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J Altern Complement Med. 2011 Aug;17(8):691-9. Epub 2011 Jul 18.

A feasibility study exploring the role of chinese herbal medicine in the treatment of endometriosis.

Flower A, Lewith GT, Little P.

Source

Department of Primary Medical Care, University of Southampton , Southampton, United Kingdom .

Abstract

Abstract Background: Endometriosis is a common and disabling gynecologic condition affecting between 5% and 15% of women of childbearing age. Conventional medical intervention has unpleasant side-effects, and symptoms frequently return after treatment. Preliminary evidence suggests Chinese herbal medicine (CHM) may contribute to the treatment of endometriosis. Objectives: The aims of this study were to test the feasibility of a novel methodology for investigating individualized decoctions of CHM rigorously and to gather preliminary data on the treatment effect of CHM for a larger definitive trial. Design: This was a 16-week prospective, double blinded, randomized controlled trial of 40 women with laparoscopically confirmed endometriosis. Settings: The trial was conducted at a private CHM clinic in Hove (U.K.) and at a National Health Service outpatient clinic in London (U.K.). Interventions: Participants were initially randomized to either wait-list control (WLC) or treatment groups to receive either individualized CHM decoctions or a therapeutically inert placebo decoction. Outcome measures: Four 10-cm visual analogue scales (VAS) were used to measure menstrual pain, daily pain, and pain on intercourse and bowel movement; these measurements were recorded weekly. The Endometriosis Health Profile-30 (EHP-30) endometriosis-specific quality-of-life questionnaire was completed at the beginning and at the end of the trial. The Measure Yourself Medical Outcomes Profile (MYMOP) a patient-centered health questionnaire was completed monthly. Liver and renal function was measured at 0, 4, 8, and 16 weeks. Results: Twenty-eight (28) women completed the trial. High dropout rates led to the suspension of the WLC. Randomization, double blinding, and allocation concealment was achieved successfully. Adjusted mean differences favored the active treatment in the EHP-30 and MYMOP scores. VAS scores favored the active treatment for relief of menstrual pain and the placebo group for reduction of daily pain. Conclusions: the methodology successfully allowed individualized CHM decoctions to be tested rigorously. There are nonspecific contextual effects from CHM that require further investigation. Provisional data were generated to warrant a larger, more-definitive study.

Eur J Obstet Gynecol Reprod Biol. 2011 Jul 14. [Epub ahead of print]

Combination of polymorphisms in luteinizing hormone β, estrogen receptor β and progesterone receptor and susceptibility to infertility and endometriosis.

Christofolini DM, Vilarino FL, Mafra FA, André GM, Bianco B, Barbosa CP.

Source

Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, SP, Brazil.

Abstract

OBJECTIVES:

To determine whether the combination of PR (PROGINS), ERβ G+1730A and/or LHβ G1502A polymorphisms in infertile women with and without endometriosis and in a control group increases the risk of infertility and/or endometriosis.

STUDY DESIGN:

Case-control study including 201 infertile women with endometriosis, 80 infertile women without endometriosis and 206 fertile women as control group. PROGINS was identified by PCR (polymerase chain reaction) and ERβ G+1730A and LHβ G1502A were identified by PCR-RFLP (restriction fragment length polymorphism).

RESULTS:

A statistically significant difference was found for the combination of LHβ+ERβ polymorphisms among infertile patients with endometriosis and control group (p=0.003, OR=2.468), among infertile patients with endometriosis I/II and control group (p=0.002, OR=3.081), among infertile patients with endometriosis III/IV and control group (p=0.035, OR=2.136) and for the combination of LHβ+PROGINS polymorphisms among infertile patients with endometriosis I/II and control group (p=0.014, OR=3.081). However, the odds of developing endometriosis are not enhanced in the presence of the two polymorphisms, being similar to the odds when only LH polymorphism is present.

CONCLUSIONS:

Individually, the presence of LHβ G1502A and ERβ G+1730A polymorphisms is associated with infertility and endometriosis associated infertility. However, when two polymorphisms are present in the same individual it does not appear to increase the chance of developing endometriosis or infertility.

Reprod Biomed Online. 2011 Jun 15. [Epub ahead of print]

Complete surgical removal of minimal and mild endometriosis improves outcome of subsequent IVF/ICSI treatment.

Opøien HK, Fedorcsak P, Byholm T, Tanbo T.

Source

Norwegian Resource Centre for Women’s Health, Oslo University Hospital Rikshospitalet, Box 4950 Nydalen, 0424 Oslo, Norway; Section of Reproductive Medicine, Department of Gynaecology, Oslo University Hospital Rikshospitalet, Box 4950 Nydalen, 0424 Oslo, Norway.

Abstract

Surgical eradication of minimal and mild endometriosis has been shown to increase the birth rate both spontaneously and after intrauterine insemination. This study from a reproductive medicine unit at a referral university hospital examined whether surgical eradication of minimal and mild endometriosis prior to IVF improved the treatment outcome. Records of infertile patients with minimal and mild endometriosis (American Society for Reproductive Medicine stages I and II) with no prior IVF/intracytoplasmic sperm injection (ICSI) treatments were analysed. During the first treatment cycle, women who had undergone complete removal (n=399) of endometriotic lesions experienced, compared with women with diagnostic laparoscopy only (n=262), a significantly improved implantation rate (30.9% versus 23.9%, P=0.02), pregnancy rate (40.1% versus 29.4%, P=0.004) and live-birth rate per ovum retrieval (27.7% versus 20.6%, P=0.04). Surgical removal of minimal and mild endometriotic lesions also gave shorter time to first pregnancy and a higher cumulative pregnancy rate. The study shows that women with stages I and II endometriosis undergoing IVF/ICSI have significantly shorter time to pregnancy and higher live-birth rate if all visible endometriosis is completely eliminated at the time of diagnostic surgery. Surgical elimination of minimal and mild endometriosis has been shown to increase the birth rate both spontaneously and after intrauterine insemination. In this study from a reproductive medicine unit at a referral university hospital, we examined whether surgical elimination of minimal and mild endometriosis prior to IVF improved the outcome of this treatment as well. During the first IVF treatment cycle, women who had undergone complete surgical removal of endometriosis experienced, compared with women who still had their endometriosis, an improved rate of embryo implantation, pregnancy rate and live birth rate per ovum retrieval. Surgical removal of minimal and mild endometriotic lesions also gave shorter time to first pregnancy and a higher cumulative pregnancy rate. In summary, our study shows that women with minimal and mild endometriosis undergoing IVF have shorter time to pregnancy and higher live-birth rate if all visible endometriosis is completely eliminated before the start of treatment.

Placenta. 2011 Jul 15. [Epub ahead of print]

Surgical measures for endometriosis-related infertility: A plea for research.

Somigliana E, Benaglia L, Vigano’ P, Candiani M, Vercellini P, Fedele L.

Source

Dept Obset/Gynecol, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy.

Abstract

The precise relationship between endometriosis and infertility is debated. Surgery is considered to play a role within the framework of the therapeutic options to cure infertile women with the disease even though its effectiveness is generally modest. In fact, there is unquestionably the need to improve surgical techniques in this area. Specifically, two main aspects require optimization: 1) preventing the injury to the follicular reserve that follows surgical excision of ovarian endometriomas and 2) preventing post-surgical formation and re-formation of adhesions. The comparison between the excision/stripping and the vaporization/coagulation techniques represents the main point of debate on what is the best procedure to remove ovarian endometrioma. Randomized controlled trials showed that the excision technique is associated with a higher pregnancy rate and a lower rate of recurrence although it may determine severe injury to the ovarian reserve. Improvements to this latter aspect may be represented by a combined excisional-vaporization technique or by replacing diathermy coagulation with surgical ovarian suture. Barrier agents reduce but not eliminate the post-surgical adhesion formation in women with endometriosis. Encouraging evidence has been reported with Interceed, Oxiplex/AP gel and Adept solution. However, available studies are mainly based on II look laparoscopies performed few weeks after the intervention and data on fertility is lacking. Clinical trials including pregnancy rate as a specific outcome are warranted.

Fertil Steril. 2011 Jul 15. [Epub ahead of print]

TAGLN expression is deregulated in endometriosis and may be involved in cell invasion, migration, and differentiation.

Dos Santos Hidalgo G, Meola J, Rosa E Silva JC, Paro de Paz CC, Ferriani RA.

Source

Department of Gynecology and Obstetrics, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.

Abstract

We found an increased expression of the TAGLN gene in endometriotic lesions compared with the eutopic endometrium of the same patients by real-time polymerase chain reaction. It is possible that this deregulation contributes to the development and maintenance of endometriosis by being involved in the pathways of organization of cytoskeletal architecture.

Fertil Steril. 2011 Jul 13. [Epub ahead of print]

Interleukin-1β induces cyclooxygenase-2 expression and promotes the invasive ability of human mesenchymal stem cells derived from ovarian endometrioma.

Kao AP, Wang KH, Long CY, Chai CY, Tsai CF, Hsieh TH, Hsu CY, Chang CC, Lee JN, Tsai EM.

Source

Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

OBJECTIVE:

To elucidate the role of interleukin-1β (IL-1β) on cyclooxygenase-2 (COX-2) expression and invasion of endometrioma-derived ectopic endometrial mesenchymal stem cells (EN-MSCs) and to develop an organoid method to study the invasive ability of endometrial cells.

DESIGN:

Gene expression and cell functions.

SETTING:

Kaohsiung Medical University, Kaohsiung, Taiwan.

PATIENT(S):

Human eutopic and endometrioma-derived ectopic EN-MSCs were isolated from different endometrium biopsy samples after surgery for treatment of endometriosis.

INTERVENTION(S):

Chemical treatment of cell culture.

MAIN OUTCOME MEASURE(S):

Comparative analysis of genomewide messenger RNA (mRNA) expression, cell migration, and invasion abilities in cell culture and organoid culture.

RESULT(S):

Gene expression profiles revealed that the expression of IL-1β and COX-2 were statistically significantly higher in ectopic EN-MSCs compared with eutopic EN-MSCs. These enhanced expressions coincided with a greater ability for cell migration and invasion in ectopic EN-MSCs and were found to be distinctly regulated by IL-1β which up-regulates COX-2 expression. Furthermore, IL-1β treatment of ectopic EN-MSCs in organoids was found to induce tentacle-like structures that mimicked cell invasion.

CONCLUSION(S):

These results indicate that COX-2 and IL-1β regulate the invasion ability of ectopic EN-MSCs. The information may be useful for developing a new therapeutic strategy for endometriosis. The ex vivo invasion model will be useful for characterization of EN-MSCs.

Fertil Steril. 2011 Jul 13. [Epub ahead of print]

How can macroscopically normal peritoneum contribute to the pathogenesis of endometriosis?

Fassbender A, Overbergh L, Verdrengh E, Kyama CM, Vodolazakaia A, Bokor A, Meuleman C, Peeraer K, Tomassetti C, Waelkens E, Mathieu C, D’Hooghe T.

Source

Leuven University Fertility Centre, Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium.

Abstract

This study indicates that the immunobiology of macroscopically normal peritoneum is relevant to understand the pathogenesis of endometriosis. Peritoneal interleukin 6, interleukin 12, and ferritin were differentially expressed in women with and without endometriosis.

Fertil Steril. 2011 Jul 14. [Epub ahead of print]

Reply of the Authors.

Yeung P Jr, Sinervo K, Winer W, Albee RB Jr.

Source

St. Louis University Center for Endometriosis, Department of Obstetrics, Gynecology & Women’s Health, St. Louis University, St. Louis, Missouri.

Fertil Steril. 2011 Jul 14. [Epub ahead of print]

Does complete laparoscopic excision of endometriosis in teenagers really occur?

Laufer MR, Missmer SA.

Source

Division of Gynecology, Department of Surgery, Children’s Hospital Boston, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, Division of Reproductive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.

Zhonghua Yi Xue Za Zhi. 2011 May 10;91(17):1207-10.

Culture and identification of fibroblast from human endometriosis.

[Article in Chinese]

Ouyang Z, Liang YJ, Zhang WY, Lu D.

Source

Department of Gynecology, Beijing Obstetrics & Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Abstract

OBJECTIVE:

To establish the model of cultivating and identifying fibroblast from human endometriosis (HEFC) in vitro.

METHODS:

The tissues of human endometriotic cysts of ovary were digested by collagenases I, II and IV The resulting cells were purified by centrifugation and differential adhesion. HEFC was identified by observing the morphologic changes under an inverted microscope and the expressions of vimentin, α-SMA (α-smooth muscle actin) and keratin were detected by immunocytochemistry.

RESULTS:

Immunohistochemical staining of vimentin was positive, α-SMA rarely positive and keratin completely negative in cultured fibroblasts. HEFC grew as a confluent monolayer of short fat fusiform, triangular, star-shaped and polygonal fiber-like cells. Furthermore HEFC could be well sub-cultured.

CONCLUSION:

Acquired fibroblast can be cultured in vitro stably. It is quite important to study the specificities of HEFC. Sufficient and reliable target cells may be obtained for studying the mechanisms of fibrosis and adhesion in endometriosis at the molecular level.

Curr Pain Headache Rep. 2011 Jul 14. [Epub ahead of print]

Endometriosis and Abdominal Myofascial Pain in Adults and Adolescents.

Jarrell J.

Source

Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada, T2N 2T9, john.jarrell@albertahealthservices.ca.

Abstract

Endometriosis and myofascial pain are common disorders with significant impact on quality of life. Increasingly, these conditions are being recognized as highly interconnected through processes that have been described for more than a century. This review is directed to this interconnection through a description of the relationships of endometriosis to proposed mechanisms of pain and chronic pain physiology; the clinical assessment of myofascial representations of this pain; and an approach to the management of these interconnected disorders.

Genet Mol Res. 2011 Jul 6;10(3):1364-70.

Polymorphism of the progesterone receptor gene associated with endometriosis in patients from Goiás, Brazil.

Costa IR, Silva RC, Frare AB, Silva CT, Bordin BM, Souza SR, Ribeiro Júnior CL, Moura KK.

Source

Núcleo de Pesquisas Replicon, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brasil iasmimribeirodacosta@gmail.com.

Abstract

We investigated a possible link between endometriosis and polymorphism of the progesterone receptor gene (PROGINS). The endometriosis group consisted of 54 patients with a diagnosis of endometriosis by laparoscopy, and the control group comprised 44 women without endometriosis. Genotypes for PROGINS polymorphisms (A1/A1, A1/A2 and A2/A2) were determined by polymerase chain reaction and analyzed on a 2% agarose gel stained with ethidium bromide. The frequency of polymorphic genotypes (A1/A2 and A2/A2) was significantly higher in patients with endometriosis (33%) than in the control group (16%). We conclude that there is a significant correlation between PROGINS polymorphism and endometriosis.

BJOG. 2011 Aug;118(9):1143. doi: 10.1111/j.1471-0528.2011.02981.x.

Origins of ‘deep infiltrating endometriosis’.

Kondo W, Canis M.

Source

CHU Estaing, Clermont-Ferrand, France.

BJOG. 2011 Aug;118(9):1142-3. doi: 10.1111/j.1471-0528.2011.02980.x.

Origins of ‘deep infiltrating endometriosis’.

Quinn Md Llm M.

Source

London, UK.

Minerva Ginecol. 2011 Aug;63(4):375-86.

The effect of hormones on endometriosis development.

Parente Barbosa C, Bentes De Souza A, Bianco B, Christofolini D.

Source

Division of Human Reproduction and Genetics, Department of Gynecology and Obstetrics, Faculty of Medicine, Santo André/SP, Brazil – caiopb@uol.com.br.

Abstract

Endometriosis is a common gynecological condition in which tissue that is histologically similar to the endometrium with glands and/or stroma grows outside the uterine cavity and can lead to pelvic pain, dysmenorrhea and infertility. Many aspects of female reproductive function are strongly influenced by genetic factors and numerous studies have attempted to identify susceptibility genes for disorders affecting female fertility such as endometriosis. The importance of steroid hormones on endometriosis is unquestionable. The disease is most prevalent in women of reproductive age and regresses after menopause and its occurrence before menarche has not been reported. Sex steroids, estrogen and progesterone, are mainly produced in the ovaries and they regulate the growth of endometrial tissue, basically by stimulating and inhibiting cell proliferation, respectively. In addition, estrogen plays an important role in the regulation of cyclic gonadotropin release and in folliculogenesis. Numerous studies have been conducted to demonstrate the interaction of hormone and their receptors with endometriosis with conflict results. Besides, environmental chemicals, known as endocrine disruptors, have the capacity to mimic, block or modulate the endocrine system through the interaction with steroidal receptors. Recently evidences have proposed a putative role for ubiquitous environmental contaminants in the occurrence of endometriosis. Here, we reviewed significant articles regarding the interaction among endometriosis, hormones and genetic polymorphic variants.

Minerva Ginecol. 2011 Aug;63(4):365-73.

Infertility and endometriosis: a need for global management that optimizes the indications for surgery and ART.

De Ziegler D, Streuli M, Borghese B, Bajouh O, Abrao M, Chapron C.

Source

Department of Obstetrics and Gynecology and Reproductive Medicine, Paris Descartes University, Assistance Publique Hôpitaux de Paris, CHU Cochin, Paris, France – ddeziegler@orange.fr.

Abstract

Endometriosis causes pelvic pain and infertility. Infertility results from effects of endometriosis exerted in the pelvic cavity, in the ovaries and/or on the uterus. Medical treatment effective on pain and at preventing disease recurrence following surgery is of no use for improving the chances of conceiving naturally. Surgery however improves the chances of conceiving in the 12-18 months afterward. Endometriosis through extension of the disease to the ovaries may harm ovarian response to COS needed in ART. Surgery for endometrioma(s) may further reduce ovarian responses to COS in case of endometriosis. Remarkably however, reduced ovarian responses due to endometriosis are not necessarily associated with reduced oocyte quality and ART outcome. Pre-ART treatment with oral contraceptives (OC) improves ART outcome in case of ovarian endometriosis particularly, if endometriomas are present at the time of oocyte retrieval. This measure requires however that a proper OC-FSH/hMG interval is respected and that “LH” effects are provided during the ovarian stimulation, using either hMG or small doses of hCG. These latter precautions prevent the adverse outcome reported in case of pre-ART use of OC when ovarian stimulation is conducted using r-FSH exclusively.

J Laparoendosc Adv Surg Tech A. 2011 Jul 11. [Epub ahead of print]

Retroperitoneoscopic Nephrectomy for Symptomatic Hydronephrosis Using a SAND Balloon Catheter.

Nozaki T, Asao Y, Ito T, Tsuritani S, Okumura A, Fujiuchi Y, Fuse H.

Source

1 Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama , Toyama, Japan .

Abstract

Abstract Introduction: A retroperitoneoscopic nephrectomy (RN) for symptomatic hydronephrosis (SH) is a challenging procedure because of the limited working space. This report describes a specific technical modification for efficient and successful RN for SH by using the SAND balloon catheter. Patient and Methods: A 38-year-old woman underwent RN for SH caused by extrinsic compression of the ureter by a pelvic endometriosis. The SAND balloon catheter was directly inserted into the expanded hydronephrotic sac, and the liquid was extracted, appropriately. Urine leakage from the hydronephrotic sac could be avoided because the puncture site was sealed firmly between the two adjacent balloons at the tip of the catheter. Disposal counter traction using the catheter facilitated the mobilization of the hydronephrotic sac. Results: The patient was discharged 3 days after undergoing this procedure. Conclusions: This method improves the surgeon’s vision and facilitates resection without causing any injury to the hydronephrotic sac wall during RN.

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2011 Jun;36(6):554-8.

Inhibitory effect of GnRHII and GnRH Ia on the stromal cell proliferation from endometriosis patients.

[Article in Chinese]

Huang F, Wang H, Wu M, Yin T.

Source

Department of Obstetrics and Gyneology, Second Xiangya Hospital, Central South University, Changsha 410011, China.

Abstract

OBJECTIVE:

To investigate the inhibitory effect of gonadotropin-releasing hormone II(GnRHII) and gonadotropin-releasing hormone I agonist (GnRH Ia) on the proliferation of endometrial stromal cells in vitro from endometriosis patients.

METHODS:

Different concentrations of GnRHII or GnRH Ia were added into the cultured endometrial stromal cells in vitro to detect the cell proliferation inhibition by MTT test.

RESULTS:

The inhibitory rate of GnRHII or GnRH Ia on eutopic and ectopic endometrial stromal cells in vitro was both dose- and time-dependent (P<0.05). Effect of GnRHII or GnRH Ia on the inhibitory rate of ectopic endometrial stromal cells was significantly higher than that of eutopic (P<0.05). GnRH II had a higher inhibitory rate on the endometrial stromal cells in vitro than did GnRH Ia (P<0.05).

CONCLUSION:

GnRHII has more antiproliferative effect on endometrial stromal cells than GnRH Ia in vitro, especially on ectopic endometrial stromal cells, suggesting that GnRHII may be more effective than GnRH Ia on endometriosis.

Gynecol Obstet Fertil. 2011 Jul-Aug;39(7-8):407-11. Epub 2011 Jul 13.

Early evaluation of the feasibility of robot-assisted laparoscopy in the surgical treatment of deep infiltrating endometriosis.

[Article in French]

Bot-Robin V, Rubod C, Zini L, Collinet P.

Source

Pôle de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.

Abstract

BACKGROUND:

Preliminary study of the feasibility of robot-assisted laparoscopy for deep pelvic endometriosis nodule resection.

PATIENTS AND METHODS:

Between May 2009 and February 2010, we collected medical and surgical data about deep infiltrating endometriosis resections performed in our institution, using robot-assisted laparoscopy (DA VINCI Intuitive Surgical System(®)).

RESULTS:

Six patients were included: four partial bladder and two uterosacral ligament resections. The median age was 29.5 years (24-48). All patients reported chronic pelvic pain, associated with urinary tract symptoms in case of bladder endometriosis. Before surgery, lesion mapping was performed using magnetic resonance imaging for all, and mechanical bowel preparation or double-j stenting were prescribed, depending on the endometriosis location. Surgical procedures median time was 173minutes (156-244), and median length of stay was 3 days (2-5). Complete resection was possible in all cases. There was no conversion in classical laparoscopy or laparotomy, and no intraoperative complication. Pathology diagnosis of surgical pieces concluded to endometriosis lesion in all cases.

CONCLUSION:

This study shows the feasibility of the robot-assisted laparoscopy in the resection of deep pelvic endometriosis, without increasing of surgical timing, blood loss or intraoperative complications.

Gynecol Oncol. 2011 Jul 8. [Epub ahead of print]

The association between endometriosis and gynecological cancers and breast cancer: A review of epidemiological data.

Munksgaard PS, Blaakaer J.

Abstract

OBJECTIVE:

This article critically reviews the literature on the association between endometriosis and gynecological cancers and breast cancer, based on epidemiologic data.

METHODS:

Literature review of the English language literature based on searching in the MEDLINE (PubMed) database and additional collection of reports by systematically reviewing all references from retrieved papers.

RESULTS:

Data from large cohort and case-control studies indicate that endometriosis patients only have an increased risk of ovarian cancer among the gynecological malignancies and breast cancer, although most of the observed associations are modest. Data on the association between endometriosis and breast cancer are inconsistent. Endometriosis patients have a reduced risk of cervical cancer, and there is no association between endometriosis and endometrial cancer. Endometriosis-associated ovarian cancer seems to be a distinct clinical entity; patients are younger, diagnosed in earlier stages, have lower grade lesions and a better survival. Further, endometriosis-associated ovarian cancers are predominantly clear cell and endometrioid histologic subtypes.

CONCLUSIONS:

Endometriosis seems to be a precursor of epithelial ovarian cancer, especially clear cell and endometrioid adenocarcinomas. However, current evidence is insufficient to draw any definitive conclusions whether this association represents causality or the sharing of similar risk factors and/or antecedent mechanisms.

Eur J Obstet Gynecol Reprod Biol. 2011 Jul 6. [Epub ahead of print]

Regression of endometrial autografts in a rat model of endometriosis treated with etanercept.

Islimye M, Kilic S, Zulfikaroglu E, Topcu O, Zergeroglu S, Batioglu S.

Source

Department of Obstetrics and Gynecology, Ankara Dr Zekai Tahir Burak Women Health Teaching and Research Hospital, 7.Cadde 70 A/14, 06490-Bahcelievler, Ankara, Turkey.

Abstract

OBJECTIVE:

To determine the efficacy of anti-tumor necrosis factor therapy (etanercept) for treating endometriosis in the rat endometriosis model.

STUDY DESIGN:

A randomized, placebo-controlled, blinded study using rat endometriosis model. After the peritoneal implantation of endometrial tissue, twenty-eight Wistar female rats were randomized to two equal intervention groups: the control group and the etanercept-treated group. After measuring implant volume, pretreatment blood and peritoneal fluid samples were obtained. A vehicle treatment of 2mL saline to the rats in control group and 0. 4mg/kg etanercept SC once weekly were administered in the etanercept-treated group. After four weeks treatment period, the volumes and histopathological properties of the implants were evaluated. A scoring system was used to evaluate preservation of epithelia. Endometrial explants were evaluated immunohistochemically for tumor necrosis factor receptor type 2 (TNFR2). A scoring system was used to evaluate expression grade of TNFR2.

RESULTS:

There was not a significant difference in spherical volume between control (131.0 (60.3-501.2)) and treatment groups (72.8 (31.2-149.6)) (p>0.025). There was a significant change in between the volumes of implants before and after treatment in etanercept group (p<0.05). At the end of the treatment significant differences among the groups were found in histopathological and immunohistochemical parameters (p<0.05) also histologic scores and HSCORES were decreased in the treatment group significantly (p<0.05).

CONCLUSION:

These results indicate that etanercept was found to effectively reduce the development of endometriosis in this experimental rat model.

 

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