METHODS This study is a prospective, 8-week, randomized, placebo-controlled, parallel-group clinical trial. A total of 70 patients with CTS were analyzed. The intervention group (n = 35) received a topical curcumin gel and a night wrist splint and the control group (n = 35) received a placebo gel and a night wrist splint for 8 weeks. The primary outcome was the assessment of the symptom severity scale (SSS) and functional status scale (FSS) of the participants using the Boston Carpal Tunnel Questionnaire (BCTQ) after 8 weeks. In addition, all participants were evaluated by electrodiagnostic (EDX) test at baseline and after 8 weeks. RESULTS The mean scores of SSS demonstrated a significant decrease in the curcumin group compared to the placebo group; P-value= 0.021. The mean change score of SSS after the intervention was 12.45 ± 8.18 in curcumin and 3.28 ± 7.06 in the placebo group; P-value = 0.0001 and the mean change score of FSS were 6.24 ± 4.91 and 2.31 ± 4.95 in curcumin and placebo groups, respectively; P-value = 0.002. However, the EDX study showed no significant changes in both groups. CONCLUSIONS It seems that curcumin gel could be effective in the improvement of the symptom severity and daily activity of patients with CTS.
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Affiliation(s)
- Athena Sharifi Razavi
- Department of Neurology, Clinical Research Development Unit of Bou Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, 4815838477, Iran
| | - Fatemeh Mohajerani
- School of Medicine, Clinical Research Development Unit of Bou Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, 4815838477, Iran
| | - Fatemeh Niksolat
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, 4816633131, Iran
| | - Narges Karimi
- Department of Neurology, Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, 4815838477, Iran
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Chiarle G, Allais G, Sinigaglia S, Airola G, Rolando S, Bergandi F, Micalef S, Benedetto C. Acupuncture for pain and pain-related disability in deep infiltrating endometriosis. FRONTIERS IN PAIN RESEARCH 2024; 5:1279312. [PMID: 38524269 PMCID: PMC10957595 DOI: 10.3389/fpain.2024.1279312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Objectives To evaluate the efficacy of acupuncture in relieving symptoms (dysmenorrhea, dyspareunia, pelvic pain and dyschezia) intensity, improving functional disability, reducing the number of days per months of dysmenorrhea, the frequency and the efficacy of analgesic use in deep infiltrating endometriosis (DIE). The safety profile was also evaluated. Methods The study sample was 34 patients with DIE; for 2 months (T-2, T-1) the women recorded diary notes on the numbers of days of menstruation, the presence, intensity, and disability related to dysmenorrhea, dyspareunia, pelvic pain, and dyschezia. They then received a total of 15 acupuncture treatments over 6 months (T1-T6; once a week for 12 weeks, then once a month for 3 months). Results Dysmenorrhea intensity was decreased during treatment. A decrease of at least 50% in number of days of dysmenorrhea, and a decrease in moderate-to-severe disability starting from T1 to T6 was recorded for 58.6% of patients. Dyspareunia intensity steadily decreased starting at T2; the percentage of women with moderate-to-severe disability declined from 73.3% at T-2, to 36.9% at T3, T4, and T5. A decrease in pelvic pain score was noted starting at T1; the percentage of disability decreased from 83.3% at T-2 to 33.3% at T3 and T6. The intensity of dyschezia decreased from T-2 to T3 and T4 and then increased slightly. Analgesic drug use was lower during treatment and its efficacy appeared to be greater. Conclusions The limitations notwithstanding our study-findings show that acupuncture was safe and effective in reducing pain intensity and symptoms-related disability. Larger-scale studies are needed to compare acupuncture and pharmacotherapy for endometriosis-related pain.
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Affiliation(s)
- Giulia Chiarle
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
- Department of Gynaecology and Obstetrics, University of Turin, Turin, Italy
- Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
| | - Gianni Allais
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
- Department of Gynaecology and Obstetrics, University of Turin, Turin, Italy
| | - Silvia Sinigaglia
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
- Department of Gynaecology and Obstetrics, University of Turin, Turin, Italy
| | - Gisella Airola
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
- Department of Gynaecology and Obstetrics, University of Turin, Turin, Italy
| | - Sara Rolando
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
| | - Fabiola Bergandi
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
| | - Salvatore Micalef
- Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Women’s Headache Center, Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
- Gynaecology and Obstetrics Unit, Sant’Anna Hospital, University of Turin, Turin, Italy
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Zhang JC, Zhang HL, Xin XY, Zhu YT, Mao X, Hu HQ, Jin YX, Fan RW, Zhang XH, Ye Y, Li D. Mechanisms of Bushen Tiaoxue Granules against controlled ovarian hyperstimulation-induced abnormal morphology of endometrium based on network pharmacology. J Ovarian Res 2024; 17:25. [PMID: 38279186 PMCID: PMC10811918 DOI: 10.1186/s13048-023-01339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/30/2023] [Indexed: 01/28/2024] Open
Abstract
Bushen Tiaoxue Granules (BTG) is an empirical Chinese herbal formula that has been used for the treatment of subfertility. The protective effect of BTG on controlled ovarian hyperstimulation (COH)-induced impaired endometrial receptivity has been reported in our previous study. This study aims to explore the mechanisms of BTG on ameliorating abnormal morphology of endometrium based on network pharmacology. Active compounds of BTG were identified via the traditional Chinese medicine systems pharmacology and UPLC-MS technology. The SwissTargetPrediction platform and HERB database were used to screen out the putative targets of BTG. Potential targets of endometrial dysfunction caused by COH were obtained from three GEO databases. Through the STRING database, the protein-protein interaction was carried out according to the cross-common targets of diseases and drugs. GO terms and KEGG pathways enrichment analyses were conducted via the Metascape database. AutoDock Vina was used for docking validation of the affinity between active compounds and potential targets. Finally, in vivo experiments were used to verify the potential mechanisms derived from network pharmacology study. A total of 141 effective ingredients were obtained from TCMSP and nine of which were verified in UPLC-MS. Six genes were selected through the intersection of 534 disease related genes and 165 drug potential targets. Enrichment analyses showed that BTG might reverse endometrial dysfunction by regulating adherens junction and arachidonic acid metabolism. Hematoxylin-eosin staining revealed that BTG ameliorated the loose and edematous status of endometrial epithelium caused by COH. The protein expression of FOXO1A, β-Catenin and COX-2 was decreased in the COH group, and was up-regulated by BTG. BTG significantly alleviates the edema of endometrial epithelium caused by COH. The mechanisms may be related to adheren junctions and activation of arachidonic acid metabolism. The potential active compounds quercetin, taxifolin, kaempferol, eriodictyol, and isorhamnetin identified from the BTG exhibit marginal cytotoxicity. Both high and low concentrations of kaempferol, eriodictyol, and taxifolin are capable of effectively ameliorating impaired hESC cellular activity.
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Affiliation(s)
- Jia-Cheng Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Hao-Lin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xi-Yan Xin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yu-Tian Zhu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xin Mao
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Hang-Qi Hu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yu-Xin Jin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Rui-Wen Fan
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xiao-Hui Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China.
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China.
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Shim JY, Laufer MR, King CR, Lee TTM, Einarsson JI, Tyson N. Evaluation and Management of Endometriosis in the Adolescent. Obstet Gynecol 2024; 143:44-51. [PMID: 37944153 DOI: 10.1097/aog.0000000000005448] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/05/2023] [Indexed: 11/12/2023]
Abstract
Endometriosis is a chronic condition, with debilitating symptoms affecting all ages. Dysmenorrhea and pelvic pain often begin in adolescence, affecting school, daily activities, and relationships. Despite the profound burden of endometriosis, many adolescents experience suboptimal management and significant delay in diagnosis. The symptomatology and laparoscopic findings of endometriosis in adolescents are often different than in adults, and the medical and surgical treatments for adolescents may differ from those for adults as well. This Narrative Review summarizes the diagnosis, evaluation, and management of endometriosis in adolescents. Given the unique challenges and complexities associated with diagnosing endometriosis in this age group, it is crucial to maintain a heightened level of suspicion and to remain vigilant for signs and symptoms. By maintaining this lower threshold for consideration, we can ensure timely and accurate diagnosis, enabling early intervention and improved management in our adolescent patients.
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Affiliation(s)
- Jessica Y Shim
- Division of Gynecology, Department of Surgery, Boston Children's Hospital, the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, and the Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts; the Women's Health Institute at Cleveland Clinic, Division of Minimally Invasive Gynecologic Surgery and Medical Gynecology, Cleveland Clinic, Cleveland, Ohio; the Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and Pediatric and Adolescent Gynecology, Division of Gynecologic Specialties, Stanford University School of Medicine, Palo Alto, California
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Jeffrey S, Ashton L, Ferfolja T, Armour M. Transgender and gender diverse people with endometriosis: A perspective on affirming gynaecological care. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241251974. [PMID: 38742674 PMCID: PMC11095187 DOI: 10.1177/17455057241251974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care.
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Affiliation(s)
- Sam Jeffrey
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | | | - Tania Ferfolja
- School of Education, Western Sydney University, Penrith, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
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Yang XC, Liu Y, Sun WW, Shi G, Wu Y, Xu C, Meng QW, Hao ZP, Han Q, Zhao RH. Efficacy of Chinese Herbal Medicines on Pregnancy Outcomes in Patients with Endometriosis in Long-Term Management: A Multicenter Retrospective Cohort Study. Chin J Integr Med 2023; 29:971-979. [PMID: 37118531 DOI: 10.1007/s11655-023-3736-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines (CHMs) can improve pregnancy outcomes in patients with endometriosis in long-term management. METHODS This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019. A total of 252 patients with endometriosis from 5 level-III Grade A hospitals in Beijing were included in this study. Univariate and multivariate logistic regression analysis were performed for the relevant factors. The propensity score matching (PSM) function of SPSS software was used to match the CHMs group with the non-CHMs group. The pregnancy rate and live birth rate were analyzed. RESULTS The results of univariate analysis showed that age, disease course, presence of infertility, presence of adenomyosis, time after surgery or use of gonadotropin-releasing hormone agonist (GnRH-a), use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients (P<0.05). The results of multivariate analysis showed that age, presence of adenomyosis, time after surgery or use of GnRH-a, use of CHMs and follow-up time were independent factors affecting pregnancy in endometriosis patients, among which, age ⩾35 years old, presence of adenomyosis and follow-up time >6 months were independent risk factors (OR=0.445, 0.348, 0.140, respectively, P<0.05), time after surgery or use of GnRH-a ⩽6 months and use of CHMs were independent protective factors (OR=3.839, 3.842, respectively, P<0.05). After PSM, 99 pairs of two groups were matched successfully. The pregnancy rate of the CHMs group was higher than that of the non-CHMs group [55.56% (55/99) vs. 36.36% (36/99), P<0.05]. The live birth rate of the CHMs group was higher than that of the non-CHMs group [49.49% (49/99) vs. 35.35% (35/99), P<0.05]. CONCLUSION CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.
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Affiliation(s)
- Xin-Chun Yang
- Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yong Liu
- Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Wei-Wei Sun
- Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Guang Shi
- Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Ying Wu
- Department of Traditional Chinese Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Cai Xu
- Department of Gynecology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Qing-Wei Meng
- Department of Obstetrics and Gynecology, Beijing Hospital, Beijing, 100730, China
| | - Zeng-Ping Hao
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Qian Han
- Department of Traditional Chinese Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Rui-Hua Zhao
- Department of Gynecology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
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Tassinari V, Smeriglio A, Stillittano V, Trombetta D, Zilli R, Tassinari R, Maranghi F, Frank G, Marcoccia D, Di Renzo L. Endometriosis Treatment: Role of Natural Polyphenols as Anti-Inflammatory Agents. Nutrients 2023; 15:2967. [PMID: 37447296 DOI: 10.3390/nu15132967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Endometriosis is an estrogen-dependent common chronic inflammatory disease defined by the presence of extrauterine endometrial tissue that promotes pelvic pain and fertility impairment. Its etiology is complex and multifactorial, and several not completely understood theories have been proposed to describe its pathogenesis. Indeed, this disease affects women's quality of life and their reproductive system. Conventional therapies for endometriosis treatment primarily focus on surgical resection, lowering systemic levels of estrogen, and treatment with non-steroidal anti-inflammatory drugs to counteract the inflammatory response. However, although these strategies have shown to be effective, they also show considerable side effects. Therefore, there is a growing interest in the use of herbal medicine for the treatment of endometriosis; however, to date, only very limited literature is present on this topic. Polyphenols display important anti-endometriotic properties; in particular, they are potent phytoestrogens that in parallel modulates estrogen activity and exerts anti-inflammatory activity. The aim of this review is to provide an overview on anti-inflammatory activity of polyphenols in the treatment of endometriosis.
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Affiliation(s)
- Valentina Tassinari
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Antonella Smeriglio
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Virgilio Stillittano
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178 Rome, Italy
| | - Domenico Trombetta
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Romano Zilli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178 Rome, Italy
| | - Roberta Tassinari
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Francesca Maranghi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Giulia Frank
- Ph.D. School of Applied Medical-Surgical Sciences, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Daniele Marcoccia
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178 Rome, Italy
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Laura Di Renzo
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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Cho MK, Jin JS, Jo Y, Han JH, Shin S, Bae SJ, Ryu D, Joo J, Park JK, Ha KT. Frankincense ameliorates endometriosis via inducing apoptosis and reducing adhesion. Integr Med Res 2023; 12:100947. [PMID: 37168676 PMCID: PMC10165193 DOI: 10.1016/j.imr.2023.100947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 04/05/2023] Open
Abstract
Background Frankincense, a resin derived from trees of the Boswellia genus, has been used as an incense and a type of herbal medicine for treating inflammatory diseases such arthritis, chronic bowel illness, and asthma. While endometriosis is a well-known inflammatory gynecological illness caused by the ectopic attachment and development of uterine tissue over the menstrual cycle, the impact of frankincense on this illness is poorly understood. The purpose of this study was to explore the effects of frankincense on endometriosis. Methods We used a network pharmacological assessment, in vitro and in vivo investigations with a human endometriotic cell line as well as a syngeneic uterine transfer mouse model. High-performance liquid chromatographic analysis was used to compare water-extracted frankincense (Fr) to its reference compounds and validate the sample. Results A network pharmacological analysis suggested a positive effect of Fr on endometriosis. Fr relieved endometriosis by reducing ectopic endometrial adherence and development, according to both in vivo and in vitro models. We suggested that the ER stress/p53-apoptosis and chemokine-migration/adhesion pathways underlie Fr's anti-endometriotic action using RNA sequencing and bioinformatic analysis. Conclusion This study revealed the potential effect of Fr on endometriosis using an experimental investigation. Fr may have the potential to be an effective and safe treatment for endometriosis.
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Giese N, Heirs MK. Development of Provisional Acupuncture Guidelines for Pelvic Pain in Endometriosis Using an e-Delphi Consensus Process. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:169-180. [PMID: 36454211 PMCID: PMC10039271 DOI: 10.1089/jicm.2022.0659] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction: Growing evidence suggests that acupuncture can improve pelvic pain in women with endometriosis. The treatments used in research vary considerably. It remains unclear which treatment could be recommended for clinical practice. This research project aimed at clarifying how acupuncture could be used when treating this condition. Methods: This research comprised two phases: a systematized literature review to extract acupuncture treatment details from published research, and an e-Delphi study to gain knowledge about details as used by expert acupuncturists. Review: Four databases were searched using predefined eligibility criteria. Data were extracted based on the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) criteria. e-Delphi: Purposeful sampling from colleagues and international experts. An open first round gathered qualitative data, analyzed with the Framework method. In rounds 2 and 3, experts rated statements to build group consensus, defined as a rating of ≥5 on a 7-point Likert scale by ≥70% of the experts. The strength of agreement was graded using the median score and interquartile range. Results from the literature review and the e-Delphi were compared using the STRICTA items. Results: The literature review (n = 29 unique studies) found a wide range of treatment details with little agreement. The e-Delphi of international experts (n = 20) resulted in agreement on 94 statements (such as key factors for effectiveness); disagreement on a further 29 (such as acupressure); and absence of consensus on 55 statements (such as the number of needle insertions). A comparison of the review and e-Delphi results found little agreement. Conclusions: Details of acupuncture treatment for endometriosis-related pelvic pain were presented. In the absence of acupuncture guidelines for this condition, the researchers of this e-Delphi recommend using the treatment details on which experts agreed as guidance for good practice. The effectiveness of these guidelines should be evaluated in future research. Study registration: Deutsches Register Klinischer Studien, DRKS00022215, June 30, 2020, retrospectively registered.
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Affiliation(s)
- Nora Giese
- Department of Advanced Oriental Medicine, Northern College of Acupuncture, York, United Kingdom
- Praxis für Chinesische Medizin, Bonn, Germany
| | - Morag K Heirs
- Department of Advanced Oriental Medicine, Northern College of Acupuncture, York, United Kingdom
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The Multiple Pharmacologic Functions and Mechanisms of Action of Guizhi Fuling Formulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6813421. [PMID: 35529925 PMCID: PMC9076289 DOI: 10.1155/2022/6813421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
Abstract
Objectives Guizhi Fuling Formulation (GZFL), a traditional Chinese medical formulation, consists of Cinnamomi Ramulus, Paeoniae Radix Alba (or Paeoniae Radix Rubra), Moutan Cortex, Persicae Semen, and Poria, with multiple therapeutic functions such as sedation, antitumor activity, anti-inflammation, and neuroprotection. However, its clinical applications remain relatively fragmented, and the underlying mechanisms of GZFL in different diseases are still not very certain. Further research and summary in both application and mechanisms remain to be needed for human health and the best use of GZFL. Therefore, we summarized the multiple pharmacologic effects and possible mechanisms of action of GZFL according to recent 17 years of research. Methods We retrieved four English and two Chinese databases using these keywords (the formulation name or its synonyms) and searched articles written in English from January 2006 up to February 2022. Key Findings. GZFL exhibits multiple pharmacologic advantages in gynecologic diseases and other expanding diseases such as cancer, blood, and vascular disease, renal failure, inflammation, and brain injury. Possibly due to its diverse bioactive components and pharmacologic activities, GZFL could target the multiple signaling pathways involved in regulating blood circulation, inflammatory and immune factors, proliferation, apoptosis, and so on. Conclusion This review suggests that GZFL displays promising therapeutic effects for many kinds of diseases, which have been beyond the scope of the original prescription for gynecologic diseases. In this way, we wish to provide a reference and recommendation for further preclinic and clinic studies.
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Matloobi M, Amini L, Shahali S, Haghani H, Tahermanesh K, Hassanlouei B, Allahqoli L, Alkatout I. Effect of sex education on sexual function and sexual quality of life in women with endometriosis: A quasi-experimental study. Int J Gynaecol Obstet 2022; 159:702-710. [PMID: 35514234 DOI: 10.1002/ijgo.14254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/22/2022] [Accepted: 05/03/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the effect of a sex education program on sexual function and sexual quality of life in women with endometriosis. METHODS In a quasi-experimental study, women with endometriosis who had undergone laparoscopic surgery were assigned to an intervention group (n = 36) or a control group (n = 36). The intervention group received a sex education program consisting of two sessions a week (90 min each) for two consecutive weeks; the control group received none. Both groups were followed for 12 weeks. Sexual function and sexual quality of life were assessed on the Female Sexual Function Index (FSFI) and the Sexual Quality of life-Female (SQOL-F) questionnaire before the intervention, as well as 8 and 12 weeks after the intervention. Outcomes were analyzed using Student t test, the χ2 test, Fisher exact test, and repeated measures analysis of variance. RESULTS The mean age of the study participants was 36.9 ± 5.7 years. The two groups did not differ significantly in terms of demographics and pre-intervention clinical characteristics. At the end of the study, sex education reduced female sexual dysfunction by 58.1% in the intervention group. The mean FSFI score increased significantly in the intervention group from pre-intervention to 8 and 12 weeks post-intervention compared with the scores in the control group (P < 0.001). CONCLUSIONS Sex education appears to be a promising intervention for reducing sexual dysfunction and improving sexual function and sexual quality of life in women with endometriosis. Future studies should encompass longer periods of follow up to obtain further data on the efficacy of sex education in this setting.
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Affiliation(s)
- Maryam Matloobi
- Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amini
- Nursing Care Research Center (NCRC), Department of Midwifery, Reproductive Health, and pregnancy, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shadab Shahali
- Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Kobra Tahermanesh
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Hassanlouei
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany
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12
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Wang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y. Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:1364297. [PMID: 35096102 PMCID: PMC8791705 DOI: 10.1155/2022/1364297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/13/2021] [Indexed: 12/05/2022]
Abstract
Pelvic inflammatory disease (PID), a common infectious disease of the female reproductive tract, is mainly characterized by abdominal/pelvic pain and tenderness of the uterus, cervix, or adnexa on physical exam. In recent years, its incidence has gradually increased yearly due to numerous factors, including sexually transmitted diseases and intrauterine operations. Based on self-report of PID in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 survey, PID impacts approximately 2.5 million women in the US during their reproductive age. Although empiric treatments such as antibiotics or surgery could alleviate the related symptoms of PID, its unsatisfactory obstetric outcome and high relapse bring heavy physical and psychological burden to women. Complementary and alternative medicine (CAM), a complementary therapy other than Western medicine with a complete theoretical and practical system, has been attached to importance in the world due to its remarkable efficacy. More people are accepting and trying to use CAM to treat gynecological diseases, including infertility, polycystic ovary syndrome, and PID, but its efficacy and mechanism are still controversial. This article reviews the previous literature systematically focusing on the effectiveness, safety, and mechanism of CAM in the treatment of PID to provide an evidence-based basis for the clinical application of CAM in patients with PID.
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Affiliation(s)
- Dongmei Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yue Jiang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiaxing Feng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jingshu Gao
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinlan Yu
- Harbin Daoli District People's Hospital, Harbin, China
| | - Jing Zhao
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Pihong Liu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yaguang Han
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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13
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Moini A, Azizlou Z, Hosseini R, Hosseini L. The effect of acetylsalicylic acid on pain and recurrence of endometriosis after surgery: A randomized controlled trial. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2021. [DOI: 10.1177/22840265211049669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Reactive oxygen species (ROS) might increase growth and adhesion of endometrial cells in the peritoneal cavity, and lead to endometriosis. In this study the we evaluate the effect of an antioxidant, acetylsalicylic acid (aspirin), to determine whether aspirin administration to patients with endometriosis would affect pelvic pain and disease recurrence. Material and methods: This randomized controlled trial was conducted from March 2018 to March 2020 on women, 19 to 40 years of age, who were diagnosed with endometriosis after undergoing laparoscopic surgery. Study participants were randomly assigned to one of two groups, Oral contraceptive pills (OCP) and placebo or OCP and aspirin, which were administered daily for 6 months. Pelvic pain, dysmenorrhea, mass size, and menstrual bleeding were evaluated at 3 and 6 months. Results: There were 38 patients in the aspirin group and 49 participants in the placebo group. The mean dysmenorrhea Visual analog scale (VAS) score after 3 months was 2.24 in the aspirin group and 3.61 in the placebo group. After 6 months, the dysmenorrhea VAS scores were 0.68 (aspirin group) and 2.69 (placebo group) ( p = 0.005 and p = 0.00, respectively). Dyspareunia and pelvic pain showed significant reductions ( p = 0.00). Six patients in the control group and four patients in the aspirin group experienced lesion recurrence ( p = 0.45). Conclusion: The results suggest that aspirin, as an antioxidant, could effectively reduce pain in women with endometriosis. However, additional studies that enroll larger numbers of participants and long-term follow up will enable better evaluation of recurrence.
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Affiliation(s)
- Ashraf Moini
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Zahra Azizlou
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Hosseini
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Hosseini
- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
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14
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Polyphenols as a Diet Therapy Concept for Endometriosis-Current Opinion and Future Perspectives. Nutrients 2021; 13:nu13041347. [PMID: 33919512 PMCID: PMC8074087 DOI: 10.3390/nu13041347] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
Endometriosis represents an often painful, estrogen-dependent gynecological disorder, defined by the existence of endometrial glands and stroma exterior to the uterine cavity. The disease provides a wide range of symptoms and affects women’s quality of life and reproductive functions. Despite research efforts and extensive investigations, this disease’s pathogenesis and molecular basis remain unclear. Conventional endometriosis treatment implies surgical resection, hormonal therapies, and treatment with nonsteroidal anti-inflammatory drugs, but their efficacy is currently limited due to many side effects. Therefore, exploring complementary and alternative therapy strategies, minimizing the current treatments’ adverse effects, is needed. Plants are sources of bioactive compounds that demonstrate broad-spectrum health-promoting effects and interact with molecular targets associated with endometriosis, such as cell proliferation, apoptosis, invasiveness, inflammation, oxidative stress, and angiogenesis. Anti-endometriotic properties are exhibited mainly by polyphenols, which can exert a potent phytoestrogen effect, modulating estrogen activity. The available evidence derived from preclinical research and several clinical studies indicates that natural biologically active compounds represent promising candidates for developing novel strategies in endometriosis management. The purpose of this review is to provide a comprehensive overview of polyphenols and their properties valuable for natural treatment strategy by interacting with different cellular and molecular targets involved in endometriosis progression.
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15
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Lin J, Wu D, Jia L, Liang M, Liu S, Qin Z, Zhang J, Han Y, Liu S, Zhang Y. The Treatment of Complementary and Alternative Medicine on Premature Ovarian Failure. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:6677767. [PMID: 33936242 PMCID: PMC8062183 DOI: 10.1155/2021/6677767] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/05/2021] [Indexed: 12/27/2022]
Abstract
It has been confirmed by growing evidence that common hormone replacement therapy is associated with an increasing risk of causing cardiovascular disease and cancer, while complementary and alternative medicine (CAM) is gaining popularity and application in more and more patients with premature ovarian failure (POF). Although there is little data concerning the clinical safety and efficacy of CAM, the literature includes application studies on the phytoestrogen-rich herbal, acupuncture treatment and intervention therapy. This article reviews recent literature on CAM therapy for POF, aiming to provide theoretical support for clinical application.
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Affiliation(s)
- Jing Lin
- Chinese Medicine Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Denghui Wu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Liyan Jia
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mengmeng Liang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Siyu Liu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhen Qin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiao Zhang
- Chinese Medicine Department, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yanhua Han
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Songjiang Liu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuehui Zhang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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16
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Mehdizadeh Kashi A, Niakan G, Ebrahimpour M, Allahqoli L, Hassanlouei B, Gitas G, Alkatout I. A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis. Int J Gynaecol Obstet 2021; 156:124-132. [PMID: 33728657 DOI: 10.1002/ijgo.13677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/26/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare the effects of dienogest and a combined oral contraceptive pill (COCP) after laparoscopic surgery on pain and quality of life in women with severe endometriosis. METHODS A randomized double-blind pilot study was conducted from March 2018 to March 2020 in women with severe endometriosis confirmed by laparoscopic surgery. A total of 108 patients who had undergone laparoscopic surgery received dienogest, COCP, or placebo daily for 6 months. Primary and secondary outcomes were compared between the three groups. RESULTS Treatment with dienogest or COCP was associated with improved self-reported pain after 6 months of treatment, as evidenced by significantly lower scores for pelvic pain and dyspareunia compared with placebo (P < 0.05). Significant differences in overall quality of life score were observed over 6 months in the dienogest, COCP, and placebo groups (mean difference 22.00, 23.45, and 6.45 points, respectively; P < 0.001). Post-hoc analysis revealed a significant difference in overall quality of life score between the placebo group and the dienogest (P < 0.001) and COCP groups (P = 0.004). CONCLUSION Postoperative administration of dienogest or COCP reduced endometriosis-associated pain and improved quality of life in women with severe endometriosis. CLINICAL TRIALS REGISTRATION https://en.irct.ir/trial/43070.
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Affiliation(s)
| | - Gelareh Niakan
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Ebrahimpour
- Department of Psychology, Qaenat Branch, Islamic Azad University, Qaenat, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Hassanlouei
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Georgios Gitas
- Department of Obstetrics and Gynecology, University Hospital Schleswig Holstein, Luebeck, Germany
| | - Ibrahim Alkatout
- Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
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17
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Della Corte L, Noventa M, Ciebiera M, Magliarditi M, Sleiman Z, Karaman E, Catena U, Salvaggio C, Falzone G, Garzon S. Phytotherapy in endometriosis: an up-to-date review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 17:jcim-2019-0084. [PMID: 31532753 DOI: 10.1515/jcim-2019-0084] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/28/2019] [Indexed: 12/11/2022]
Abstract
Endometriosis is a benign gynecological disease which symptoms can provide a severe impact on patient's quality of life with subsequent impact on psychological well-being. Different therapeutic strategies are available to treat this disease, such as surgery, hormonal therapies, and nonsteroidal anti-inflammatory drugs. Nevertheless, the efficacy of conventional medical treatments is limited or intermittent in most of the patients due to the associated side effects. Therefore, a woman with endometriosis often search for additional and alternative options, and phytotherapy might be a promising alternative and complementary strategy. Different medicinal plants, multicomponent herbal preparations, and phytochemicals were investigated for pharmacological proprieties in endometriosis therapy. In most of the cases, the effect on endometriosis was related to phenolic compounds, such as flavonoids and phenolic acids reporting anti-inflammatory, proapoptotic, antioxidant, and immunomodulatory functions. Moreover, some phytochemicals have been related to a strong phytoestrogenic effect modulating the estrogen activity. Although promising, available evidence is based on in vitro and animal models of endometriosis with a limited number of well-performed clinical studies. There are almost none randomized control trials in this area. Therefore, properly constructed clinical trials are mandatory to achieve more conclusive results about the promising role of phytotherapy in the management of endometriosis.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marco Noventa
- Department of Women and Children's Health, Clinic of Gynecology and Obstetrics, University of Padua, Padua, Italy
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Maria Magliarditi
- Department of Obstetrics & Gynaecology, Policlinico Universitario Gazzi, University of Messina, Messina, Italy
| | - Zaki Sleiman
- Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon
| | - Erbil Karaman
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Ursula Catena
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Calogero Salvaggio
- Azienda Sanitaria Provinciale 2 Caltanissetta, "Sant'Elia" Hospital, Caltanissetta, Italy
| | - Giovanni Falzone
- Obstetrics and Gynaecology Unit, "Umberto I" Hospital, Enna, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
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Liu Y, Lu C, Fan L, Wang J, Li T, Liu Z, Sheng J, Qian R, Duan A, Lu D. MiR-199a-5p Targets ZEB1 to Inhibit the Epithelial-Mesenchymal Transition of Ovarian Ectopic Endometrial Stromal Cells Via PI3K/Akt/mTOR Signal Pathway In Vitro and In Vivo. Reprod Sci 2020; 27:110-118. [PMID: 32046378 DOI: 10.1007/s43032-019-00016-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 02/28/2019] [Indexed: 02/06/2023]
Abstract
Endometriosis (Ems) is a common gynecological disease with the characteristics of infertility, pelvic pain, and sexual intercourse difficulty. Our present study aimed to investigate the effect of miR-199a-5p on cell mobility and epithelial-mesenchymal transition (EMT) in Ems. Ectopic endometrial stromal cells (EcSCs) and control endometrial stromal cells (CSCs) were isolated in our in vitro experiments. The level of miR-199a-5p in EcSCs was found much lower than that in CSCs. Besides, miR-199a-5p mimic suppressed the invasion and migration ability of EcSCs. At the same time, EMT was also found to be suppressed by miR-199a-5p mimic in EcSCs. Our further bioinformatics analysis and luciferase reporter assay revealed that ZEB1, a marker of EMT, was a direct target of miR-199a-5p. In addition, the combination of pcDNA3.1-ZEB1 weakened the inhibiting effect of miR-199a-5p mimic on the mobility and EMT of EcSCs. What is more, the PI3K/Akt/mTOR signal pathway was demonstrated to be inactivated by miR-199a-5p mimic. And then, the inducer of PI3K/Akt/mTOR signal pathway, IGF-1, abolished the effect of miR-199a-5p mimic on Ems progression. At last, an Ems rat model was established, and we found that miR-199a-5p agomir effectively suppressed the expression of vascular endothelial growth factor (VEGF) and EMT in vivo. The PI3K/Akt/mTOR signal pathway was also inactivated by miR-199a-5p agomir in our Ems rat model. Taken together, we concluded that miR-199a-5p targeted ZEB1 to inhibit the EMT of ovarian ectopic endometrial stromal cells via PI3K/Akt/mTOR signal pathway in vitro and in vivo, advancing our understanding of miR-199a-5p as regulators of Ems progression and making contribution to the treatment of Ems.
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Affiliation(s)
- Yong Liu
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Chang Lu
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Linyuan Fan
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Jingxuan Wang
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Ting Li
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Zhaohui Liu
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Jie Sheng
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - RuiYa Qian
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Aihong Duan
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China
| | - Dan Lu
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
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Schwartz ASK, Gross E, Geraedts K, Rauchfuss M, Wölfler MM, Häberlin F, von Orelli S, Eberhard M, Imesch P, Imthurn B, Leeners B. The use of home remedies and complementary health approaches in endometriosis. Reprod Biomed Online 2018; 38:260-271. [PMID: 30612955 DOI: 10.1016/j.rbmo.2018.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 10/17/2018] [Accepted: 10/31/2018] [Indexed: 12/13/2022]
Abstract
RESEARCH QUESTION Conventional treatments are often associated with adverse effects and endometriosis pain symptoms may reoccur despite treatment. Consequently, many women use complementary health approaches (CHA) and home remedies (HR) to relieve their pain. The aim of this study was to examine the frequency and the subjectively perceived efficacy of CHA/HR use by women affected by endometriosis. DESIGN Retrospective evaluation using medical charts and a questionnaire. Women recruited in hospitals and in self-help groups were asked about the use of 'topical heat', 'repose/relaxation', 'movement/massages', 'homeopathy/phytotherapy', 'acupuncture/traditional Chinese medicine (TCM)' and 'kinesiology/physiotherapy'. RESULTS From a total of 574 women with a confirmed diagnosis of endometriosis, 359 (62.5%) applied some form of CHA/HR. Women suffering from fatiguing disease symptoms more often selected alternative therapies (odds ratio [OR] 3.14, 95% confidence interval [CI] 1.39-7.11, P = 0.006) compared with women without these characteristics. Furthermore, women dissatisfied with healthcare provided by their treating physician, more frequently (OR 2.30, 95% CI 1.19-4.45, P = 0.013) chose the aforementioned alternative strategies. CONCLUSION As conventional therapies may not be sufficiently effective, women's needs should be closely examined, and individual treatment options should be discussed and initiated by clinicians to provide the best comprehensive treatment possible for endometriosis.
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Affiliation(s)
- Alexandra Sabrina Kohl Schwartz
- University Hospital Zürich, Department of Reproductive Endocrinology, Zürich 8910, Switzerland; University Women's Hospital, Division of Gynecological Endocrinology and Reproductive Medicine, Bern 3010, Switzerland
| | - Elvira Gross
- University Hospital Zürich, Department of Reproductive Endocrinology, Zürich 8910, Switzerland
| | - Kirsten Geraedts
- University Hospital Zürich, Department of Reproductive Endocrinology, Zürich 8910, Switzerland
| | - Martina Rauchfuss
- Charité Berlin, University Hospital, Department of Psychosomatics, Berlin 10117, Germany
| | - Monika Maria Wölfler
- University Hospital Graz, Department of Gynecology and Obstetrics, Graz 8036, Austria
| | - Felix Häberlin
- Canton Hospital St. Gallen, Department of Gynecology and Obstetrics, St. Gallen 9007, Switzerland
| | - Stephanie von Orelli
- Triemli Hospital Zürich, Department of Gynecology and Obstetrics, Zürich 8036, Switzerland
| | - Markus Eberhard
- Canton Hospital Schaffhausen, Department of Gynecology and Obstetrics, Schaffhausen 8208, Switzerland
| | - Patrick Imesch
- University Hospital Zürich, Department of Gynecology, Zürich 8910, Switzerland
| | - Bruno Imthurn
- University Hospital Zürich, Department of Reproductive Endocrinology, Zürich 8910, Switzerland
| | - Brigitte Leeners
- University Hospital Zürich, Department of Reproductive Endocrinology, Zürich 8910, Switzerland.
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20
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Zheng W, Cao L, Xu Z, Ma Y, Liang X. Anti-Angiogenic Alternative and Complementary Medicines for the Treatment of Endometriosis: A Review of Potential Molecular Mechanisms. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:4128984. [PMID: 30402122 PMCID: PMC6191968 DOI: 10.1155/2018/4128984] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 12/16/2022]
Abstract
Endometriosis is caused by the growth or infiltration of endometrial tissues outside of the endometrium and myometrium. Symptoms include pain and infertility. Surgery and hormonal therapy are widely used in Western medicine for the treatment of endometriosis; however, the side effects associated with this practice include disease recurrence and menopause, which can severely influence quality of life. Angiogenesis is the main biological mechanism underlying the development of endometriosis. Numerous natural products and Chinese medicines with potent anti-angiogenic effects have been investigated, and the molecular basis underlying their therapeutic effects in endometriosis has been explored. This review aims to describe natural products and compounds that suppress angiogenesis associated with endometriosis and to assess their diverse molecular mechanisms of action. Furthermore, this review provides a source of information relating to alternative and complementary therapeutic products that mediate anti-angiogenesis. An extensive review of the literature and electronic databases, such as the China National Knowledge Infrastructure, PubMed, and Embase, was conducted using the keywords 'endometriosis,' 'traditional Chinese medicine,' 'Chinese herbal medicine,' 'natural compounds,' and 'anti-angiogenic' therapy. Anti-angiogenic therapy is an emerging strategy for the treatment of endometriosis. Natural anti-angiogenic products and Chinese medicines provide several beneficial clinical effects, including pain relief. In this review, we summarize clinical trials and experimental studies of endometriosis using natural products and Chinese medicines. In particular, we focus on anti-angiogenic products and alternative and complementary medicines for the treatment of endometriosis and additionally examine their therapeutic efficacy and mechanisms of action. Anti-angiogenic natural products and/or compounds provide a new approach for the treatment of endometriosis. Future work will require randomized trials with larger numbers of subjects, as well as long-term follow-up to confirm the findings described here.
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Affiliation(s)
| | - Lixing Cao
- Team of Application of Chinese Medicine in Perioperative Period, Guangdong Provincial Hospital of Chinese Medicine, China
| | - Zheng Xu
- Guangzhou University of Chinese Medicine, China
| | - Yuanyuan Ma
- Department of Gynecology, Anyang Hospital of Traditional Chinese Medicine, China
| | - Xuefang Liang
- Department of Gynecology, Guangdong Provincial Hospital of Chinese Medicine, China
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21
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Abstract
This retrospective study evaluated the effect of neuromuscular electrical stimulation (NMES) for the treatment of endometriosis-associated pain (EAP).A total of 154 patients with EAP were included and were divided into 2 groups in this retrospective study. Eighty-three patients were assigned a treatment group, and underwent NMES therapy, while 71 subjects in the control group were at waiting list. The primary outcome of pain was measured by the numerical rating scale (NRS) and the Endometriosis Symptom Severity scale (ESSS). The secondary outcome was quality of life, measured by the 36-Item Short Form Health Survey (SF-36). All outcomes were measured before and after 5-week and 10-week treatment. Moreover, we also recorded the adverse events in this study.After 5-week treatment, no significant differences in all outcome measurements were found between the 2 groups. However, after 10-week treatment, NMES therapy exerted better outcomes in NRS (P = .02), ESSS (P = .04), and SF-36 [Physical Component Summary (PCS), P < .01; Mental Component Summary (MCS), P < .01], compared with the patients at the waiting list. Moreover, no significant differences of all adverse events were found between the 2 groups, although mild and acceptable adverse events occurred in the treatment group.This study demonstrated that NMES is effective for treating patients with EAP.
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Affiliation(s)
- Xue-ling Bi
- First Ward of Department of Obstetrics and Gynecology, The Yan’an People's Hospital
| | - Cai-xia Xie
- Third Ward of Department of Obstetrics and Gynecology, The Yan’an People's Hospital, Yan’an, China
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Torres-Reverón A, Rivera LL, Flores I, Appleyard CB. Environmental Manipulations as an Effective Alternative Treatment to Reduce Endometriosis Progression. Reprod Sci 2017; 25:1336-1348. [PMID: 29137551 DOI: 10.1177/1933719117741374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Treatments for endometriosis include pharmacological or surgical procedures that produce significant side effects. We aimed to determine how environmental enrichment (EE) could impact the progression of endometriosis using the autotransplantation rat model. Female rats were exposed to EE (endo-EE: toys and nesting materials, 4 rats per cage, larger area enclosure) or no enrichment (endo-NE: 2 rats per cage) starting on postnatal day 21. After 8 weeks, sham surgery or surgical endometriosis was induced by suturing uterine horn tissue next to the intestinal mesentery, then allowed to progress for 60 days during which EE or NE continued. At the time of killing, we measured anxiety behaviors, collected endometriotic vesicles and uterus, and processed for quantitative real-time polymerase chain reaction for corticotropin-releasing hormone (CRH), urocortin-1, CRH receptors type 1 and type 2, and glucocorticoid receptor (GR). Endometriosis did not affect anxiety-like behaviors, yet rats in enriched conditions showed lower basal anxiety behaviors than the nonenriched group. Importantly, the endo-EE group showed a 28% reduction in the number of endometriosis vesicles and the vesicles were significantly smaller compared to the endo-NE group. Endometriosis increased CRH and GR only in the vesicles of endo-NE, and this increase was dampened in the endo-EE. However, urocortin 1 was increased in the vesicles of the endo-EE group, suggesting different pathways of activation of CRH receptors in this group. Our results suggest that the use of multimodal complementary therapies that reduce stress in endometriosis could be an effective and safe treatment alternative, with minimal side effects.
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Affiliation(s)
- Annelyn Torres-Reverón
- 1 Division of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.,2 Department of Biomedical Sciences, Division of Neuroscience, School of Medicine, University of Texas at Rio Grande Valley, Edinburg, TX, USA.,3 Department of Psychiatry and Neurology, School of Medicine, University of Texas at Rio Grande Valley, Edinburg, TX, USA
| | - Leslie L Rivera
- 2 Department of Biomedical Sciences, Division of Neuroscience, School of Medicine, University of Texas at Rio Grande Valley, Edinburg, TX, USA.,3 Department of Psychiatry and Neurology, School of Medicine, University of Texas at Rio Grande Valley, Edinburg, TX, USA
| | - Idhaliz Flores
- 1 Division of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.,4 Department of Obstetrics and Gynecology, School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Caroline B Appleyard
- 1 Division of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.,5 Department of Internal Medicine, School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico
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Jin Z, Huang J, Zhu Z. Baicalein reduces endometriosis by suppressing the viability of human endometrial stromal cells through the nuclear factor-κB pathway in vitro. Exp Ther Med 2017; 14:2992-2998. [PMID: 28912852 PMCID: PMC5585734 DOI: 10.3892/etm.2017.4860] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 03/17/2017] [Indexed: 11/20/2022] Open
Abstract
The aim of the present study was to evaluate the effects of baicalein on human endometrial stromal cells in vitro. Ectopic endometrium samples were obtained from 6 female patients with ovarian endometriosis who underwent laparoscopic surgical procedures from July to September 2015. After culturing the cells, immunocytochemistry was performed to verify the purity and homogeneity of the endometrial stromal cells, and a Cell Counting Kit-8 assay was used to evaluate cell viability. In addition, cell cycle progression was analyzed using flow cytometry, and the effects of baicalein on the expression of B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), proliferating cell nuclear antigen (PCNA) and cyclin D1 in endometrial stromal cells were evaluated using western blot analysis. The related signaling pathways were also investigated by incubating cells with inhibitors of signaling pathways, prior to adding 40 µM baicalein for 48 h, followed by analysis of cell viability using a Cell Counting Kit-8 assay. The results indicated that treatment with baicalein significantly induced a dose-dependent decrease (P<0.05) in the viability of human endometrial stromal cells, which was abolished by inhibition of the nuclear factor (NF)-κB signaling pathway. However, baicalein treatment did not induce a time-dependent decrease in viability, as cell viabilities between the 24, 48 and 72 h treatment groups did not differ significantly. The number of cells in the G0/G1 phase significantly increased following treatment with baicalein (P<0.05), while the number of cells in the S and G2/M phases significantly decreased (P<0.05). Baicalein-treated cells also exhibited significantly reduced expression of Bcl-2, PCNA and cyclin D1 compared with control cells (P<0.05). These results suggested that baicalein may suppress the viability of human endometrial stromal cells through the NF-κB signaling pathway in vitro, and may induce apoptosis and promote cell cycle arrest at the G0/G1 phase. Thus, baicalein may provide a novel treatment option for endometriosis.
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Affiliation(s)
- Zhixing Jin
- Department of Obstetrics and Gynecology, Shanghai Medical College of Fudan University, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai 200011, P.R. China
| | - Jianqin Huang
- Department of Integrated Traditional & Western Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P.R. China
| | - Zhiling Zhu
- Department of Integrated Traditional & Western Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P.R. China
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Identifying Chinese Herbal Medicine Network for Endometriosis: Implications from a Population-Based Database in Taiwan. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7501015. [PMID: 28740539 PMCID: PMC5504931 DOI: 10.1155/2017/7501015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/11/2017] [Accepted: 05/21/2017] [Indexed: 02/07/2023]
Abstract
Background Endometriosis is a common but bothersome gynecological disease, and Chinese herbal medicine (CHM) is used for treating endometriosis. The aim of this study is to explore CHM network and core treatments for endometriosis by analyzing nationwide CHM prescription database. Methods From 1998 to 2013, the CHM prescriptions made primarily for endometriosis among women diagnosed with endometriosis (ICD-9-CM code: 671) by gynecologists during their reproductive age were collected. CHM network analysis was then carried out by using association rule mining and social network analysis. Results A total of 12,986 CHM prescriptions made for endometriosis were analyzed. There were 556 kinds of CHM ever used, and, in average, each prescription was composed of 6.2 CHMs. Gui-Zhi-Fu-Ling-Wan (GZFLW) was used most frequently, followed by Cyperus rotundus (28.1% and 18.8% of all prescriptions, resp.). Additionally, the combination of Cyperus rotundus with GZFLW (8.0%) was the most frequently used combination of two CHMs. CHM network showed that GZFLW was the core CHM for endometriosis and graphically demonstrated the extensive coverage of TCM syndromes and pathogenesis of endometriosis. Conclusions CHM network provides graphical demonstration and summary of commonly used CHMs for endometriosis, and further studies are warranted based on these findings.
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Arnouk A, De E, Rehfuss A, Cappadocia C, Dickson S, Lian F. Physical, Complementary, and Alternative Medicine in the Treatment of Pelvic Floor Disorders. Curr Urol Rep 2017; 18:47. [DOI: 10.1007/s11934-017-0694-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ping-Chong-Jiang-Ni Formula Induces Apoptosis and Inhibits Proliferation of Human Ectopic Endometrial Stromal Cells in Endometriosis via the Activation of JNK Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:6489427. [PMID: 28656053 PMCID: PMC5471564 DOI: 10.1155/2017/6489427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/22/2017] [Accepted: 03/13/2017] [Indexed: 12/19/2022]
Abstract
Endometriosis is a common gynecological condition in childbearing age women and its therapy in modern medicine achieves usually temporary cure. Ping-Chong-Jiang-Ni formula (PCJNF), a Chinese herbal medicine (CHM), was shown to be clinically effective on endometriosis. Meanwhile, c-Jun N-terminal kinase (JNK) signaling pathway was involved in the therapeutic process of CHM on endometriosis. Here, we explored the effect of PCJNF on the ectopic endometrial stromal cells (EESCs) from endometriosis and test whether JNK signaling was involved. After being treated with PCJNF-containing serum obtained from Sprague Dawley rat, cell proliferation, migration, invasion, and apoptosis were evaluated in EESCs, and the total and phosphorylated JNK, ERK, and p38 proteins were detected. Our results showed that PCJNF could suppress cell proliferation, migration, and invasion and induce apoptosis in EESCs. The suppressed proliferation and increased apoptosis were dependent on JNK activation. Additionally, PCJNF caused cell cycle arrest at G2/M phase and this effect was mediated by JNK signaling, while the decreased cell migration and invasion treated by PCJNF were independent of JNK signaling. In summary, our results provided the first evidence that PCJNF could suppress cell proliferation, migration, and invasion, while increasing apoptosis in EESCs, and the suppressed proliferation and enhanced apoptosis were mediated by JNK signaling.
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Buggio L, Barbara G, Facchin F, Frattaruolo MP, Aimi G, Berlanda N. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. Int J Womens Health 2017; 9:281-293. [PMID: 28496368 PMCID: PMC5422563 DOI: 10.2147/ijwh.s119724] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Endometriosis has a multifactorial etiology. The onset and progression of the disease are believed to be related to different pathogenic mechanisms. Among them, the environment and lifestyle may play significant roles. Diet, dietary supplements, physical exercise, osteopathy, massage, acupuncture, transcutaneous electrical nerve stimulation, and Chinese herbal medicine may represent a complementary and feasible approach in the treatment of symptoms related to the disease. In this narrative review, we aimed to examine the most updated evidence on these alternative approaches implicated in the self-management of the disease. In addition, several studies have demonstrated that endometriosis may negatively impact mental health and quality of life, suggesting that affected women may have an increased risk of developing psychological suffering as well as sexual problems due to the presence of pain. In light of these findings, we discuss the importance of integrating psychological interventions (including psychotherapy) and sexual therapy in endometriosis treatment.
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Affiliation(s)
- Laura Buggio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.,Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Giussy Barbara
- Department of Obstetrics and Gynecology and Service for Sexual and Domestic Violence (SVSeD), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico
| | - Federica Facchin
- Faculty of Psychology, Catholic University of Milan, Milan, Italy
| | - Maria Pina Frattaruolo
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.,Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Giorgio Aimi
- Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Nicola Berlanda
- Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
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Steel A, Reid R. A need for a better understanding of the role, value and effectiveness of complementary and integrative medicine for women with endometriosis. ADVANCES IN INTEGRATIVE MEDICINE 2017. [DOI: 10.1016/j.aimed.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tao F, Ruan S, Liu W, Wang L, Xiong Y, Shen M. Fuling Granule, a Traditional Chinese Medicine Compound, Suppresses Cell Proliferation and TGFβ-Induced EMT in Ovarian Cancer. PLoS One 2016; 11:e0168892. [PMID: 28036353 PMCID: PMC5201296 DOI: 10.1371/journal.pone.0168892] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/01/2016] [Indexed: 12/14/2022] Open
Abstract
The compound fuling granule (CFG) is a traditional Chinese drug which has been used to treat ovarian cancer in China for over twenty years. Nevertheless, the underlying molecular mechanism of its anti-cancer effect remains unclear. In this study, microarray data analysis was performed to search differentially expressed genes in CFG-treated ovarian cancer cells. Several cell cycle and epithelial-mesenchymal transition (EMT) related genes were identified. The microarray analyses also revealed that CFG potentially regulates EMT in ovarian cancer. We also found that, functionally, CFG significantly suppresses ovarian cancer cell proliferation by cell cycle arrest, apoptosis and senescence and the AKT/GSK-3β pathway is possibly involved. Additionally, the invasion and migration ability of ovarian cancer induced by TGFβ is significantly suppressed by CFG. In conclusion, our results demonstrated that CFG suppresses ovarian cancer cell proliferation as well as TGFβ1-induced EMT in vitro. Finally, we discovered that CFG suppresses tumor growth and distant metastasis in vivo. Overall, these findings provide helpful clues to design novel clinical treatments against cancer.
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Affiliation(s)
- Fangfang Tao
- Department of Immunology and Microbiology, Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shanming Ruan
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenhong Liu
- Department of Immunology and Microbiology, Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Libin Wang
- Institute of Stem Cell Research, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yang Xiong
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Minhe Shen
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Machado DE, Rodrigues-Baptista KC, Alessandra-Perini J, Soares de Moura R, dos Santos TA, Pereira KG, Marinho da Silva Y, Souza PJC, Nasciutti LE, Perini JA. Euterpe oleracea Extract (Açaí) Is a Promising Novel Pharmacological Therapeutic Treatment for Experimental Endometriosis. PLoS One 2016; 11:e0166059. [PMID: 27851787 PMCID: PMC5113045 DOI: 10.1371/journal.pone.0166059] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/21/2016] [Indexed: 12/23/2022] Open
Abstract
This study investigated the therapeutic potential of Euterpe oleracea extract (açaí) on the growth and survival of endometriotic lesions using an experimental model. Twenty female Sprague-Dawley rats were randomized into two groups after the implantation and establishment of autologous endometrium onto the peritoneum abdominal wall and treated with 200 mg/kg hydroalcoholic solution extract from açaí stone or vehicle via gastric tube for 30 consecutive days. Body weight, lesion surface areas, histological and immunohistochemistry analyses of vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2), metalloproteinase-9 (MMP-9), cyclooxygenase-2 (COX-2) and F4-80 were performed. Levels of VEGF, VEGFR-2, MMP-9 and COX-2 mRNA were measured. Flow cytometry of F4-80 was performed, and ELISA immunoassays measured prostaglandin E2 (PGE2), VEGF and nitric oxide (NO) and concentrations. Macrophage cell line J774.G8 was treated with 10, 20, and 40 μg/mL of açaí for 24, 48 and 72 h, and cell viability was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Açaí treatment significantly decreased the implant size, and histological examination indicated atrophy and regression. A reduction in immunostaining and mRNA expression of VEGF, MMP-9 and COX-2 was observed, and F4-80 was lower in the treated group than the control group. The treated group also exhibited lower concentrations of PGE2, VEGF and NO compared to the control group. Macrophages cells treated with 20 and 40 μg/ml of açaí reduced cell viability in about 50% after 24, 48 and 72 h. Our results suggest that açaí effectively suppressed the establishment and growth of endometriotic lesions, and this agent is a promising novel pharmacological therapeutic treatment for endometriosis.
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Affiliation(s)
- Daniel Escorsim Machado
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
| | - Karina Cristina Rodrigues-Baptista
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
- Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública, Fundação Osvaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Jessica Alessandra-Perini
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
- Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública, Fundação Osvaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Roberto Soares de Moura
- Departamento de Farmacologia e Psicobiologia, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Thiago Alves dos Santos
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
- Programa de Pós-Graduação em Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, RJ, Brasil
| | - Kariny Gomes Pereira
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
| | - Yasmin Marinho da Silva
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
| | | | - Luiz Eurico Nasciutti
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Jamila Alessandra Perini
- Unidade de Farmácia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, RJ, Brasil
- Programa de Pós-Graduação em Saúde Pública e Meio Ambiente, Escola Nacional de Saúde Pública, Fundação Osvaldo Cruz, Rio de Janeiro, RJ, Brasil
- * E-mail:
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Gonçalves AV, Makuch MY, Setubal MS, Barros NF, Bahamondes L. A Qualitative Study on the Practice of Yoga for Women with Pain-Associated Endometriosis. J Altern Complement Med 2016; 22:977-982. [PMID: 27552065 DOI: 10.1089/acm.2016.0021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To understand the meaning women with pain-associated endometriosis attribute to yoga practice regarding their physical and emotional state at the beginning of the practice; pain management by integrating body and mind; secondary benefits of the practice of yoga, such as self-knowledge, self-care, and autonomy; and the role of the yoga group as psychosocial support. DESIGN Qualitative study conducted simultaneously with a randomized clinical trial. SETTING Public university hospital in southeastern Brazil between August 2013 and December 2014. PARTICIPANTS Fifteen women with pain-associated endometriosis who practiced yoga for 8 weeks. INTERVENTION After completing the twice-a-week program, all women participated in a single, semi-structured interview. Interviews were recorded and transcribed verbatim, and thematic analyses were performed. OUTCOME MEASURES The main themes of analysis were women's expectations regarding the practice of yoga, physical and emotional state of women at the beginning of yoga practice, control and pain management through the integration of body and mind, secondary benefits, acquisition of self-knowledge and autonomy, and the role of yoga group as psychosocial support. RESULTS All participants reported that yoga was beneficial to control pelvic pain. They related that they were aware of the integration of body and psyche during yoga practice and that this helped in the management of pain. Women said they had identified a relationship between pain management and breathing techniques (pranayama) learned in yoga and that breathing increased their ability to be introspective, which relieved pain. The participants have developed greater self-knowledge, autonomy, and self-care and have reduced the use of pain and psychiatric medications. They created ties among themselves, suggesting that the yoga group allowed psychosocial support. CONCLUSIONS Bodily and psychosocial mechanisms to control pain were identified in women with endometriosis. To reach such control, it is crucial that mind and body integrative techniques are learned.
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Affiliation(s)
| | - Maria Y Makuch
- 1 Department of Obstetrics and Gynecology, University of Campinas Medical School , Campinas, São Paulo, Brazil
| | - Maria Silvia Setubal
- 1 Department of Obstetrics and Gynecology, University of Campinas Medical School , Campinas, São Paulo, Brazil
| | - Nelson Filice Barros
- 2 Department of Collective Health, University of Campinas Medical School , Campinas, São Paulo, Brazil
| | - Luis Bahamondes
- 1 Department of Obstetrics and Gynecology, University of Campinas Medical School , Campinas, São Paulo, Brazil
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Fisher C, Adams J, Hickman L, Sibbritt D. The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: a cross-sectional study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:129. [PMID: 27189381 PMCID: PMC4870787 DOI: 10.1186/s12906-016-1119-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/13/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. METHODS Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. RESULTS The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p < 0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p < 0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p < 0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p < 0.05). CONCLUSIONS There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life.
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Greene AD, Lang SA, Kendziorski JA, Sroga-Rios JM, Herzog TJ, Burns KA. Endometriosis: where are we and where are we going? Reproduction 2016; 152:R63-78. [PMID: 27165051 DOI: 10.1530/rep-16-0052] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 05/09/2016] [Indexed: 12/25/2022]
Abstract
Endometriosis currently affects ~5.5 million reproductive-aged women in the U.S. with symptoms such as painful periods (dysmenorrhea), chronic pelvic pain, pain with intercourse (dyspareunia), and infertility. It is defined as the presence of endometrial tissue outside the uterine cavity and is found predominately attached to sites within the peritoneal cavity. Diagnosis for endometriosis is solely made through surgery as no consistent biomarkers for disease diagnosis exist. There is no cure for endometriosis and treatments only target symptoms and not the underlying mechanism(s) of disease. The nature of individual predisposing factors or inherent defects in the endometrium, immune system, and/or peritoneal cavity of women with endometriosis remains unclear. The literature over the last 5 years (2010-2015) has advanced our critical knowledge related to hormones, hormone receptors, immune dysregulation, hormonal treatments, and the transformation of endometriosis to ovarian cancer. In this review, we cover the aforementioned topics with the goal of providing the reader an overview and related references for further study to highlight the progress made in endometriosis research, while concluding with critical areas of endometriosis research that are urgently needed.
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Affiliation(s)
- Alexis D Greene
- Department of Obstetrics and GynecologyUniversity of Cincinnati Center for Reproductive Health, Cincinnati, Ohio, USA
| | - Stephanie A Lang
- Department of Environmental HealthUniversity of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jessica A Kendziorski
- Department of Environmental HealthUniversity of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Julie M Sroga-Rios
- Department of Obstetrics and GynecologyUniversity of Cincinnati Center for Reproductive Health, Cincinnati, Ohio, USA
| | - Thomas J Herzog
- Department of Obstetrics and GynecologyUniversity of Cincinnati Center for Reproductive Health, Cincinnati, Ohio, USA University of Cincinnati Cancer InstituteUniversity of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Katherine A Burns
- Department of Environmental HealthUniversity of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Abstract
Introduction Endometriosis is a multifactorial, estrogen-dependent, inflammatory gynecological condition – often with long-lasting visceral pelvic pain of different origin, and infertility among women. Current management options for patients’ are often inadequate, with side effects for many for whom acupuncture techniques could be an alternative. Earlier studies have discussed the efficacy of acupuncture, but not its methodological aspects. Objectives To summarize the documented clinical effects of acupuncture on rated visceral pelvic endometriosis-related pain, and associated variables among individuals, within and between studied groups, and to discuss the methodological treatment aspects. Methods Published full text clinical studies, case reports, and observational studies with abstracts written in English were searched by using the keywords “Acupuncture and Endometriosis” in databases such as PubMed, Web of Science, and CINAHL. The reporting guidelines, Standards for Reporting Interventions in Clinical Trials of Acupuncture was used for the methodological report. Results Three studies were found including 99 women, 13–40 years old, with diagnosed endometriosis. The studies were different in research design, needle stimulation techniques, and evaluation instruments. Methodological similarities were seven to12 needle insertions per subject/session, and 15–25 minutes of needle retention time. The needles were placed in lower back/pelvic-abdominal area, in the shank, feet, and hands. Treatment numbers varied from nine to 16 and patients received one to two treatments per week. Similarity in reported treatment effects in the quoted studies, irrespective of research design or treatment technique, was reported decrease of rated pain intensity. Discussion Meta-analysis is the standard procedure for the evaluation of evidence of treatment effects, ie, on a group level, usually without analysis of the individual responses even with obvious spread in the results leading to lack of guidance for treatment of the individual patient. By conceptualizing pain as subjective, the individual aspect should serve as the basis for the analysis to allow clinical recommendations. From a physiological and a western medical perspective, acupuncture can be regarded as a type of sensory stimulation that induces changes in the function of the central nervous system that partly can explain the decrease of perceived pain in response to acupuncture treatment irrespective of the technique. Conclusion Endometriosis is often painful, although with various origin, where standard treatments may be insufficient or involve side effects. Based on the reported studies, acupuncture could be tried as a complement as it is an overall safe treatment. In the future, studies designed for evaluating effectiveness between treatment strategies rather than efficacy design would be preferred as the analyses of treatment effects in the individual patients.
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Affiliation(s)
- Iréne Lund
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Lundeberg
- Rehabilitation Medicine University Clinic Stockholm, Danderyds Hospital AB, Stockholm, Sweden
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Reinstein AS, Erickson LO, Griffin KH, Rivard RL, Kapsner CE, Finch MD, Dusek JA. Acceptability, Adaptation, and Clinical Outcomes of Acupuncture Provided in the Emergency Department: A Retrospective Pilot Study. PAIN MEDICINE 2016; 18:169-178. [PMID: 26917627 DOI: 10.1093/pm/pnv114] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective To evaluate acceptability and clinical outcomes of acupuncture on patient-reported pain and anxiety in an emergency department (ED). Design Observational, retrospective pilot study. Setting Abbott Northwestern Hospital ED, Minneapolis, MN. Methods Retrospective data was used to identify patients receiving acupuncture in addition to standard medical care in the ED between 11/1/13 and 12/31/14. Feasibility was measured by quantifying the utilization of acupuncture in a novel setting and performing limited tests of its efficacy. Patient-reported pain and anxiety scores were collected by the acupuncturist using an 11-point (0-10) numeric rating scale before (pre) and immediately after (post) acupuncture. Efficacy outcomes were change in pain and anxiety scores. Results During the study period, 436 patients were referred for acupuncture, 279 of whom were approached by the acupuncturist during their ED visit. Consent for acupuncture was obtained from 89% (248/279). A total of 182 patients, who had a pre-pain score >0 and non-missing anxiety scores, were included in analyses. Of the 52% (94/182) who did not have analgesics before or during the acupuncture session, the average decrease of 2.37 points (95% CI: 1.92, 2.83) was not different (p > 0.05) than the mean decrease of 2.68 points for those receiving analgesics (95% CI 2.21, 3.15). The average pre-anxiety score was 4.73 points (SD = 3.43) and the mean decrease was 2.27 points (95% CI: 1.89, 2.66). Conclusions Results from this observational trial indicate that acupuncture was acceptable and effective for pain and anxiety reduction, in conjunction with standard medical care. These results will inform future randomized trials.
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Affiliation(s)
- Adam S Reinstein
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Lauren O Erickson
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | | | - Michael D Finch
- Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
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Hashempur MH, Lari ZN, Ghoreishi PS, Daneshfard B, Ghasemi MS, Homayouni K, Zargaran A. A pilot randomized double-blind placebo-controlled trial on topical chamomile (Matricaria chamomilla L.) oil for severe carpal tunnel syndrome. Complement Ther Clin Pract 2015; 21:223-8. [PMID: 26573447 DOI: 10.1016/j.ctcp.2015.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/02/2015] [Accepted: 08/07/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the effectiveness of standardized topical Chamomile (Matricaria chamomilla L.) oil in patients with severe carpal tunnel syndrome, as a complementary treatment. METHOD A pilot randomized double-blind placebo-controlled trial was conducted. Twenty six patients with documented severe carpal tunnel syndrome were treated in two parallel groups with a night splint plus topical chamomile oil or placebo. They were instructed to use their prescribed oil for 4 weeks, twice daily. Symptomatic and functional status of the patients and their electrodiagnostic parameters were evaluated when enrolled and after the trial period, as our outcome measures. RESULTS A significant improvement of symptomatic and functional status of patients in the chamomile oil group was observed (p = 0.019 and 0.016, respectively) compared with those in the placebo group. However, electrodiagnostic parameters showed no significant changes between the two groups. CONCLUSION Chamomile oil improved symptomatic and functional status of patients with severe carpal tunnel syndrome.
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Affiliation(s)
- Mohammad Hashem Hashempur
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Department of Traditional Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Zeinab Nasiri Lari
- Department of Traditional Persian Medicine, School of Traditional Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parissa Sadat Ghoreishi
- Department of Traditional Persian Medicine, School of Traditional Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Daneshfard
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Kaynoosh Homayouni
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Arman Zargaran
- Pharmaceutical Sciences Research Center and Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Research Office for the History of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Endometrial ILKAP expression among patients with endometriosis and its association with clinical characteristics. Int J Gynaecol Obstet 2015; 130:23-6. [PMID: 25872452 DOI: 10.1016/j.ijgo.2015.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/07/2015] [Accepted: 03/23/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate expression of ILKAP among women with endometriosis and its association with clinical characteristics. METHODS A retrospective study was conducted at a center in China in 2012, using samples of ectopic (n=55) and eutopic (n=33) endometrium from women with endometriosis, and control endometrium samples (n=33) from women without endometriosis. Information on clinical characteristics was obtained from records. The expression of ILKAP was tested by immunohistochemistry. RESULTS The expression of ILKAP was higher in the secretory phase of the menstrual cycle than in the proliferative phase, and it was lower in eutopic and ectopic endometriosis tissue than in control endometrium (P<0.001 for both). A lower expression of ILKAP in ectopic endometrium was associated with moderate-to-severe dysmenorrhea, infertility for more than 1year, a cancer antigen 125 level of more than 35 U/mL, a disease duration of at least 1year, and American Fertility Society grade IV disease (P<0.05 for all). CONCLUSION A low level of ILKAP could facilitate the pathogenesis of endometriosis. Additionally, the level of ILKAP expression in ectopic endometrium might reflect the severity of endometriosis.
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Xu X, Zheng Q, Zhang Z, Zhang X, Liu R, Liu P. Periostin Enhances Migration, Invasion, and Adhesion of Human Endometrial Stromal Cells Through Integrin-Linked Kinase 1/Akt Signaling Pathway. Reprod Sci 2015; 22:1098-106. [DOI: 10.1177/1933719115572481] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Xiaoxuan Xu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Qiaomei Zheng
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zongzheng Zhang
- Department of Orthopedics, Taishan Medical University, Tai’an, Shandong, China
| | - Xiaolei Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Ruihan Liu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Peishu Liu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Effect of GuiXiong Xiaoyi Wan in Treatment of Endometriosis on Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:208514. [PMID: 25691906 PMCID: PMC4322821 DOI: 10.1155/2015/208514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/03/2015] [Accepted: 01/08/2015] [Indexed: 12/31/2022]
Abstract
Objective. To evaluate the effect of GuiXiong Xiaoyi Wan (GXXYW) on the development of endometriosis in a rat model. Methods. Sprague-Dawley rats with surgically induced endometriosis were randomly treated with low-dose GXXYW, high-dose GXXYW, or vehicle (negative control) for 28 days. Immunohistochemistry was used to assess cell proliferation in the lesions. The terminal deoxynucleotidyl transferase- (TdT-) mediated dUTP biotin nick end labelling (TUNEL) method was performed to analyse the apoptosis induced by GuiXiong Xiaoyi Wan. The percentages of CD3+ lymphocytes, CD4+ lymphocytes, and CD8+ lymphocytes in the spleens of the rats were evaluated using flow cytometric analysis. Results. Treatment with GXXYW significantly decreased the lesion size, inhibited cell proliferation, and induced apoptosis in endometriotic tissue. The spleens of GXXYW-treated rats also demonstrated a significant increase in the percentage of CD4+ lymphocytes and a significant decrease in the percentage of CD8+ lymphocytes. Conclusions. These results suggest that, in a rat model, GXXYW may be effective in the suppression of the growth of endometriosis, possibly through the inhibition of cell proliferation, the induction of apoptosis of endometriotic cells, and the regulation of the immune system.
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