Pag. 13

Gynecol Endocrinol.2012 Apr 3. [Epub ahead of print]

Characterization of periostin expression in human endometrium and endometriotic lesions.

Shen L, Liu P, Zhang P, Zhang X, Cui J.

Source

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University , Jinan, Shandong , People’s Republic of China.

Abstract

Objective(s): To investigate the expression of periostin in the eutopic and ectopic endometrium of women diagnosed as endometriosis and evaluate the role of periostin in the pathogenesis of endometriosis. Study design: In this study, the expression of periostin was evaluated in the endometrial specimens from 35 women diagnosed as endometriosis and from 30 healthy women. To assess the presence and localization of periostin throughout the menstrual cycle in both eutopic and ectopic endometrium of women with endometriosis, microscopic evaluation was conducted. It was also subsequently compared with normal endometrium. Results: In the eutopic and ectopic endometrium of women with endometriosis, immunoreactivities of periostin increased compared with those of normal endometrium. We also observed a cyclic variation in the eutopic stromal periostin immunoreactivity throughout their menstrual cycle because higher H score values were observed in the proliferative phase than those in the secretory phase. Conclusion(s): These findings indicated that periostin may be involved in the pathophysiology of endometriosis.

Reprod Sci.2012 Apr 3. [Epub ahead of print]

Activin a Stimulates Interleukin 8 and Vascular Endothelial Growth Factor Release From Cultured Human Endometrial Stromal Cells: Possible Implications for the Pathogenesis of Endometriosis.

Rocha AL, Carrarelli P, Novembri R, de Pascalis F, Luisi S, Reis FM, Petraglia F.

Abstract

Background: Activin A is an endometrial secretory product involved in inflammation and angiogenesis. The present study aimed to evaluate the effect of activin A and its antagonist follistatin on interleukin (IL)-6, IL-8, and vascular endothelial growth factor (VEGF) expression and release from cultured human endometrial stromal cells (HESCs) from women with and without endometriosis. Methods: The HESCs were collected from women with endometriosis (n = 6) and controls (n = 6). Primary cultures were treated with activin A at different doses or activin A plus follistatin. The IL-6, IL-8, and VEGF messenger RNA expression was evaluated by real-time polymerase chain reaction and protein release was evaluated by enzyme-linked immunosorbent assay. Results: Unstimulated HESC from women with endometriosis secreted more IL-6 and IL-8 than controls. The addition of activin A increased IL-8 and VEGF secretion in HESC from controls and decreased IL-6 and IL-8 secretion in HESC from women with endometriosis. These effects were counteracted by follistatin. Conclusion: Activin A regulates the expression and secretion of IL-8 and VEGF in cultured HESC, and this mechanism appears to be disrupted in eutopic endometrial cells from women affected by endometriosis.

Am J Obstet Gynecol.2012 Apr;206(4):311.e1-9.

Elective repeat cesarean delivery compared with spontaneous trial of labor after a prior cesarean delivery: a propensity score analysis.

Gilbert SA, Grobman WA, Landon MB, Spong CY, Rouse DJ, Leveno KJ, Varner MW, Caritis SN, Meis PJ, Sorokin Y, Carpenter M, O’Sullivan MJ, Sibai BM, Thorp JM, Ramin SM, Mercer BM; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

Collaborators (88)

Source

The George Washington University Biostatistics Center, Washington, DC, USA.

Abstract

OBJECTIVE:

The purpose of this study was to determine outcomes, after the use of propensity score techniques, to create balanced groups according to whether a woman undergoes elective repeat cesarean delivery (ERCD) or trial of labor (TOL).

STUDY DESIGN:

Women who were eligible for a TOL with 1 previous low transverse incision were categorized according to whether they underwent an ERCD or TOL. A propensity score technique was used to develop ERCD and TOL groups with comparable baseline characteristics. Outcomes were assessed with conditional logistic regression.

RESULTS:

The rates of endometritis, operative injury, respiratory distress syndrome, and newborn infant infection were lower and the rates of hysterectomy and wound complication were higher in the ERCD group.

CONCLUSION:

Propensity score techniques can be used to generate comparable ERCD and TOL groups. Some types of maternal morbidity (such as hysterectomy) are higher; other types (such as operative injury) are lower in the ERCD group. Although the absolute risk is low, neonatal morbidity appears to be lower in the ERCD group.

Am J Obstet Gynecol.2012 Apr;206(4):351.e1-8. Epub 2011 Dec 30.

Serum HE4 levels are less frequently elevated than CA125 in women with benign gynecologic disorders.

Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G, Bast RC Jr.

Source

Center for Biomarkers and Emerging Technologies, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, USA. rmoore@wihri.org

Abstract

OBJECTIVE:

The human epididymis protein 4 (HE4) is a novel biomarker for ovarian cancer. This study measured the HE4 and CA125 levels in women with benign gynecological disorders.

STUDY DESIGN:

Sera were obtained from women prior to surgery for a pelvic mass and HE4 and CA125 levels were determined. The proportions of patients with elevated biomarker levels were compared.

RESULTS:

There were 1042 women with benign disease. HE4 levels were less often elevated than CA125 (8% vs 29%, P < .001). A marked difference was observed in patients with endometriosis in which HE4 was elevated in 3% of patients and CA125 in 67% (P < .0001). Serous ovarian tumors were associated with elevated levels of HE4 in 8% of patients and CA125 in 20% (P = .0002); uterine fibroids in 8% vs 26% (P = .0083); dermoids in 1% vs 21% (P = .0004); and inflammatory disease in 10% vs 37% (P = .014).

CONCLUSION:

HE4 is elevated less frequently than CA125 in benign disease, particularly in premenopausal patients.

Arch Gynecol Obstet.2012 Apr;285(4):1083-7. Epub 2011 Oct 22.

Management of hematocolpos in adolescents with transverse vaginal septum.

Deligeoroglou E, Iavazzo C, Sofoudis C, Kalampokas T, Creatsas G.

Source

Division of Pediatric-Adolescent Gynecology and Reconstructive Surgery (Referal Centre of Greece), 2nd Department of Obstetrics and Gynecology, “Aretaieion” Hospital, University of Athens, 76, Vas. Sofias Av., 11528 Athens, Greece.

Abstract

AIM:

The aim of this study was to underline the significance of premenarcheal gynecological examination in patients with transverse vaginal septum that could possibly be complicated with endometriosis.

DESIGN:

Retrospective study including the period between January 2008 and December 2010.

SETTING:

Second Department of Obstetrics and Gynecology.

PATIENTS:

We searched our databases regarding cases of hematocolpos caused by transverse vaginal septum.

MAIN OUTCOME:

Among the patients presented with hematocolpos we identified 4 cases caused by transverse vaginal septum.

RESULTS:

We present the management of these cases regarding diagnosis, differential diagnosis, and treatment. The mean age of the patients was 13.1 years. All patients presented in our department with hypogastric abdominal pain and hematocolpos. No problems in adrenarche or thelarche were mentioned. The U/S and MRI revealed a normal cystic in the upper part of the vagina–hematocolpos varying from 42 × 26 × 30 to 73 × 55 × 32 mm. Three of the patients had an upper transverse vaginal septum while one had a middle transverse vaginal septum. Only one patient had a concomitant anomaly of the urinary system (ectopic kidney). In our patients, after laparoscopic examination 3 out of 4 patients had findings of endometriosis (2/3 with stage I-minimal endometriosis and 1/3 with stage II-mild endometriosis).

CONCLUSION:

Physicians should be aware of transverse vaginal septum in the differential diagnosis of hematocolpos with abdominal pain and primary amenorrhea in the early adolescent years. Early diagnosis could be based on premenarcheal gynecological examination and could lead to correct management in order to avoid the complications of endometriosis (dysmenorrhea or infertility).

Arch Gynecol Obstet.2012 Apr;285(4):1065-72. Epub 2011 Oct 20.

Expression of miR-126 and Crk in endometriosis: miR-126 may affect the progression of endometriosis by regulating Crk expression.

Liu S, Gao S, Wang XY, Wang DB.

Source

Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China. fkzlliushuang@126.com

Abstract

PURPOSE:

To evaluate the relationship between miR-126 and Crk and discuss the role of miR-126 in the development and progression of endometriosis (EMs).

METHODS:

The expression levels of miR-126 and Crk mRNA were quantified using real time fluorescent quantitative polymerase chain reaction (real time PCR) in ectopic endometrium (ECs) and eutopic endometrium (EUs) in patients with EMs and normal endometrium (ENs) in EMs-free subjects. The expression levels of Crk protein in all samples were evaluated by Western blot.

RESULTS:

The expression level of miR-126 was significantly downregulated in ECs versus EUs (p = 5.45E(-5)) in the experimental group and in EUs versus ENs (p = 0.019). The expression level of Crk mRNA did not distinguish ECs from EUs (p = 0.995) but was overexpressed in EUs versus ENs (p = 0.006). Crk protein was overexpressed in ECs versus EUs (p = 0.002) in the experimental group and in EUs versus ENs (p = 1.13E(-6)). The expression level of miR-126 had no correlation with Crk mRNA (p = 0.496) but was negatively correlated with Crk protein (p = 3.134E(-5)). The expression level of miR-126 in EUs and ECs was negatively correlated with American Fertility Society (AFS) stage (p = 0.022, p = 0.025) and AFS score (p = 0.002, p = 0.007). miR-126 expression decreased with the progression of EMs, but the decrease was not significantly different.

CONCLUSIONS:

miR-126 may play an initial role in the development and progression of EMs. Crk may be regulated by miR-126, and synergism between abnormal expressions may play an important role in the pathogenesis of EMs.

Arch Gynecol Obstet.2012 Apr;285(4):1001-7. Epub 2011 Sep 20.

Co-expression of bone morphogenetic protein 6 with estrogen receptor a in endometriosis.

Athanasios F, Afrodite N, Effstratios P, Demetrios K.

Source

First Department of Obstetrics and Gynecology, “Helena Venizelou” Hospital, Agias Barbaras 32, Palaio Faliro, 17563 Athens, Greece. farfaras@gmail.com

Abstract

BACKGROUND:

Bone morphogenetic protein 6 (BMP-6) has decisive role in controlling multiple organogenetic processes, as well as modulating cell differentiation and proliferation. Considering those pleiotropic effects, we focused on determining expression of that multifunctional growth factor in ectopic endometriotic tissues.

MATERIALS AND METHODS:

In this prospective study, 85 consecutive women with endometriosis were included. All patients underwent gynecological operations due to endometriosis associated problems and tissue specimens were collected from ectopic endometriotic lesions. Immunohistochemical staining of paraffin sections for both BMP-6 and estrogen receptors a (ERa) was performed in all 85 cases using an avidin-biotin-peroxidase procedure.

RESULTS:

Ectopic endometrium showed intense cytoplastic immunoreactivity to BMP-6 in both epithelium and stroma. In addition, we have demonstrated that BMP-6 expression is highly associated with strong expression of ERa.

DISCUSSION:

The availability of BMP-6 in the ectopic endometrium may be at least partly involved in the mechanisms of attachment, survival and expansion of endometriosis. Moreover, the statistically significant correlation in expression of BMP-6 and ERa demonstrated in this study may be associated with the development of rich in estrogen microenvironment, but requires further investigation. In conclusion, this is the first study in our knowledge demonstrating strong expression of BMP-6 in endometriosis.

Aust N Z J Obstet Gynaecol.2012 Apr;52(2):140-5. doi: 10.1111/j.1479-828X.2011.01405.x. Epub 2012 Jan 25.

Identification of endometriosis-related genes by representational difference analysis of cDNA.

Chen Q, Zhang C, Chen Y, Lou J, Wang D.

Source

Department of Obstetrics & Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, China.

Abstract

BACKGROUND:

Accumulated evidence reveals that abnormally expressed genes in eutopic endometrium of endometriosis play a critical role in the pathogenesis of endometriosis.

AIMS:

Identification of endometriosis-related genes for further revealing the pathogenesis of endometriosis and offering the basis for developing the molecular-targeted diagnosis and therapy of endometriosis.

METHODS:

Forty women with endometriosis and forty control women without endometriosis during their secretory phase were selected for this study. cDNA representational difference analysis (cDNA-RDA) was performed to screen the up-regulated genes in eutopic endometrium samples of endometriosis (n = 10) compared with the controls (n = 10). To validate the results, MAT2A, the most abundantly expressed gene, was selected to detect mRNA and protein levels between eutopic endometrium of endometriosis (n = 40) and controls (n = 40) using immunohistochemistry, real-time fluorescent quantitative PCR and Western blotting.

RESULTS:

Ten up-regulated genes were identified in eutopic endometria of endometriosis compared with controls. Among these genes, COX-2, BRAF, NRAS and CFL1 have already been reported to be associated with the endometriosis in previous studies. MAT2A, SEPT9, ATAD3A and CADM2 have been reported to be involved in other diseases but not in endometriosis. NAA15 and CCDC21 have not reported in any diseases. Further study showed that MAT2A protein was localised in both endometrial glandular and stromal cells. Compared with controls, the mRNA and protein levels of MAT2A were significantly higher in eutopic endometrium of endometriosis (P < 0.05).

CONCLUSIONS:

cDNA-RDA can be used to effectively identify the endometriosis-related genes, which can provide novel experimental data and further understand the pathogenesis of endometriosis.

Br J Pharmacol.2012 Apr;165(8):2414-24. doi: 10.1111/j.1476-5381.2011.01497.x.

Δ(9) -Tetrahydrocannabinol and N-arachidonyl glycine are full agonists at GPR18 receptors and induce migration in human endometrial HEC-1B cells.

McHugh D, Page J, Dunn E, Bradshaw HB.

Source

Department of Psychological and Brain Sciences, Indiana University, Bloomington,IN 47405, USA.

Abstract

BACKGROUND AND PURPOSE:

Endometriosis is a disorder in which the endometrium forms growths outside the uterus and is associated with chronic pain. Recent evidence suggests that endometrial motility plays a role in the aetiology of endometriosis. The endocannabinoid system regulates cellular migration. Given the growing involvement of the endocannabinoids in reproduction, we investigated the role of the endocannabinoid system in migration of endometrial cells.

EXPERIMENTAL APPROACH:

Migration of the human endometrial HEC-1B cells was assayed. Standard PCR techniques were used to determine the presence of the GPCR, GPR18, in HEC-1B cells, and p44/42 MAPK was assayed in stably transfected HEK293-GPR18 cells to determine receptor specificity for known cannabinoid agonists and antagonists. N-arachidonoyl ethanolamine (AEA) metabolism was measured, using HPLC/MS/MS for lipid analysis.

KEY RESULTS:

AEA, Δ(9) -tetrahydrocannabinol (Δ(9) -THC) and N-arachidonoyl glycine (NAGly) induce migration of HEC-1B cells through cannabinoid CB(1) receptor-independent mechanisms. MAPK activation in HEK293-GPR18 cells revealed novel pharmacology for known CB(1) and CB(2) receptor ligands at GPR18 receptors, including Δ(9) -THC, which activates MAPK at nanomolar concentrations, whereas WIN 55212-2, CP55940, JWH-133 and JWH-015, and arachidonyl-1-hydroxy-2-propylamide (R1-methanandamide) had no effect. Moreover, HEC-1B migration and MAPK activation by NAGly and Δ(9) -THC were antagonized by Pertussis toxin, AM251 and cannabidiol.

CONCLUSIONS AND IMPLICATIONS:

An understanding of the function and regulation of GPR18 and its molecular interactions with endogenous ligands, and how phytocannabinoids play a role with GPR18 signalling is vital if we are to comprehensively assess the function of the cannabinoid signalling system in human health and disease. LINKED ARTICLES: This article is commented on by Alexander, pp. 2411-2413 of this issue and is part of a themed section on Cannabinoids in Biology and Medicine. To view Alexander visit http://dx.doi.org/10.1111/j.1476-5381.2011.01731.x. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7.

Comment in

Colorectal Dis.2012 Apr;14(4):502-7. doi: 10.1111/j.1463-1318.2011.02659.x.

Sacral nerve modulation in the treatment of chronic pain after pelvic surgery.

Martellucci J, Naldini G, Del Popolo G, Carriero A.

Source

General Surgery I, University of Siena, Siena, Italy. jamjac64@hotmail.com

Abstract

AIM:

The aim of the study was to evaluate the efficacy of sacral nerve modulation for chronic pelvic pain after pelvic or anal surgery for benign disease.

METHOD:

From January 2004 to December 2009, 17 (14 female; age 56 years) consecutive patients suffering from chronic pelvic pain underwent evaluation for sacral nerve modulation in three pelvic floor units.

RESULTS:

The previous surgery included stapled transanal rectal resection (five), hysterectomy (four), haemorrhoidectomy (two), stapled haemorrhoidopexy (one), fistulectomy (one), urethral sphincterotomy (one), appendicectomy (one), discectomy (one) and laparoscopy for endometriosis (one). Eight (47%) patients fulfilled the criteria for definitive implantation and were followed for a mean of 39 months. Using a visual analog pain score, pain levels fell from 8.2 preoperatively to 1.9, 2.1, 2.0 and 1.8 at 6, 12, 24 and 36 months, respectively. Age < 60 years and duration of symptoms of <24 months were good predictors and stapling was a poor predictor of success.

CONCLUSION:

Sacral nerve modulation seems to be effective over time in some patients with chronic pain related to previous surgery.

Cytokine.2012 Apr;58(1):47-9. Epub 2012 Jan 20.

The effect of formoterol on peritoneal VEGF levels in rats with endometriosis.

Yilmaz N, Ozaksit G, Keskin R, Tapisiz O, Mollamahmutoglu L, Uysal S, Astarci M, Ustun H, Mulazımoglu B.

Source

Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey. nafiyekarakas@gmail.com

Abstract

AIM:

The aim of this study is to investigate the effect of formoterol (β2 adrenergic receptor agonist) on peritoneal VEGF levels in rats with endometriosis.

MATERIALS AND METHODS:

Experimental endometriosis was constituted with implantation of endometrial tissue. The implants were examined by second laparatomy and rats were divided randomly into four groups. One cc saline was applied ip to the control (C) group (n=8) daily, 22.5μg/kg/day ip formoterol was applied to the second (F) group (n=10) daily, 22.5μg/kg/day ip formoterol and 10mg/kg/day ip propranolol were applied to the third (FP) group (n=10) daily, 45μg/kg/day ip formoterol was applied to the fourth (FF) group (n=9). Before treatment and after 30 days treatment period, peritoneal VEGF levels, the volumes and histopathological properties of the implants were evaluated.

RESULTS:

There were significant differences in between the peritoneal VEGF levels before and after treatment in group 2(F) and group 4(FF) (p(a): 0.01, 0.01 respectively). But there were no significant changes in between the volumes of implants before and after treatment among the groups (p>0.05). There were no significant differences among the groups in histopathological parameters (p>0.05).

CONCLUSION:

Formoterol treatment was seen to have no effect on the volumes and histopathological structure of endometriotic implants in our study. On the other hand, based on the group 2(F) and 4’s (FF) VEGF levels after the treatment, low dose or high dose formoterol may be effective with long term therapy. Formoterol may reduce the development of endometriosis.

Endocrinology.2012 Apr;153(4):1593-602. Epub 2012 Mar 13.

Minireview: human ovarian cancer: biology, current management, and paths to personalizing therapy.

Romero I, Bast RC Jr.

Source

M.D. Anderson Cancer Center, Translational Research, Houston, Texas 77030, USA.

Abstract

More than 90% of ovarian cancers have been thought to arise from epithelial cells that cover the ovarian surface or, more frequently, line subserosal cysts. Recent studies suggest that histologically similar cancers can arise from the fimbriae of Fallopian tubes and from deposits of endometriosis. Different histotypes are observed that resemble epithelial cells from the normal Fallopian tube (serous), endometrium (endometrioid), cervical glands (mucinous), and vaginal rests (clear cell) and that share expression of relevant HOX genes which drive normal gynecological differentiation. Two groups of epithelial ovarian cancers have been distinguished: type I low-grade cancers that present in early stage, grow slowly, and resist conventional chemotherapy but may respond to hormonal manipulation; and type II high-grade cancers that are generally diagnosed in advanced stage and grow aggressively but respond to chemotherapy. Type I cancers have wild-type p53 and BRCA1/2, but have frequent mutations of Ras and Raf as well as expression of IGFR and activation of the phosphatidylinositol-3-kinase (PI3K) pathway. Virtually all type II cancers have mutations of p53, and almost half have mutation or dysfunction of BRCA1/2, but other mutations are rare, and oncogenesis appears to be driven by amplification of several growth-regulatory genes that activate the Ras/MAPK and PI3K pathways. Cytoreductive surgery and combination chemotherapy with platinum compounds and taxanes have improved 5-yr survival, but less than 40% of all stages can be cured. Novel therapies are being developed that target high-grade serous cancer cells with PI3Kness or BRCAness as well as the tumor vasculature. Both in silico and animal models are needed that more closely resemble type I and type II cancers to facilitate the identification of novel targets and to predict response to combinations of new agents.

Fertil Steril.2012 Apr;97(4):912-8. Epub 2012 Feb 15.

In vitro fertilization is a successful treatment in endometriosis-associated infertility.

Opøien HK, Fedorcsak P, Omland AK, Abyholm T, Bjercke S, Ertzeid G, Oldereid N, Mellembakken JR, Tanbo T.

Source

Section for Reproductive Medicine, Department of Gynaecology, Oslo University Hospital Rikshospitalet, Oslo, Norway. hans.kristian.opoien@rikshospitalet.no

Abstract

OBJECTIVE:

To assess success rates of IVF and intracytoplasmic sperm injection in women with various stages of endometriosis.

DESIGN:

Retrospective cohort study.

SETTING:

Reproductive medicine unit in a university hospital.

PATIENT(S):

Infertile women (n = 2,245) with various stages of endometriosis or tubal factor infertility.

INTERVENTION(S):

IVF or intracytoplasmic sperm injection.

MAIN OUTCOME MEASURE(S):

Dose of FSH, number of oocytes retrieved, fertilization rate, implantation rate, pregnancy rate (PR), live birth/ongoing PR.

RESULT(S):

Women with endometriosis had similar pregnancy and live birth/ongoing PR as did women with tubal factor infertility, but the American Society for Reproductive Medicine (ASRM) stage I and II endometriosis patients had a lower fertilization rate, and stage III and IV patients required more FSH and had fewer oocytes retrieved. Splitting the stage III and IV groups into patients with and without endometriomas showed that the endometrioma group required more FSH and had a significantly lower pregnancy and live birth/ongoing PR.

CONCLUSION(S):

With the exception of patients with endometrioma, infertile women with various stages of endometriosis have the same success rates with IVF and intracytoplasmic sperm injection as patients with tubal factor. This contrasts with the systematic review on which the European Society of Human Reproduction and Embryology bases its recommendations.

Fertil Steril.2012 Apr;97(4):904-11. Epub 2012 Jan 24.

Sphingosine pathway deregulation in endometriotic tissues.

Santulli P, Marcellin L, Noël JC, Borghese B, Fayt I, Vaiman D, Chapron C, Méhats C.

Source

Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, AP- HP, Groupe Hospitalier Universitaire Ouest, Centre Hospitalier Universitaire Cochin Saint Vincent de Paul, Department of Gynecology Obstetrics II and Reproductive Medicine, Paris, France. pietro.santulli@inserm.fr

Abstract

OBJECTIVE:

To investigate key genes expression of the sphingosine-1-phosphate pathway in endometriotic tissues.

DESIGN:

A case-control laboratory study.

SETTING:

Tertiary care university hospital.

PATIENT(S):

A total of 31 women, with (n = 16) and without (n = 15) endometriosis took part in the study.

INTERVENTION(S):

After surgical excision with pathological analysis, endometrial specimens were obtained from women affected or not by endometriosis.

MAIN OUTCOME MEASURE(S):

SPHK1-2, SGPP1-2, SGPL1, SPHKAP, and S1PR1-5 messenger RNA expression by quantitative real-time polymerase chain reaction (PCR) in the endometrium of 15 disease-free women, 16 eutopic and 16 ectopic endometrium of endometriosis-affected women. The S1PR1 and S1PR2 expression were further investigated by immunohistochemistry.

RESULT(S):

The SGPP2 expression was decreased in eutopic and ectopic endometrium of endometriosis-affected women (1.7- and 16.7-fold, respectively). The SGPP1, weakly expressed in healthy endometrium, is up-regulated in endometriosis-affected women (11.9- and 64.7-fold, respectively), but its expression remains low. The SGPL1 expression was decreased in ectopic endometrium (3.3-fold) and SPHKAP expression was increased in ectopic endometrium (112.6-fold) compared with endometrium of disease-free women. In endometriosis-affected women, S1PR3 expression was decreased in eutopic and ectopic endometrium (2.1- and 6.3-fold, respectively); S1PR2 and S1PR1 expression was increased in eutopic (2.5-fold) and ectopic endometrium (2.6-fold). These increases were confirmed at the protein levels by immunohistochemistry.

CONCLUSION(S):

Expression of the enzymes implicated in the regulation of the sphingosine-1-phosphate level balance and of its receptors is overall heavily deregulated in endometriotic lesions in favor of a decreased sphingosine-1-phosphate catabolism. Our results plead for a role of the sphingosine pathway in establishing and survival of endometriotic lesions.

Fertil Steril.2012 Apr;97(4):919-29. Epub 2012 Jan 20.

Chemokine CCL2 enhances survival and invasiveness of endometrial stromal cells in an autocrine manner by activating Akt and MAPK/Erk1/2 signal pathway.

Li MQ, Li HP, Meng YH, Wang XQ, Zhu XY, Mei J, Li DJ.

Source

Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics & Gynecology, Fudan University Shanghai Medical College, Shanghai, People’s Republic of China.

Abstract

OBJECTIVE:

To clarify the role and mechanism of CCL2 in regulating the biological functions of endometrial stromal cells (ESCs).

DESIGN:

The CCL2 effect on the viability, proliferation, and invasion in the eutopic ESCs from endometriosis.

SETTING:

Research laboratories.

PATIENT(S):

Patients with endometriosis aged 23-47 years.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Signal transduction and downstream molecules from CCR2.

RESULT(S):

We have found that the secretion of CCL2 by the eutopic ESCs from endometriosis is higher than that of healthy ESCs without endometriosis. The CCL2 can enhance the viability, proliferation, and invasion of ESCs in a dosage and time-dependent manner. Anti-CCL2 neutralizing antibody and CCR2 antagonist can completely abolish the increase in viability, proliferation, and invasiveness of ESCs induced by CCL2. The CCL2 can increase the expression of proliferating cell nuclear antigen, survivin, and matrix metalloproteinase 2, and decrease the expression of tissue inhibitor of metalloproteinase 1 and 2, and promote the viability, proliferation and invasiveness of ESCs by activating Akt and MAPK/Erk1/2 signal pathway, but not p38 and JNK signal pathway.

CONCLUSION(S):

CCL2 might play an important role in regulating the functions of ESCs through Akt and MAPK/Erk1/2 signal pathway, and overexpression of CCL2 in ESCs and peritoneal fluid (PF) would lead to onset and development of endometriosis.

Gut Liver.2012 Apr;6(2):284-5. Epub 2012 Apr 17.

An unusual cause of inguinal hernia in a male patient: endometriosis.

Simsek G, Bulus H, Tas A, Koklu S, Yilmaz SB, Coskun A.

Source

Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey.

Gynecol Endocrinol.2012 Apr;28(4):314-21. Epub 2012 Feb 4.

Gonadotrophin-releasing hormone analogues and endometriosis: current strategies and new insights.

Abu Hashim H.

Source

Department of Obstetrics & Gynecology, Mansoura Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt. hatem_ah@hotmail.com

Abstract

BACKGROUND:

Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5% to 10% of women in reproductive age and has been reported also in adolescents. Its main clinical presentations are chronic pelvic pain and infertility.

OBJECTIVE:

To provide a comprehensive review of the recently published data concerning the mechanism of action of gonadotrophin-releasing hormone analogues (GnRHas) as well as to analyze their role in the management of endometriosis-associated pain and infertility in addition to its value in adolescent cases. Furthermore, to provide practical recommendations and new insights based on the best available information.

METHODS:

Systematic search was performed of the Cochrane Library and Medical Literature Analysis and Retrieval System Online database looking for the different trials, reviews and various guidelines relating to GnRHas usage in the management of endometriosis-associated pain, infertility and in adolescent cases.

RESULTS:

From a pathophysiological perspective, there is a growing scientific evidence that GnRHas exert its therapeutic effects by their classical pituitary downregulation and via a direct effect on the endometrial cells themselves. Accordingly, they represent an important medical option for the management of different aspects of this enigmatic disease.

CONCLUSION:

GnRHas have a valuable strategic role in treatment of endometriosis-associated pain and infertility as well as in adolescents above 16 years.

Gynecol Endocrinol.2012 Apr;28(4):310-3. Epub 2011 Nov 16.

Expression of ghrelin and its receptors in ovarian endometrioma.

Milewski L, Wójtowicz K, Roszkowski PI, Barcz E, Ziarkiewicz-Wróblewska B, Kamiński P, Malejczyk J.

Source

Department of Histology and Embryology, Centre of Biostructure Research, Medical University of Warsaw, Warsaw, Poland.

Abstract

Endometriosis is a common gynaecological disorder manifesting by implantation and growth of endometrial tissue outside the uterine cavity. The evidence accumulates that endometriosis may be associated with abrogated regulation of energy balance. Ghrelin is one of the most important orexigenic factor which may also play a role in regulation of inflammatory and angiogenic reactions. The present study was aimed at investigating expression profile of ghrelin and its receptors (GHSR1α and GHSR1β) in endometriotic lesions. The study included ovarian cysts and peritoneal fluid specimens obtained laparoscopically from 20 women with revised American Fertility Society stage III or IV endometriosis. Expression of specific mRNAs was assessed by reverse transcription-polymerase chain reaction. Expression of ghrelin and GHSR1α protein was studied by immunohistochemical staining with specific antibodies. Ghrelin and its receptors mRNA expression was found in all tested specimens. Specific mRNAs for these factors were also expressed in the peritoneal leukocytes. Immunohistochemical staining revealed expression of ghrelin and GHSR1α both in glandular endometrioid epithelium and in some stromal cells, particularly in some fibroblasts, blood vessels and infiltrating leukocytes. Co-localization of ghrelin and its receptors strongly suggests that this neuropeptide may affect development and growth of endometriotic lesions and may influence local inflammatory and angiogenic response.

Gynecol Endocrinol.2012 Apr;28(4):305-9. Epub 2011 Nov 15.

XRCC1 399 Arg-related genotype and allele, but not XRCC1 His107Arg, XRCC1 Trp194Arg, KCNQ2, AT1R, and hOGG1 polymorphisms, are associated with higher susceptibility of endometriosis.

Hsieh YY, Chang CC, Chen SY, Chen CP, Lin WH, Tsai FJ.

Source

School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.

Abstract

X-ray repair cross-complementing group 1 (XRCC1) and human 8-oxoguanine glycosylase 1 (hOGG1) play important roles in base excision repair. KCNQ genes comprising voltage-gated ion-channels related with cell stability. Angiotensin II type 1 receptor (AT1R) is related with angiogenesis, which influence endometriosis growth, invasion and regression. We aimed to investigate whether these polymorphisms were associated with endometriosis susceptibility. Women were divided [ 1 ]: endometriosis (n = 136 [ 2 ]); non-endometriosis groups (n = 112). XRCC1 (codon 107, 194, 399), hOGG1, KCNQ2, AT1R polymorphisms were amplified by PCR and detected by electrophoresis after restriction enzyme (RsaI, HpaII, MspI, Fnu4HI, Ava II, Dde I) digestions. Genotypes and allelic frequencies in both groups were compared. Proportions of XRCC1 Arg399Gln*GG/GA/AA and G/A allele between both groups were [ 1 ]: 41.9/53.7/4.4% and 68.8/31.2% [ 2 ]; 30.4/54.5/15.1% and 57.6/42.4% (p < 0.05). Other 5 polymorphisms (XRCC1 codon 107 and 194, hOGG1, KCNQ2, and AT1R) between both groups were non-significantly different. Proportions of XRCC1 107*AA/AG/GG and XRCC1 194*TT/TC/CC between both groups were [ 1 ]: 3.7/27.2/69.1% and 5.8/34.6/59.6% [ 2 ]; 2.6/21.4/75.8% and 11.6/37.5/50.9%. HOGG1*CC/CG/GG, KCNQ2*AA/AC/CCC and AT1R*AA/AC/CC were [ 1 ]: 14.8/42.6/42.6, 14/41.9/44.1 and 92.6/7.4/0% [ 2 ]; 11.6/50/38.4, 17/50/33 and 100/0/0%. We concluded that XRCC1 399 Arg-related genotype and allele are correlated with higher susceptibility to endometriosis, which suggested its association with endometriosis pathogenesis. XRCC1 107 and 194, hOGG1, KCNQ2, and AT1R are not associated with endometriosis susceptibility.

Hum Reprod.2012 Apr;27(4):1043-9. Epub 2012 Feb 10.

Cumulative pregnancy rate after ICSI-IVF in patients with colorectal endometriosis: results of a multicentre study.

Ballester M, d’Argent EM, Morcel K, Belaisch-Allart J, Nisolle M, Daraï E.

Source

Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris 6, Paris, France. marcos.ballester@tnn.aphp.fr

Abstract

BACKGROUND:

There is currently no consensus about indications for surgery for infertility associated with colorectal endometriosis. The aim of this study was to evaluate cumulative pregnancy rates (CPRs) after ICSI-IVF cycles in patients with colorectal endometriosis and to identify determinant factors of fertility outcome.

METHODS:

Prospective longitudinal multicentre study from January 2005 to June 2011. We included 75 patients with colorectal endometriosis and proved infertility without prior surgery for deep infiltrating endometriosis. Univariable analysis was used to identify determinant factors of pregnancy rate. CPR was calculated using cumulative-incidence methods from log-rank test and Kaplan-Meier curves. For multivariable analysis, Cox proportional hazards model was used.

RESULTS:

For CPR per patient analysis, the total number of cycles was 113 and the median number of cycles per patient was 1 (range: 1-3). In the whole population the CPR per patient after three ICSI-IVF cycles was 68.6%. The CPR for patients with or without associated adenomyosis was 19 and 82.4%, respectively (P= 0.01). In addition, a patient age over 35 years (P= 0.02) and anti-Mullerian hormone serum level under 2 ng/ml (P= 0.02) were associated with a decreased CPR per patient. At multivariable analysis, adenomyosis [HR = 0.34, 95% CI (0.12-0.99), P= 0.49] was associated with a decreased CPR.

CONCLUSIONS:

Our data confirm that ICSI-IVF offers a high CPR per patient. However, determinant factors of CPR should be taken into account when informing couples of their options.

Int J Surg Pathol.2012 Apr;20(2):205-7. Epub 2011 Aug 23.

Aggressive angiomyxoma admixed with endometriosis: a case report.

Coyne JD.

Source

Department of Pathology, Royal Liverpool University Hospital, Liverpool, UK. johnnycoyne@doctors.org.uk

Abstract

Aggressive angiomyxoma and endometriosis are two apparently unrelated lesions which commonly arise within the pelvis. However, whilst their simultaneous occurrence in this site may be fortuitous, a shared pathogenesis cannot be entirely excluded.

J Cell Biochem.2012 Apr;113(4):1292-301.

In vitro model of stromal and epithelial immortalized endometriotic cells.

Boccellino M, Quagliuolo L, Verde A, La Porta R, Crispi S, Piccolo MT, Vitiello A, Baldi A, Signorile PG.

Source

Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy.

Abstract

Endometriosis is a relatively common chronic gynecologic disorder that usually presents with chronic pelvic pain or infertility. It results from implantation of endometrial tissue outside the uterine cavity. Despite its frequency and its impact on quality of life, the understanding of pathogenesis of endometriosis remains incomplete and its treatment remains controversial. In this work, we established a suitable in vitro model system of immortalized human endometriotic cell line taking advantage of the human telomerase reverse transcriptase. The results demonstrate that these cells retain the natural characteristics of endometrial cells in term of phenotype and of functional expression of estrogen and progesterone receptors, without chromosomal abnormalities. In conclusion, these cells are potentially useful as an experimental model to investigate endometriosis biology.

J Cell Physiol.2012 Apr;227(4):1653-6. doi: 10.1002/jcp.22888.

Embryologic origin of endometriosis: analysis of 101 human female fetuses.

Signorile PG, Baldi F, Bussani R, Viceconte R, Bulzomi P, D’Armiento M, D’Avino A, Baldi A.

Source

Fondazione Italiana Endometriosi, Rome, Italy. research@endometriosi.it

Abstract

The etiology of endometriosis, a gynecological disease characterized by the presence of endometrial glands and stroma outside the uterine cavity, is still unknown. Our research group has recently demonstrated the presence of ectopic endometrium in human female fetuses at different gestational ages. In this manuscript we describe four new cases of fetal endometriosis found among a series of 52 female fetuses analyzed at autopsy. The anatomical localization of this ectopic endometrium, and its histological and immunohistochemical characteristics are depicted. We suggest that endometriosis is caused by dislocation of primitive endometrial tissue outside the uterine cavity during organogenesis. The clinical and pathological implications of these findings are discussed.

J Gynecol Obstet Biol Reprod (Paris).2012 Apr;41(2):128-35. Epub 2011 Nov 8.

Laparoscopic colorectal resection for deep pelvic endometriosis: Evaluation of post-operative outcome.

[Article in French]

Boileau L, Laporte S, Bourgaux JF, Rouanet JP, Filleron T, Mares P, de Tayrac R.

Source

Service de gynécologie et d’obstétrique, CHU de Nîmes, place du Pr R.-Debré, 30029 Nîmes, France. boileau.laurent34@gmail.com

Abstract

OBJECTIVES:

Evaluation of mid-term functional results and the quality of life after laparoscopic colorectal resection.

PATIENTS AND METHODS:

Twenty-three consecutive patients were included in a retrospective monocentric study. Postoperative functional outcomes and quality of life were analyzed.

RESULTS:

The median follow-up after colorectal resection was of 24±15.7 months (6-72). Major complications occurred in three cases (12,9%) including one anastomotic stenosis, one digestive and one bladder fistula. A significant improvement in pelvic pain symptoms was observed. De novo constipation and pain on defecation occurred in respectively 23% and 42% of the cases. Transient de novo dysuria occurred in 18% of the cases. The quality of life has been significantly improved.

CONCLUSION:

Laparoscopic colorectal resection is associated with unfavourable postoperative digestive and urological outcomes, such as bladder and rectal dysfunction. Radical treatment should be limited to selected patients.

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