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Kleimenova T, Polyakova V, Linkova N, Drobintseva A, Medvedev D, Krasichkov A. The Expression of Kisspeptins and Matrix Metalloproteinases in Extragenital Endometriosis. Biomedicines 2024; 12:94. [PMID: 38255200 PMCID: PMC10813454 DOI: 10.3390/biomedicines12010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Endometriosis is characterized by a condition where endometrial tissue grows outside the uterine cavity. The mechanisms of endometrium growth during endometriosis might be similar to the development of a tumor. The kisspeptin (KISS1) gene was initially discovered as a suppressor of metastasis. Matrix metalloproteinases (MMPs) and their inhibitors are described as factors in the early stages of endometriosis and tumor growth progression. We applied the quantitative polymerase chain reaction and the immunofluorescence method to investigate KISS1, its receptor (KISS1R), MMP-2, and MMP-9 in the eutopic and ectopic endometrium in women with and without endometriosis. We presume that the dysregulation of KISS1 and MMPs might contribute to endometriosis pathogenesis. Samples for the immunofluorescence study were collected from patients with a confirmed diagnosis of endometriosis in stages I-IV, aged 23 to 38 years old (n = 40). The cell line was derived from the endometrium of patients with extragenital endometriosis (n = 7). KISS1 and KISS1R expression are present in the ectopic endometrium of patients with extragenital endometriosis, as opposed to the control group where these proteins were not expressed. There is a decrease in KISS1 and KISS1R values at all stages of endometriosis. MMP-2 and MMP-9 genes express statistically significant increases in stages II, III, and IV of extragenital endometriosis. MMP synthesis increased in the last stages of endometriosis. We suppose that the KISS1/KISS1R system can be used in the future as a suppressive complex to reduce MMP-2 and MMP-9 expression and prevent endometrial cells from invading.
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Affiliation(s)
- Tatiana Kleimenova
- Department of Medical Biology, Federal State Budgetary Educational Institution of Higher Education, St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation, 194100 St. Petersburg, Russia
| | - Victoria Polyakova
- Research Laboratory for the Development of Drug Delivery Systems, St. Petersburg State Research Institute of Phthisiopulmonology, Ministry of Healthcare of the Russian Federation, 2-4, Ligovskiy pr., 191036 St. Petersburg, Russia
| | - Natalia Linkova
- Research Laboratory for the Development of Drug Delivery Systems, St. Petersburg State Research Institute of Phthisiopulmonology, Ministry of Healthcare of the Russian Federation, 2-4, Ligovskiy pr., 191036 St. Petersburg, Russia
- Department of Biogerontology, St. Petersburg Institute of Bioregulation and Gerontology, Dynamo pr., 3, 197110 St. Petersburg, Russia
| | - Anna Drobintseva
- Department of Medical Biology, Federal State Budgetary Educational Institution of Higher Education, St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation, 194100 St. Petersburg, Russia
| | - Dmitriy Medvedev
- Department of Biogerontology, St. Petersburg Institute of Bioregulation and Gerontology, Dynamo pr., 3, 197110 St. Petersburg, Russia
| | - Alexander Krasichkov
- Department of Radio Engineering Systems, Saint Petersburg Electrotechnical University ‘LETI’, 197376 St. Petersburg, Russia
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Ekine AA, Fülöp I, Tekse I, Rúcz Á, Jeges S, Koppán Á, Koppán M. The Surgical Benefit of Hysterolaparoscopy in Endometriosis-Related Infertility: A Single Centre Retrospective Study with a Minimum 2-Year Follow-Up. J Clin Med 2020; 9:E507. [PMID: 32069800 PMCID: PMC7073634 DOI: 10.3390/jcm9020507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 11/25/2022] Open
Abstract
AIM This study examined the fertility performance of women after combined hysterolaparoscopic surgical management of endometriosis. Design: This study is a hospital-based retrospective review. MATERIALS AND METHODS Data collected from the records of all patients presented with endometriosis-related infertility using a checklist designed for the purpose. Result: A total of 81.3% (370/455) of women who have had the desire to have children became pregnant during the study period after the surgery. Of those who became pregnant, all three-hundred-forty-seven patients were followed to the end of their pregnancies. A successful live birth occurred in 94.2% (327/347) of individuals, and pregnancy loss occurred in 5.8% (20/347). The mean patient age was 34.1 ± 4.1 years, and the average duration of infertility was 3.4 ± 3.3 years. Pregnancy occurred spontaneously in 39.5% (146/370) of patients, after artificial insemination (AIH) in 3.8% (14/370) of women, and after in vitro fertilization-embryo transfer (IVF-ET) in 56.8% (210/370) of cases. Patients aged ≤ 35 years had a higher chance of conception post-surgery-84% versus 77%, respectively (p = 0.039). Based on the modes of pregnancy, the timely introduction of an assisted reproductive technique (ART) demonstrated a significant effect on fertility performance postsurgery. Comparatively, this effect was 91.3% vs. 74.1% among the ≤35- and >35-year-old age groups, respectively. There was no significant difference in reproductive performance based on stages of endometriosis, nor in the other parameters evaluated. Conclusion: Our data are consistent with previous clinical studies regarding the management options of endometriosis-related infertility. Overall, the combined hysterolaparoscopy treatment is a very effective and reliable procedure, and is even more effective when combined with ART. It enhances women's wellbeing and quality of life, and significantly improves reproductive performance.
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Affiliation(s)
- Atombosoba Adokiye Ekine
- Department of Obstetrics & Gynaecology, Robert Károly Private Hospital, 1135 Budapest, Hungary; (I.F.); (I.T.); (Á.R.)
| | - István Fülöp
- Department of Obstetrics & Gynaecology, Robert Károly Private Hospital, 1135 Budapest, Hungary; (I.F.); (I.T.); (Á.R.)
| | - István Tekse
- Department of Obstetrics & Gynaecology, Robert Károly Private Hospital, 1135 Budapest, Hungary; (I.F.); (I.T.); (Á.R.)
| | - Árpád Rúcz
- Department of Obstetrics & Gynaecology, Robert Károly Private Hospital, 1135 Budapest, Hungary; (I.F.); (I.T.); (Á.R.)
| | - Sara Jeges
- Faculty of Health Sciences, University of Pécs, 48-as tér 1, 7622 Pécs, Hungary; (S.J.); (Á.K.)
| | - Ágnes Koppán
- Faculty of Health Sciences, University of Pécs, 48-as tér 1, 7622 Pécs, Hungary; (S.J.); (Á.K.)
| | - Miklós Koppán
- Department of Obstetrics & Gynaecology, University of Pécs, 48-as tér 1, 7622 Pécs, Hungary;
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Ren XU, Wang Y, Xu G, Dai L. Effect of rapamycin on endometriosis in mice. Exp Ther Med 2016; 12:101-106. [PMID: 27347023 PMCID: PMC4907216 DOI: 10.3892/etm.2016.3280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 03/14/2016] [Indexed: 12/16/2022] Open
Abstract
The aims of the present study were to investigate the impact of rapamycin (RAPA) on the endometriosis (EMS) lesions in severe combined immunodeficiency (SCID) mice, and to examine the possible mechanism involved in a novel therapy in EMS. Following the successful establishment of an EMS-SCID mouse model, the mice were randomly assigned into the RAPA, control and saline treatment groups. Subsequent to treatment for 2 weeks, the serum hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were detected using ELISA. The levels of HIF-1α and VEGF, as well as the size of EMS lesions, were compared among the three groups. In addition, the HIF-1α, VEGF and CD34 protein expression levels, and the microvessel density (MVD) of the lesions were determined by immunohistochemical analysis. Compared with the control and saline groups, the volume of EMS lesions in the RAPA-treated SCID mice was significantly reduced. Furthermore, the serum level and protein expression of VEGF, and the MVD in the lesions of the RAPA-treated group were significantly reduced when compared with the other two groups. These parameters were comparable in the control and saline groups. In conclusion, RAPA may inhibit the growth of endometriotic lesions, most possibly through the inhibition of the expression of VEGF in lesions, thereby inhibiting angiogenesis.
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Affiliation(s)
- X U Ren
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, P.R. China; Department of Obstetrics and Gynecology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong 510120, P.R. China
| | - Yifeng Wang
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, P.R. China
| | - Gang Xu
- Department of Endocrinology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong 510120, P.R. China
| | - Libing Dai
- Department of Obstetrics and Gynecology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong 510120, P.R. China
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Pellegrino A, Damiani GR, Trio C, Faccioli P, Croce P, Tagliabue F, Dainese E. Robotic Shaving Technique in 25 Patients Affected by Deep Infiltrating Endometriosis of the Rectovaginal Space. J Minim Invasive Gynecol 2015; 22:1287-92. [DOI: 10.1016/j.jmig.2015.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
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Jovanovic AM, Dikic SD, Janković-Raznatovic S, Savija J, Radaković J. The Importance of the Surgical Approach in the Prevention of Recurrence of Endometriosis. J Gynecol Surg 2015. [DOI: 10.1089/gyn.2014.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ana Mitrovic Jovanovic
- Department of Obstetrics and Gynecology, University Clinic of Gynecology and Obstetrics of “Narodni Front,” Beograd, Serbia, and Medical School University of Belgrade, Serbia
| | - Svetlana Dragojevic Dikic
- Department of Obstetrics and Gynecology, University Clinic of Gynecology and Obstetrics of “Narodni Front,” Beograd, Serbia, and Medical School University of Belgrade, Serbia
| | - Svetlana Janković-Raznatovic
- Department of Obstetrics and Gynecology, University Clinic of Gynecology and Obstetrics of “Narodni Front,” Beograd, Serbia, and Medical School University of Belgrade, Serbia
| | - Jelena Savija
- Department of Obstetrics and Gynecology, University Clinic of Gynecology and Obstetrics of “Narodni Front,” Beograd, Serbia, and Medical School University of Belgrade, Serbia
| | - Jovana Radaković
- Department of Obstetrics and Gynecology, University Clinic of Gynecology and Obstetrics of “Narodni Front,” Beograd, Serbia, and Medical School University of Belgrade, Serbia
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Robotic-Assisted Laparoscopy vs Conventional Laparoscopy for the Treatment of Advanced Stage Endometriosis. J Minim Invasive Gynecol 2015; 22:40-4. [DOI: 10.1016/j.jmig.2014.06.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 06/03/2014] [Accepted: 06/04/2014] [Indexed: 11/21/2022]
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Moawad NS, Caplin A. Diagnosis, management, and long-term outcomes of rectovaginal endometriosis. Int J Womens Health 2013; 5:753-63. [PMID: 24232977 PMCID: PMC3825702 DOI: 10.2147/ijwh.s37846] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Rectovaginal endometriosis is the most severe form of endometriosis. Clinically, it presents with a number of symptoms including chronic pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia, and rectal bleeding. The gold standard for diagnosis is laparoscopy with histological confirmation; however, there are a number of options for presurgical diagnosis, including clinical examination, transvaginal/transrectal ultrasound, magnetic resonance imagining, colonoscopy, and computed tomography colonography. Treatment can be medical or surgical. Medical therapies include birth control pills, oral progestins, gonadotropin-releasing hormone agonists, danazol, and injectable progestins. Analgesics are often used as well. Surgery improves up to 70% of symptoms. Surgery is either ablative or excisional, and is conducted via transvaginal, laparoscopic, laparotomy, or combined approaches. Common surgical techniques involve shaving of the superficial rectal lesion, laparoscopic anterior discoid resection, and low anterior bowel resection and reanastomosis. Outcomes are generally favorable, but postoperative complications may include intra-abdominal bleeding, anastomotic leaks, rectovaginal fistulas, strictures, chronic constipation, and the need for reoperation. Recurrence of rectal endometriosis is a possibility as well. Other outcomes are improved pain-related symptoms and fertility. Long-term outcomes vary according to the management strategy used. This review will provide the most recent approaches and techniques for the diagnosis and treatment of rectovaginal endometriosis.
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Affiliation(s)
- Nash S Moawad
- Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Florida, FL, USA
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Rimbach S, Ulrich U, Schweppe KW. Surgical Therapy of Endometriosis: Challenges and Controversies. Geburtshilfe Frauenheilkd 2013; 73:918-923. [PMID: 24771943 DOI: 10.1055/s-0033-1350890] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 02/07/2023] Open
Abstract
Endometriosis is one of the most common disorders encountered in surgical gynaecology. The laparoscopic technique, the planning of the surgical intervention, the extent of information provided to patients and the interdisciplinary coordination make it a challenging intervention. Complete resection of all visible foci of disease offers the best control of symptoms. However, the possibility of achieving this goal is limited by the difficulty of detecting all foci and the risks associated with radical surgical strategies. Thus, the excision of ovarian endometrioma can result in a significant impairment of ovarian function, while damage to nerve structures during resection of the uterosacral ligaments, the parametrium, the rectovaginal septum or the vaginal cuff to treat deep infiltrating endometriosis can lead to serious functional impairments such as voiding disorders. A detailed risk-benefit analysis is therefore necessary, and patients must be treated using an individual approach.
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Affiliation(s)
- S Rimbach
- Gynäkologie und Geburtshilfe, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - U Ulrich
- Klinik für Gynäkologie und Geburtshilfe, Martin-Luther-Krankenhaus, Berlin
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Zheng N, Pan C, Liu W. New serum biomarkers for detection of endometriosis using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. J Int Med Res 2012; 39:1184-92. [PMID: 21986120 DOI: 10.1177/147323001103900406] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study used proteomic fingerprint technology, combining nano-sized magnetic beads with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS), to screen for potential protein biomarkers for the diagnosis of endometriosis. Serum proteins from 126 patients with endometriosis and 120 healthy controls were profiled and compared. Biomarker pattern software identified 46 discriminating mass-to-charge m/z ratio peaks that were related to endometriosis. The model constructed by the software, based on three of these peaks (m/z 5988.7, 7185.3 and 8929.8), generated excellent separation between the endometriosis and control groups. The sensitivity was 91.4% and the specificity 95.0%. Blind testing on a second series of serum samples from patients with endometriosis and healthy controls indicated a sensitivity of 89.3% and a specificity of 90.0%. Biomarkers for endometriosis can be discovered in serum by MALDI-TOF-MS in combination with nano-sized magnetic beads. The pattern of combined markers provides a powerful and reliable diagnostic method for endometriosis, with high sensitivity and specificity.
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Affiliation(s)
- N Zheng
- Department of Gynaecology and Obstetrics, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Abstract
PURPOSE OF REVIEW Rectal endometriosis is a very indolent disease whose treatment has been debated by a range of competing schools. Meanwhile, not all audiences in the scientific community are entirely familiar with the full aspects of the disease. Hence, the purpose of this review is to outline the basic as well as the recent literature pertaining to the disease, thus offering a broader view to the interested reader. RECENT FINDINGS Laparoscopic shaving or disc excision for rectal endometriotic nodules may be simple, safe options of controlling the disease. On the contrary, laparoscopic rectal resections, originally reserved for more extensive disease, are now more skillfully mastered by surgeons and gynecologists. Meta-analyses, retrospective, and prospective studies are being published frequently supporting one form of therapy at a time and discrediting another at other times. SUMMARY Laparoscopic shaving or disc excisions for rectal endometriotic foci or rectal resections are feasible and efficient methods for treating rectal endometriosis. More complex surgery to the bowel means more risk for complications. With the rising learning curve of the operators, laparoscopic rectal resections have become a safe option that should be offered to patients. The patient's preference to a particular treatment option should be central to the type of surgery to be elected.
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Laparoscopic Management of Endometriosis. APOLLO MEDICINE 2010. [DOI: 10.1016/s0976-0016(11)60090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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