Bibliografia 2012

Dal 10-02-12 al 3-7-12

Pag. 1

Colloids Surf B Biointerfaces.2012 Sep 1;97:84-9. Epub 2012 Apr 13.

Enhanced transdermal permeability of estradiol using combination of PLGA nanoparticles system and iontophoresis.

Tomoda K, Watanabe A, Suzuki K, Inagi T, Terada H, Makino K.

Source

Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan; Center for Drug Delivery Research, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan; Center for Physical Pharmaceutics, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan.

Abstract

Estradiol is a therapeutic agent for treatment of perimenopausal symptoms and osteoporosis. Conventional oral or intravenous administration of estradiol has many problems, such as, metabolization in gastrointestinal tract and liver, pain by using an injection needle, rapid increase of drug levels in blood and fast clearance with unwanted side effects including thrombosis, endometriosis and uterus carcinoma. The use of nanocarriers for transdermal delivery has been studied because of their ability to deliver therapeutic agents for long time with a controlled ratio, escaping from the first pass effect by liver. In this study, permeability of estradiol-loaded PLGA nanoparticles through rat skin was studied. Higher amount of estradiol was delivered through skin when estradiol was loaded in nanoparticles than estradiol was free molecules. Also, iontophoresis was applied to enhance the permeability of nanoparticles. When iontophoresis was applied, permeability of estradiol-loaded PLGA nanoparticles was much higher than that obtained by simple diffusion of them through skin, since they have negative surface charges. They were found to penetrate through follicles mainly. Also, enhanced permeability effect of estradiol by using nanoparticle system and iontophoresis were observed in vivo. The combination of charged nanoparticle system with iontophoresis is useful for effective transdermal delivery of therapeutic agents.

Minerva Ginecol.2012 Aug;64(4):331-5.

Simplified approach to the treatment of endometriosis – ECO system.

Bassil Lasmar R, Simões Abraão M, Lasmar RB, Leon Dewilde R.

Source

Department of Gynecology and Obstetrics of Federal Fluminense UniversityRio de Janeiro, Brazil – ricardo@lasmar.com.br.

Abstract

AIM:

The aim of the present study was to develop a system to facilitate the approach for patients with endometriosis, mainly for non-specialized gynecologists.

METHODS:

This was a multicenter study (Canadian Task Force classification II-3). The study aimed to correlate three known parameters for endometriosis, qualifying and quantifying their importance in terms of disease severity and treatment complexity. Patients were divided into three groups.

RESULTS:

Each parameter was scored from 0 to 2 in order to determine medical or surgical management for endometriosis based on the clinical and imaging results, where the total score of 0 to 2 was for medical treatment, score 3 was possible medical treatment or surgical and score of 4 to 6 was for surgical intervention. A total score from the three parameters was obtained. Anatomical extent of infiltration and complaints and objective of the patient was helpful in deciding on management of patients with endometriosis.

CONCLUSION:

The ECO system can be a qualified and helpful tool in the approach to patients with suspected endometriosis, mainly for non-specialized gynecologists.

Mol Cell Endocrinol.2012 Jul 25;358(2):232-43. Epub 2012 Mar 10.

The immninent dawn of SPRMs in obstetrics and gynecology.

Chabbert-Buffet N, Pintiaux A, Bouchard P.

Source

Obstetrics, Gynecology and Reproductive Medicine Department, AP-HP, Hospital Tenon, UPMC Paris 06, Paris, France.

Abstract

Selective progesterone receptor modulators (SPRMs) have been developed since the late 70s when mifepristone was first described. They act through nuclear progesterone receptors and can have agonist or mixed agonist antagonist actions depending on the cell and tissue. Mifepristone has unique major antagonist properties allowing its use for pregnancy termination. Ulipristal acetate has been marketed in 2009 for emergency contraception and has been recently approved for preoperative myoma treatment. Further perspectives for SPRMs use include long term estrogen free contraception, endometriosis treatment. However long term applications will be possible only after confirmation of endometrial safety.

Mol Cell Endocrinol.2012 Jul 25;358(2):208-15. Epub 2011 Nov 9.

Mechanisms of endometrial progesterone resistance.

Al-Sabbagh M, Lam EW, Brosens JJ.

Source

Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom.

Abstract

Throughout the reproductive years, the rise and fall in ovarian hormones elicit in the endometrium waves of cell proliferation, differentiation, recruitment of inflammatory cells, apoptosis, tissue breakdown and regeneration. The activated progesterone receptor, a member of the superfamily of ligand-dependent transcription factors, is the master regulator of this intense tissue remodelling process in the uterus. Its activity is tightly regulated by interaction with cell-specific transcription factors and coregulators as well as by specific posttranslational modifications that respond dynamically to a variety of environmental and inflammatory signals. Endometriosis, a chronic inflammatory disorder, disrupts coordinated progesterone responses throughout the reproductive tract, including in the endometrium. This phenomenon is increasingly referred to as ‘progesterone resistance’. Emerging evidence suggests that progesterone resistance in endometriosis is not just a consequence of perturbed progesterone signal transduction caused by chronic inflammation but associated with epigenetic chromatin changes that determine the intrinsic responsiveness of endometrial cells to differentiation cues.

Mol Cell Endocrinol.2012 Jul 25;358(2):146-54. Epub 2011 Aug 22.

Estrogen biosynthesis and signaling in endometriosis.

Huhtinen K, Ståhle M, Perheentupa A, Poutanen M.

Source

Department of Physiology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; Department of Obstetrics & Gynecology, Turku University Hospital, 20520 Turku, Finland.

Abstract

Endometriosis is an estrogen-dependent gynecological disease where endometrium-like tissue grows outside uterine cavity. Endometriotic cell proliferation is stimulated by estrogens acting predominantly via their nuclear receptors. Estrogen receptors (ESR1, ESR2) are ligand activated transcription factors whose activation is dependent on the cell-specific dynamic expression of the receptors, on the interacting proteins and on the ligand availability. The different types of endometriotic lesions, peritoneal, deep, and ovarian endometriosis, may respond to estrogens differentially due to differences in the expression of the receptors and interacting proteins, and due to potential differences in the ligand availability regulated by the local estrogen synthesis. This review summarizes the current knowledge of estrogen synthesizing enzymes and estrogen receptors in different types of endometriosis lesions. Further studies are still needed to define the possible differences in steroid metabolism in different types of endometriotic lesions.

Mol Cell Endocrinol.2012 Jul 25;358(2):155-65. Epub 2011 Jul 28.

The regulation of embryo implantation and endometrial decidualization by progesterone receptor signaling.

Large MJ, Demayo FJ.

Source

Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

Abstract

During the early stages of pregnancy, fertilized embryos must attach to the uterine epithelium, invade into the underlying uterine stroma, and the stroma must then differentiate in a process termed decidualization in order for a successful pregnancy to be initiated. The steroid hormone progesterone (P4) is an integral mediator of these early pregnancy events, exerting its effects via the progesterone receptor (PR). Insights gained from the use of mouse models and genomic profiling has identified many of the key molecules enlisted by PR to execute the paradigm of early pregnancy. This review describes several of the molecules through which the PR exerts its pleiotropic effects including ligands, receptors, chaperones, signaling proteins and transcription factors. Understanding these molecules and their concatenation is of vital importance to our ability to clinically treat reproductive health problems like infertility and endometriosis.

Mol Cell Endocrinol.2012 Jul 25;358(2):197-207. Epub 2011 Jul 27.

The endocrine and paracrine control of menstruation.

Henriet P, Gaide Chevronnay HP, Marbaix E.

Source

Cell Biology Unit, de Duve Institute, Université catholique de Louvain, avenue Hippocrate, 75, B-1200 Bruxelles, Belgium.

Abstract

During the reproductive life, the human endometrium undergoes cycles of substantial remodeling including, at menstruation, a massive but delimited tissue breakdown immediately followed by scarless repair. The present review aims at summarizing the current knowledge on the endocrine and paracrine control of menstruation in the light of recent observations that undermine obsolete dogmas. Menstruation can be globally considered as a response to falling progesterone concentration. However, tissue breakdown is heterogeneous and tightly controlled in space and time by a complex network of regulators and effectors, including cytokines, chemokines, proteases and various components of an inflammatory response. Moreover, menstruation must be regarded as part of a complex and integrated mechanism of tissue remodeling including features that precede and follow tissue lysis, i.e. decidualization and immediate post-menstrual regeneration. The understanding of the regulation of menstruation is of major basic and clinical interest. Indeed, these mechanisms largely overlap with those controlling other histopathological occurrences of tissue remodeling, such as development and cancer, and inappropriate control of menstrual features is a major potential cause of two frequent endometrial pathologies (i.e. abnormal uterine bleeding and endometriosis).

Am J Dermatopathol.2012 Jul;34(5):541-3.

Cutaneous decidualized endometriosis in a nonpregnant female: a potential pseudomalignancy.

Declerck BK, Post MD, Wisell JA.

Source

*Departments of Pathology and Dermatology, Stanford University, Palo Alto, CA †Department of Pathology, University of Colorado Denver, Aurora, CO.

Abstract

ABSTRACT:: Endometriosis is a disease process characterized by ectopic endometrial tissue. Involvement most commonly occurs in the lower pelvis, outside the uterine cavity, but can occur elsewhere, including the skin. Cutaneous endometriosis is a rare manifestation of this disease, with decidualization occurring in a very small minority of cases, almost always seen in pregnant females. Cutaneous involvement of endometriosis may present a diagnostic problem for the pathologist, particularly in the event of decidualization. Decidualization may mimic a malignancy and as a result may result in unnecessary diagnostic studies for the patient. We present a case of a nonpregnant patient with decidualized cutaneous endometriosis, discuss the histopathologic and immunohistochemical features of this entity, and review the pertinent literature on this subject. To our knowledge, this is the second reported case of cutaneous decidualized endometriosis in a nonpregnant female.

Am J Reprod Immunol.2012 Jul;68(1):68-74. doi: 10.1111/j.1600-0897.2011.01102.x. Epub 2012 Jan 9.

Serum sTREM-1 (Soluble Triggering Receptor Expressed on Myeloid Cells-1) Associates Negatively with Embryo Quality in Infertility Patients.

Haller-Kikkatalo K, Sarapik A, Faure GC, Béné MC, Massin F, Salumets A, Uibo R.

Source

Immunology Group, Institute of General and Molecular Pathology, University of Tartu, Tartu, Estonia; Competence Centre on Reproductive Medicine and Biology, Tartu, Estonia; Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia; Women’s Clinic, Tartu University Hospital, Tartu, Estonia.

Abstract

PROBLEM:

Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a useful biomarker of infection and inflammation.

METHOD OF STUDY:

We studied serum and follicular fluid sTREM-1 in infertile patients (N = 110) utilizing enzyme-linked immunosorbent assay.

RESULTS:

Serum and follicular sTREM-1 were in good correlation (Pearson’s correlation 0.56, P < 0.0001) with higher values in follicular fluid (140.4 ± 34.4 and 115.6 ± 35.1 pg/mL, t-test, P < 0.0001). Endometriosis associated with lower follicular and serum sTREM-1 compared with male factor infertility patients (age-adjusted r = -25.7 pg/mL, P = 0.018; r = -22.1 pg/mL, P = 0.030). No associations between follicular or serum sTREM-1 and clinical parameters were found, except higher serum sTREM-1 associated with lower embryo quality in all patients (adjusted r = -0.3%, P = 0.033), with a cutoff value between 111.5 and 113.3 pg/mL (OR = 0.38, P = 0.048; OR = 0.34, P = 0.028) predicting that more than 39% of embryos would be with good quality.

CONCLUSION:

Serum sTREM-1 could represent a prognostic marker for female fecundity, probably indicating impaired inflammatory reaction of immune system.

Arch Gynecol Obstet.2012 Jul;286(1):99-103. Epub 2012 May 1.

Pathogenesis of endometriosis: the role of genetics, inflammation and oxidative stress.

Augoulea A, Alexandrou A, Creatsa M, Vrachnis N, Lambrinoudaki I.

Source

2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, 6, Feidippidou Street, Ampelokipi, GR-11526, Athens, Greece, aretiaugoulea@yahoo.gr.

Abstract

INTRODUCTION:

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity.

MATERIALS AND METHODS:

The etiology of this multifactorial disease is still unresolved and an increasing number of studies suggest that genetic, hormonal, environmental, immunological and oxidative factors may all play an important role in the pathogenesis of this disorder.

CONCLUSIONS:

In this literature review, inflammatory activity, oxidative stress as well as genetic abnormalities and mutations have been studied in an effort to identify factors predisposing to endometriosis.

Arch Gynecol Obstet.2012 Jul;286(1):139-46. Epub 2012 Mar 6.

Vascular endothelial growth factor gene polymorphisms and endometriosis risk: a meta-analysis.

Liang S, Huang Y, Fan Y.

Source

Guangxi Medical University, Nanning, Guangxi, People’s Republic of China.

Abstract

PURPOSE:

The vascular endothelial growth factor (VEGF) gene polymorphism has been reported to be associated with endometriosis risk. The purpose of the present study was to perform a comprehensive meta-analysis to explore whether VEGF gene polymorphisms confer risk to endometriosis.

METHODS:

By searching PubMed and EMBASE databases, a total of 11 studies were identified. Crude odds ratio (OR) and their corresponding 95% confidence intervals (CI) for VEGF gene polymorphisms and endometriosis risk were calculated.

RESULT:

An association of VEGF gene +936TC polymorphism with endometriosis was found (Fixed-effect model: TT + TC vs. CC: OR 1.184, 95% CI 1.027-1.366, P = 0.020; TC vs. CC: OR 1.187, 95% CI 1.024-1.375, P = 0.023. Random-effcet model: TT + TC vs. CC: OR 1.203, 95% CI 1.003-1.443, P = 0.046; TC vs. CC: OR 1.188, 95% CI 1.021-1.382, P = 0.026). No association between VEGF genes -460CT, +405CG, -2578AC, -1154GA polymorphisms and endometriosis was observed.

CONCLUSION:

Our results indicate that VEGF +936TC gene polymorphism is a risk factor for endometriosis, and not -460CT, +405CG, -2578AC, -1154GA.

Arch Gynecol Obstet.2012 Jul;286(1):147-53. Epub 2012 Mar 6.

Association between endometriosis and polymorphisms in tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), TRAIL receptor and osteoprotegerin genes and their serum levels.

Kim H, Ku SY, Suh CS, Kim SH, Kim JH, Kim JG.

Source

Department of Obstetrics and Gynecology, Incheon Medical Center, Incheon, Korea.

Abstract

PURPOSE:

To evaluate the relationship between endometriosis and polymorphisms in the genes encoding tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), TRAIL receptor (DR) and osteoprotegerin (OPG) and their serum levels in Korean women.

METHODS:

A case-control study was conducted with 138 women with endometriosis and 214 women without endometriosis in academic medical center. TRAIL c.49G>A, c.592A>G, c.615A>G, and c.662T>C; DR4 c.626G>C and c.1322A>G; DR5 c.95C>T, c.200C>T, and c.72T>G; OPG -245T>G, c.9C>G, c.788A>C, and c.9938G>T polymorphisms were investigated and circulating levels of TRAIL and OPG were measured.

RESULTS:

The TRAIL c.49G>A, c.615A>G, and c.662T>C; the DR4 c.626G>C; the DR5 c.72T>G; the OPG c.788A>C and c.9938G>T polymorphisms were not observed. The genotype distributions and allele frequencies of single or combined polymorphisms of TRAIL, DR4, DR5, and OPG measured in women with endometriosis were not different from those in women without endometriosis, regardless of endometriosis stage. Serum TRAIL and OPG levels were significantly lower in women with endometriosis than in women without endometriosis, but these levels did not show differences between early and advanced endometriosis.

CONCLUSIONS:

Endometriosis is associated with circulating TRAIL and OPG levels in Korean women but not with the TRAIL, DR, and OPG polymorphisms.

Arch Gynecol Obstet.2012 Jul;286(1):105-7. Epub 2012 Jan 24.

c-kit/CD 117 positive cells in the myometrium of pregnant women and those with uterine endometriosis.

Horn LC, Meinel A, Hentschel B.

Source

Division of Breast, Gynecologic & Perinatal Pathology, Institute of Pathology, University of Leipzig, Liebigstrasse 26, Leipzig, 04103, Germany, hornl@medizin.uni-leipzig.de.

Abstract

PURPOSE:

Abnormal myometrial motility may play a role in the pathogenesis of endometriosis. Uterine contractility is a major contribution to labour. Myometrial motility might be controlled by CD 117-positive uterine smooth muscle cells.

METHODS:

Myometrial tissues from 8 cases with uterine endometriosis, 9 pregnant uteri (31.1 ± 8.7 weeks of gestation), 10 cases from non-pregnant pre-menopausal and 9 cases from post-menopausal women were immunohistochemically evaluated using a polyclonal antibody against c-kit/CD 117. The number of CD 117 positive cells was counted within 10 microscopic high power fields (×400) and compared with the clinical diagnoses.

RESULTS:

Overall, a mean number of 15.7 (range 0-43) CD 117-positive cells within the myometrium was seen. Significant highest count occurred in the myometrium of non-pregnant pre-menopausal women without uterine endometriosis (30.78 ± 9.52), followed by post-menopausal women (15.5 ± 8.37) and those with uterine endometriosis (9.98 ± 4.9; p ≤ 0.01). The lowest count of CD 117-positive cells was seen in pregnant uteri (4.09 ± 2.33; p < 0.001).

CONCLUSIONS:

The lowest count of CD 117-positive cells was seen in the myometrium of pregnant women suggesting a role of preventing premature uterine contractility. There is no increase of CD 117-positive cells in the myometrium of women affected by uterine endometriosis.

Cancer Invest.2012 Jul;30(6):473-80. Epub 2012 Apr 25.

Molecular mechanisms linking endometriosis under oxidative stress with ovarian tumorigenesis and therapeutic modalities.

Shigetomi H, Tsunemi T, Haruta S, Kajihara H, Yoshizawa Y, Tanase Y, Furukawa N, Yoshida S, Sado T, Kobayashi H.

Source

Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.

Abstract

Inflammation plays a role in the pathogenesis of endometriosis. Endometriosis-associated ovarian carcinogenesis might be promoted through oxidative stress-induced increased genomic instability, aberrant methylation, and aberrant chromatin remodeling, as well as mutations of tumor suppressor genes. Aberrant expression of ARID1A, PIK3CA, and NF-kB genes has been recognized as the major target genes involved in oxidative stress-induced carcinogenesis. HNF-1beta appears to play a key role in anti-oxidative defense mechanisms. We discuss the pathophysiologic roles of oxidative stress as somatic mutations as well as highly specific agents that effectively modulate these targets.

Clin Appl Thromb Hemost.2012 Jul;18(4):345-50. Epub 2012 Apr 11.

Value of patient self-assessment in the diagnosis and monitoring of post-thrombotic syndrome: the patient-tracked symptoms questionnaire.

Hull R, Butcher P.

Source

1University of Calgary, Calgary, Alberta, Canada.

Abstract

The post-thrombotic syndrome (PTS) is a frequent and burdensome disease, but no gold standard test exists to diagnose it. The value of patient-reported outcomes (PROs) in recording transient signs/symptoms, thereby possibly improving diagnosis/monitoring and subsequent clinical care in some diseases, is increasingly being recognized. For example, PROs have been successfully used in cancer, rheumatoid arthritis, and endometriosis. In this context, we describe a patient-reported questionnaire (the Patient-Tracked Symptoms questionnaire) that contains questions on the presence of signs/symptoms of PTS. This questionnaire has face validity and was successfully used in the Home-LITE trial. It could prove valuable in monitoring patient symptoms, especially in home-based patients who do not have regular contact with hospital clinicians. Patients who report symptoms can then undergo follow-up assessment by health care professionals at their next clinic visit. The Patient-Tracked Symptoms questionnaire could help clinicians to recognize the PTS early, enabling them to initiate treatment promptly.

Clin Imaging.2012 Jul;36(4):295-300. Epub 2012 Jun 8.

Pictorial review: rectosigmoid endometriosis on MRI with gel opacification after rectosigmoid colon cleansing.

Loubeyre P, Copercini M, Frossard JL, Wenger JM, Petignat P.

Source

Department of Imaging, Geneva University Hospitals, Geneva, Switzerland.

Abstract

Posterior deeply infiltrating endometriosis (PDIE) is an invalidating disorder that may involve the rectosigmoid colon. MRI with gel opacification after rectosigmoid colon cleansing improves visualization of rectosigmoid endometriosis. Nonetheless, the depth of bowel wall infiltration is still difficult to assess. In this regard, the use of high-frequency echoendoscope may be needed. Recognition of rectosigmoid endometriosis is important to establish a correct diagnosis and provide counseling and appropriate therapy.

Eur J Obstet Gynecol Reprod Biol.2012 Jul;163(1):57-61. Epub 2012 Apr 17.

Use of laparoscopy in unexplained infertility.

Bonneau C, Chanelles O, Sifer C, Poncelet C.

Source

Department of Obstetrics and Gynaecology, Pôle Femme-et-Enfant, CHU Jean Verdier, APHP, Bondy, France.

Abstract

OBJECTIVE:

The use of laparoscopy in unexplained infertility work-up is still a subject of debate, although laparoscopy remains the gold standard for diagnosis and treatment of several pelvic pathologies. The objective of this study was to assess the rates and types of pelvic pathologies observed during diagnostic laparoscopy, and the pregnancy rate in couples with unexplained infertility following laparoscopy.

STUDY DESIGN:

Prospective study, from November 2003 to October 2009, including 114 infertile, spontaneously ovulating women with normal clinical examination, ovarian reserve assessment, pelvic ultrasound scan and patent tubes on hysterosalpingography. Semen analyses were normal according to the World Health Organization criteria. After three cycles of ovulation induction with or without intra-uterine insemination and no pregnancy, women were referred for diagnostic laparoscopy.

RESULTS:

Laparoscopy revealed pelvic pathology in 95 patients. Endometriosis, pelvic adhesions and tubal disease were observed and treated in 72, 46 and 24 patients, respectively. Following laparoscopy, bilateral and unilateral tubal patencies were observed in 107 and five patients, respectively. Pregnancy was observed in 77 out of 102 patients who tried to conceive after surgery, 35 of whom conceived using their own tubes.

CONCLUSION:

Diagnostic laparoscopy should be strongly considered in unexplained infertility work-up, and tubal efficiency should not be underestimated.

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