Biomedicines

Research

13 pages, 2507 KiB

Open AccessArticle

Expression of E-CADHERIN and miR-200b in Different Forms of Endometriosis

by Konstantinos Ntzeros, Charalampos Voros, Despoina Mavrogianni, Nikolaos Kathopoulis, Konstantinos Kypriotis, Antonia Varthaliti, Menelaos Darlas, Athanasios Douligeris and Athanasios Protopapas

Biomedicines 2025, 13(2), 524; https://doi.org/10.3390/biomedicines13020524 - 19 Feb 2025

Cited by 1 | Viewed by 480

Abstract

Background/Objectives: Epithelial–Mesenchymal Transition (EMT) is the process by which epithelial cells acquire mesenchymal properties, which helps endometriotic cells migrate and invade. This study looks at the expression of E-CADHERIN, a critical epithelial marker, and miR-200b, an EMT regulator, in several types [...] Read more.

Background/Objectives: Epithelial–Mesenchymal Transition (EMT) is the process by which epithelial cells acquire mesenchymal properties, which helps endometriotic cells migrate and invade. This study looks at the expression of E-CADHERIN, a critical epithelial marker, and miR-200b, an EMT regulator, in several types of endometriosis, including endometriomas and deep infiltrating endometriotic (DIE) nodules. Methods: We examined 19 individuals with endometriosis (9 with just endometriotic cysts and 10 with both DIE and endometriotic cysts) and 8 controls with benign gynecological abnormalities. Tissue samples were taken during laparoscopic surgery, and E-CADHERIN and miR-200b expression were measured using Real-Time PCR, with G6PD and U6 as controls. Results:E-CADHERIN expression was maintained in the eutopic endometrium of both ovarian and DIE types, but it was considerably reduced in endometriotic cysts, indicating heightened mesenchymal features. miR-200b was downregulated in the eutopic endometrium of ovarian endometriosis but upregulated in DIE. Endometriotic cysts in both groups had greater miR-200b expression than their corresponding eutopic endometrium. E-CADHERIN and miR-200b expression in DIE lesions was similar to that found in matched eutopic endometrium. Conclusions: The regulation of E-CADHERIN and miR-200b varies across ovarian and DIE lesions. The miR-200b-ZEB1 feedback loop is increased in DIE eutopic endometrium but downregulated in ovarian endometriosis. E-CADHERIN downregulation in endometriotic cysts indicates heightened mesenchymal dynamics, whereas DIE nodules have gene expression patterns similar to eutopic endometrium. These findings emphasize the distinct regulatory processes that govern endometriotic lesions. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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11 pages, 531 KiB

Open AccessArticle

Adenomyosis Localized in Both the Anterior and Posterior Myometrium Is Associated with Deep Rectal Endometriosis: A Retrospective Study

by Konstantin Schawlochow, Nicolas Samartzis, Laurin Burla, Markus Eberhard, Dimitrios Rafail Kalaitzopoulos and Brigitte Leeners

Biomedicines 2024, 12(11), 2527; https://doi.org/10.3390/biomedicines12112527 - 4 Nov 2024

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Abstract

Background: Endometriosis and adenomyosis are two closely related, estrogen-dependent, benign gynecological diseases. The available evidence on their common pathogenesis and association is limited and often does not address the heterogeneity of both entities. The aim of our study is to investigate the association [...] Read more.

Background: Endometriosis and adenomyosis are two closely related, estrogen-dependent, benign gynecological diseases. The available evidence on their common pathogenesis and association is limited and often does not address the heterogeneity of both entities. The aim of our study is to investigate the association between different types and localizations of adenomyosis and endometriosis phenotypes, using magnetic resonance imaging (MRI) and laparoscopic findings. Methods: We performed a retrospective observational study involving premenopausal women over 18 years old who underwent laparoscopic surgery for endometriosis and were pre-operatively diagnosed with adenomyosis through MRI examination at the Cantonal Hospital of Schaffhausen, Switzerland between 2011 and 2022. Results: Of 130 patients with adenomyosis, 23 (17.7%) women had adenomyosis only in the anterior wall (group 1), 38 (29.2%) only in the posterior wall (group 2), and 69 (53.1%) in both the anterior and posterior wall (group 3). Women in group 1 experienced significantly more dysuria compared to the two other groups (p = 0.018), while the prevalence of other pain symptoms (dysmenorrhea, dyspareunia, dyschesia) was comparable between the groups. Women in group 3 had significantly thicker anterior and posterior myometrium compared to groups 1 and 2 (p < 0.001). Co-existence of deep rectal endometriosis was more frequent in women from group 3 compared to groups 1 and 2 (p = 0.039) and in women with adenomyosis in the outer (extrinsic) compared to adenomyosis in the inner myometrium (intrinsic) (p < 0.001). Conclusions: This study provides evidence of an association between the localization of adenomyosis and the distribution of concomitant endometriosis. Specifically, adenomyosis localized in both the anterior and posterior wall appears to be more proliferative compared to adenomyosis found only in the anterior or posterior wall. This is indicated by its association with higher uterine volume, thicker posterior junctional zone, and greater myometrial thickness and with a higher co-existence with deep rectal endometriosis. These findings support an association between the development of specific subtypes of both entities, which represents a valuable resource for the identification of future targets for the treatment and clinical management of adenomyosis and endometriosis. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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14 pages, 2504 KiB

Open AccessArticle

Circulating Serum Micro-RNA as Non-Invasive Diagnostic Biomarkers of Endometriosis

by Antonella Ravaggi, Cosetta Bergamaschi, Chiara Galbiati, Laura Zanotti, Aline S. C. Fabricio, Massimo Gion, Elia Cappelletto, Antonette E. Leon, Massimo Gennarelli, Cesare Romagnolo, Giuseppe Ciravolo, Stefano Calza, Eliana Bignotti and Franco Odicino

Biomedicines 2024, 12(10), 2393; https://doi.org/10.3390/biomedicines12102393 - 19 Oct 2024

Cited by 1 | Viewed by 1593

Abstract

Background/Objectives: Endometriosis (END) is a painful gynecological condition. Clinical examination, imaging, and laparoscopy can provide a definitive diagnosis of END. Nonetheless, non-invasive biomarkers could help enhance and streamline the diagnostic process. Micro-RNAs (miRNAs), a family of small non-coding RNAs, could serve as useful [...] Read more.

Background/Objectives: Endometriosis (END) is a painful gynecological condition. Clinical examination, imaging, and laparoscopy can provide a definitive diagnosis of END. Nonetheless, non-invasive biomarkers could help enhance and streamline the diagnostic process. Micro-RNAs (miRNAs), a family of small non-coding RNAs, could serve as useful non-invasive biomarkers for END. The aim of this study was to perform serum miRNA profiling in a retrospective cohort of women to identify miRNAs that are differentially expressed in END compared to control patients. Methods: RNA was isolated from serum samples of 67 END patients and 60 control women. The expression profile of a 754-miRNA panel was studied with RT-qPCR performed on a QuantStudio 12K Flex with the TaqMan OpenArray miRNA panel. A Censored Regression Model was used for miRNA differential expression analysis. Several gene-enrichment algorithms were employed to identify pathways related to the target genes of differentially expressed miRNAs. Results: One hundred and thirty miRNAs were detected in at least 75% of samples from either the END or the control group. Sixteen miRNAs were significantly modulated between the END and control groups. Enrichment analysis identified targets significantly overrepresented in numerous pathways involved in biological processes related to END, including inflammation, angiogenesis, cellular invasion, cell-cycle/cell proliferation, and estrogen and progesterone hormonal signaling. Conclusions: Our study indicates that differentially expressed miRNAs between END patients and controls can be identified through liquid biopsy. Our findings also suggest a potential role for serum miRNAs in the pathophysiology of END, warranting further investigations for their use as non-invasive biomarkers. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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10 pages, 1659 KiB

Open AccessArticle

Innovative Ultrasound Criteria for the Diagnosis of Adenomyosis and Correlation with Symptoms: A Retrospective Re-Evaluation

by Anna Biasioli, Matilde Degano, Stefano Restaino, Margherita Bagolin, Francesca Moro, Francesca Ciccarone, Antonia Carla Testa, Pantaleo Greco, Giovanni Scambia, Giuseppe Vizzielli, Lorenza Driul and The Udine Hospital Endometriosis Group

Biomedicines 2024, 12(2), 463; https://doi.org/10.3390/biomedicines12020463 - 19 Feb 2024

Cited by 3 | Viewed by 4455

Abstract

The 2022 Delphi revision of the MUSA (Morphological Uterus Sonographic Assessment) criteria for the ultrasound diagnosis of adenomyosis divides the ultrasound signs for diagnosis into direct and indirect ones, considering the presence of at least one direct sign as a mandatory criterion. This [...] Read more.

The 2022 Delphi revision of the MUSA (Morphological Uterus Sonographic Assessment) criteria for the ultrasound diagnosis of adenomyosis divides the ultrasound signs for diagnosis into direct and indirect ones, considering the presence of at least one direct sign as a mandatory criterion. This study aimed to reclassify the patients referred to the Pelvic Pain specialist outpatient clinic of the Gynecological Clinic of Udine according to the new criteria, evaluating the number of overdiagnoses and the possible correlation between the direct and indirect signs and the patients’ symptoms. 62 patients affected by adenomyosis were retrospectively recruited. The patients were then re-evaluated by ultrasound and clinically. At least one direct sign of adenomyosis was found in 52 patients, while 16% of the population examined did not present any. There was no statistically significant difference between patients presenting direct signs and those presenting none for the symptoms considered. According to the new criteria, 16% of the patients examined were not affected by adenomyosis; applying the new consensus to symptomatic patients could increase false negatives. In a population of symptomatic patients, the diagnosis of adenomyosis is still highly probable even without direct ultrasound signs, given the clinical symptoms and having ruled out other causes of such symptoms. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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11 pages, 1495 KiB

Open AccessArticle

Diagnosis of Endometriosis Based on Comorbidities: A Machine Learning Approach

by Ulan Tore, Aibek Abilgazym, Angel Asunsolo-del-Barco, Milan Terzic, Yerden Yemenkhan, Amin Zollanvari and Antonio Sarria-Santamera

Biomedicines 2023, 11(11), 3015; https://doi.org/10.3390/biomedicines11113015 - 10 Nov 2023

Cited by 8 | Viewed by 2727

Abstract

Endometriosis is defined as the presence of estrogen-dependent endometrial-like tissue outside the uterine cavity. Despite extensive research, endometriosis is still an enigmatic disease and is challenging to diagnose and treat. A common clinical finding is the association of endometriosis with multiple diseases. We [...] Read more.

Endometriosis is defined as the presence of estrogen-dependent endometrial-like tissue outside the uterine cavity. Despite extensive research, endometriosis is still an enigmatic disease and is challenging to diagnose and treat. A common clinical finding is the association of endometriosis with multiple diseases. We use a total of 627,566 clinically collected data from cases of endometriosis (0.82%) and controls (99.18%) to construct and evaluate predictive models. We develop a machine learning platform to construct diagnostic tools for endometriosis. The platform consists of logistic regression, decision tree, random forest, AdaBoost, and XGBoost for prediction, and uses Shapley Additive Explanation (SHAP) values to quantify the importance of features. In the model selection phase, the constructed XGBoost model performs better than other algorithms while achieving an area under the curve (AUC) of 0.725 on the test set during the evaluation phase, resulting in a specificity of 62.9% and a sensitivity of 68.6%. The model leads to a quite low positive predictive value of 1.5%, but a quite satisfactory negative predictive value of 99.58%. Moreover, the feature importance analysis points to age, infertility, uterine fibroids, anxiety, and allergic rhinitis as the top five most important features for predicting endometriosis. Although these results show the feasibility of using machine learning to improve the diagnosis of endometriosis, more research is required to improve the performance of predictive models for the diagnosis of endometriosis. This state of affairs is in part attributed to the complex nature of the condition and, at the same time, the administrative nature of our features. Should more informative features be used, we could possibly achieve a higher AUC for predicting endometriosis. As a result, we merely perceive the constructed predictive model as a tool to provide auxiliary information in clinical practice. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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21 pages, 1469 KiB

Open AccessArticle

Puzzling Out the Genetic Architecture of Endometriosis: Whole-Exome Sequencing and Novel Candidate Gene Identification in a Deeply Clinically Characterised Cohort

by Aurora Santin, Beatrice Spedicati, Anna Morgan, Stefania Lenarduzzi, Paola Tesolin, Giuseppe Giovanni Nardone, Daniela Mazzà, Giovanni Di Lorenzo, Federico Romano, Francesca Buonomo, Alessandro Mangogna, Maria Pina Concas, Gabriella Zito, Giuseppe Ricci and Giorgia Girotto

Biomedicines 2023, 11(8), 2122; https://doi.org/10.3390/biomedicines11082122 - 27 Jul 2023

Cited by 6 | Viewed by 2300

Abstract

Endometriosis (EM) is a common multifactorial gynaecological disorder. Although Genome-Wide Association Studies have largely been employed, the current knowledge of the genetic mechanisms underlying EM is far from complete, and other approaches are needed. To this purpose, whole-exome sequencing (WES) was performed on [...] Read more.

Endometriosis (EM) is a common multifactorial gynaecological disorder. Although Genome-Wide Association Studies have largely been employed, the current knowledge of the genetic mechanisms underlying EM is far from complete, and other approaches are needed. To this purpose, whole-exome sequencing (WES) was performed on a deeply characterised cohort of 80 EM patients aimed at the identification of rare and damaging variants within 46 EM-associated genes and novel candidates. WES analysis detected 63 rare, predicted, and damaging heterozygous variants within 24 genes in 63% of the EM patients. In particular, (1) a total of 43% of patients carried variants within 13 recurrent genes (FCRL3, LAMA5, SYNE1, SYNE2, GREB1, MAP3K4, C3, MMP3, MMP9, TYK2, VEGFA, VEZT, RHOJ); (2) a total of 8.8% carried private variants within eight genes (KAZN, IL18, WT1, CYP19A1, IL1A, IL2RB, LILRB2, ZNF366); (3) a total of 24% carried variants within three novel candidates (ABCA13, NEB, CSMD1). Finally, to deepen the polygenic architecture of EM, a comprehensive evaluation of the analysed genes was performed, revealing a higher burden (p < 0.05) of genes harbouring rare and damaging variants in the EM patients than in the controls. These results highlight new insights into EM genetics, allowing for the definition of novel genotype–phenotype correlations, thereby contributing, in a long-term perspective, to the development of personalised care for EM patients. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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Review

Jump to: Research, Other

18 pages, 833 KiB

Open AccessReview

Comparison of Surgical Interventions for Endometrioma: A Systematic Review of Their Efficacy in Addressing Infertility

by Alexandra Ioannidou, Nikolaos Machairiotis, Sofoklis Stavros, Anastasios Potiris, Theodoros Karampitsakos, Athanasios G. Pantelis and Petros Drakakis

Biomedicines 2024, 12(12), 2930; https://doi.org/10.3390/biomedicines12122930 - 23 Dec 2024

Viewed by 1635

Abstract

Background: Endometriosis is characterized by the presence of endometrial tissue outside the uterus. Beyond medical treatment, surgical intervention is also a viable consideration. However, current guidelines do not clearly indicate whether laparoscopic cystectomy, ablative methods (CO₂ laser vaporization, plasma energy), or [...] Read more.

Background: Endometriosis is characterized by the presence of endometrial tissue outside the uterus. Beyond medical treatment, surgical intervention is also a viable consideration. However, current guidelines do not clearly indicate whether laparoscopic cystectomy, ablative methods (CO₂ laser vaporization, plasma energy), or sclerotherapy is the preferred option. Methods: We conducted searches in two databases (PubMed and Europe PMC) to retrieve articles containing the keywords ‘surgical intervention for Endometrioma, ovarian reserve, pregnancy rates, fertility’, published between 1 January 2000 and 31 December 2023. We included articles presenting information on surgical intervention for endometrioma and its correlation with infertility parameters. Articles describing conservative treatment were excluded. Data were extracted by two authors using predefined criteria. Results: The initial database search produced 1376 articles, which were narrowed down to 41 relevant articles meeting the eligibility criteria. Conclusions: Laparoscopic cystectomy appears to impact postoperative anti-mullerian hormone levels, showing a stronger correlation with larger cysts and individual factors. CO₂ laser vaporization demonstrates favorable results compared to traditional cystectomy. Combining GnRH agonist treatment with assisted reproduction treatment after cystectomy could be considered an alternative method. Plasma energy causes less damage to ovarian function, with pregnancy outcomes comparable to cystectomy. Sclerotherapy shows promising results for ovarian reserve preservation, recurrence rates, and safety. Further studies comparing these techniques are necessary to provide guidance to clinicians. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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13 pages, 1208 KiB

Open AccessReview

The Critical Role of Host and Bacterial Extracellular Vesicles in Endometriosis

by Michaela Wagner, Chloe Hicks, Emad El-Omar, Valery Combes and Fatima El-Assaad

Biomedicines 2024, 12(11), 2585; https://doi.org/10.3390/biomedicines12112585 - 12 Nov 2024

Viewed by 1585

Abstract

Endometriosis is a chronic, inflammatory, oestrogen-dependent disorder that is defined by the presence of endometrium-like tissue in the extra-uterine environment. It is estimated to affect approximately 10% of women of reproductive age, and the cause is still largely unknown. The heterogenous nature and [...] Read more.

Endometriosis is a chronic, inflammatory, oestrogen-dependent disorder that is defined by the presence of endometrium-like tissue in the extra-uterine environment. It is estimated to affect approximately 10% of women of reproductive age, and the cause is still largely unknown. The heterogenous nature and complex pathophysiology of the disease results in diagnostic and therapeutic challenges. This review examines the emerging role of host extracellular vesicles (EVs) in endometriosis development and progression, with a particular focus on bacterial extracellular vesicles (BEVs). EVs are nano-sized membrane-bound particles that can transport bioactive molecules such as nucleic acids, proteins, and lipids, and therefore play an essential role in intercellular communication. Due to their unique cargo composition, EVs can play a dual role, both in the disease pathogenesis and as biomarkers. Both host and bacterial EVs (HEVs and BEVs) have been implicated in endometriosis, by modulating inflammatory responses, angiogenesis, tissue remodelling, and cellular proliferation within the peritoneal microenvironment. Understanding the intricate mechanisms underlying EVs in endometriosis pathophysiology and modulation of the lesion microenvironment may lead to novel diagnostic tools and therapeutic targets. Future research should focus on uncovering the specific cargo, the inter-kingdom cell-to-cell interactions, and the anti-inflammatory and anti-microbial mechanisms of both HEVs and BEVs in endometriosis in the hope of discovering translational findings that could improve the diagnosis and treatment of the disease. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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25 pages, 1287 KiB

Open AccessReview

The Impact of Adenomyosis on Pregnancy

by Panagiotis Tsikouras, Nektaria Kritsotaki, Konstantinos Nikolettos, Sonia Kotanidou, Efthymios Oikonomou, Anastasia Bothou, Sotiris Andreou, Theopi Nalmpanti, Kyriaki Chalkia, Vlasios Spanakis, Nikolaos Tsikouras, Melda Chalil, Nikolaos Machairiotis, George Iatrakis and Nikolaos Nikolettos

Biomedicines 2024, 12(8), 1925; https://doi.org/10.3390/biomedicines12081925 - 22 Aug 2024

Cited by 2 | Viewed by 3176

Abstract

Adenomyosis is characterized by ectopic proliferation of endometrial tissue within the myometrium. Histologically, this condition is marked by the presence of islands of benign endometrial glands surrounded by stromal cells. The myometrium appears thinner, and cross-sectional analysis often reveals signs of recent or [...] Read more.

Adenomyosis is characterized by ectopic proliferation of endometrial tissue within the myometrium. Histologically, this condition is marked by the presence of islands of benign endometrial glands surrounded by stromal cells. The myometrium appears thinner, and cross-sectional analysis often reveals signs of recent or chronic hemorrhage. The ectopic endometrial tissue may respond to ovarian hormonal stimulation, exhibiting proliferative or secretory changes during the menstrual cycle, potentially leading to bleeding, uterine swelling, and pain. Adenomyosis can appear as either a diffuse or focal condition. It is crucial to understand that adenomyosis involves the infiltration of the endometrium into the myometrium, rather than its displacement. The surgical management of adenomyosis is contingent upon its anatomical extent. The high incidence of the disease and the myths that develop around it increase the need to study its characteristics and its association with pregnancy and potential obstetric complications. These complications often require quick decisions, appropriate diagnosis, and proper counseling. Therefore, knowing the possible risks associated with adenomyosis is key to decision making. Pregnancy has a positive effect on adenomyosis and its painful symptoms. This improvement is not only due to the inhibition of ovulation, which inhibits the bleeding of adenomyotic tissue, but also to the metabolic, hormonal, immunological, and angiogenic changes associated with pregnancy. Adenomyosis affects pregnancy through disturbances of the endocrine system and the body’s immune response at both local and systemic levels. It leads to bleeding from the adenomyotic tissue, molecular and functional abnormalities of the ectopic endometrium, abnormal placentation, and destruction of the adenomyotic tissue due to changes in the hormonal environment that characterizes pregnancy. Some of the obstetric complications that occur in women with adenomyosis in pregnancy include miscarriage, preterm delivery, placenta previa, low birth weight for gestational age, obstetric hemorrhage, and the need for cesarean section. These complications are an understudied field and remain unknown to the majority of obstetricians. These pathological conditions pose challenges to both the typical progression of pregnancy and the smooth conduct of labor in affected women. Further multicenter studies are imperative to validate the most suitable method for concluding labor following surgical intervention for adenomyosis. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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14 pages, 893 KiB

Open AccessReview

Endometriosis in Transgender Men: Bridging Gaps in Research and Care—A Narrative Review

by Aris Kaltsas, Marios Stavropoulos, Evangelos N. Symeonidis, Zisis Kratiras, Athanasios Zachariou, Athanasios Zikopoulos, Efthalia Emmanouela Chrisofos, Fotios Dimitriadis, Nikolaos Sofikitis and Michael Chrisofos

Biomedicines 2024, 12(7), 1481; https://doi.org/10.3390/biomedicines12071481 - 4 Jul 2024

Cited by 3 | Viewed by 2850

Abstract

Endometriosis is a debilitating gynecological condition commonly seen in individuals designated female at birth; however, there has been limited research focused on its prevalence and impact among transgender men. This narrative review aims to fill a critical knowledge gap by exploring the epidemiology, [...] Read more.

Endometriosis is a debilitating gynecological condition commonly seen in individuals designated female at birth; however, there has been limited research focused on its prevalence and impact among transgender men. This narrative review aims to fill a critical knowledge gap by exploring the epidemiology, clinical manifestations, management strategies, and quality-of-life implications of endometriosis among transgender individuals who identify as male. Specifically, this study seeks to estimate the prevalence rates and describe the symptoms experienced by transgender men undergoing testosterone therapy. Additionally, it addresses the diagnostic challenges posed by hormonal treatments and the lack of culturally competent healthcare services for this population. Recent molecular studies indicate that hormonal imbalances, such as increased estrogen synthesis and progesterone resistance, are significant factors in the persistence of endometriosis symptoms despite testosterone therapy. Moreover, evidence suggests that testosterone therapy may not always suppress endometrial activity completely, contributing to the persistence of symptoms in some individuals. Endometriosis in transgender men requires personalized approaches that consider both testosterone therapy and its interactions with endometriosis, as well as fertility preservation and the psychosocial aspects of treatment. This review emphasizes the necessity of taking an inclusive approach in both research and clinical practice to improve healthcare outcomes for this underserved population. The results demonstrate how continued research, education, and healthcare services tailored specifically to transgender men are necessary to better understand and treat endometriosis, thus improving both their overall health and quality of life. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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20 pages, 371 KiB

Open AccessReview

Endometriosis: A Comprehensive Analysis of the Pathophysiology, Treatment, and Nutritional Aspects, and Its Repercussions on the Quality of Life of Patients

by Gabriela Cano-Herrera, Sylvia Salmun Nehmad, Jimena Ruiz de Chávez Gascón, Amairani Méndez Vionet, Ximena A. van Tienhoven, María Fernanda Osorio Martínez, Mauricio Muleiro Alvarez, Mariana Ximena Vasco Rivero, María Fernanda López Torres, María Jimena Barroso Valverde, Isabel Noemi Torres, Alexa Cruz Olascoaga, Maria Fernanda Bautista Gonzalez, José Antonio Sarkis Nehme, Ignacio Vélez Rodríguez, Renata Murguiondo Pérez, Felipe Esparza Salazar, Ana Gabriela Sierra Bronzon, Eder Gabriel Rivera Rosas, Dante Carbajal Ocampo and Ramiro Cabrera Carranco Show full author list Hide full author list

Biomedicines 2024, 12(7), 1476; https://doi.org/10.3390/biomedicines12071476 - 4 Jul 2024

Cited by 11 | Viewed by 10519

Abstract

Endometriosis is a chronic proinflammatory pathology characterized by the growth of tissue similar to the endometrium outside the uterus, affecting approximately 5 to 15% of women worldwide. Suffering from endometriosis entails a complex pathophysiological process, significantly impacting the quality of life and reproductive [...] Read more.

Endometriosis is a chronic proinflammatory pathology characterized by the growth of tissue similar to the endometrium outside the uterus, affecting approximately 5 to 15% of women worldwide. Suffering from endometriosis entails a complex pathophysiological process, significantly impacting the quality of life and reproductive function of affected women; therefore, it must be addressed in a personalized and comprehensive manner, as its management requires a multidisciplinary approach. This article aims to conduct a comprehensive literature review of endometriosis, not only as a pathophysiological condition but also as a significant factor impacting the social, nutritional, and mental well-being of those who experience it. Emphasis is placed on the importance of understanding and assessing the impact of the pathology to provide a better and more comprehensive approach, integrating various alternatives and strategic treatments for the factors involved in its development. The aim is to provide a complete overview of endometriosis, from its pathophysiology to its impact on the quality of life of patients, as well as a review of current treatment options, both pharmacological and alternative, in order to broaden the perspective on the pathology to improve the care of patients with this disease. Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

Other

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15 pages, 440 KiB

Open AccessSystematic Review

The Different Gene Expression Profile in the Eutopic and Ectopic Endometrium Sheds New Light on the Endometrial Seed in Endometriosis

by Muhammad Assad Riaz, Ezekiel Onyonka Mecha, Charles O. A. Omwandho, Felix Zeppernick, Ivo Meinhold-Heerlein and Lutz Konrad

Biomedicines 2024, 12(6), 1276; https://doi.org/10.3390/biomedicines12061276 - 8 Jun 2024

Cited by 1 | Viewed by 1694

Abstract

The changes in endometrial cells, both in the eutopic endometrium of patients with and without endometriosis and in lesions at ectopic sites, are frequently described and often compared to tumorigenesis. In tumorigenesis, the concept of “seed and soil” is well established. The seed [...] Read more.

The changes in endometrial cells, both in the eutopic endometrium of patients with and without endometriosis and in lesions at ectopic sites, are frequently described and often compared to tumorigenesis. In tumorigenesis, the concept of “seed and soil” is well established. The seed refers to tumor cells with metastatic potential, and the soil is any organ or tissue that provides a suitable environment for the seed to grow. In this systematic review (PRISMA-S), we specifically compared the development of endometriosis with the “seed and soil” hypothesis. To determine changes in the endometrial seed, we re-analyzed the mRNA expression data of the eutopic and ectopic endometrium, paying special attention to the epithelial–mesenchymal transition (EMT). We found that the similarity between eutopic endometrium without and with endometriosis is extremely high (~99.1%). In contrast, the eutopic endometrium of patients with endometriosis has a similarity of only 95.3% with the ectopic endometrium. An analysis of EMT-associated genes revealed only minor differences in the mRNA expression levels of claudin family members without the loss of other cell–cell junctions that are critical for the epithelial phenotype. The array data suggest that the changes in the eutopic endometrium (=seed) are quite subtle at the beginning of the disease and that most of the differences occur after implantation into ectopic locations (=soil). Full article

(This article belongs to the Special Issue Advanced Research in Endometriosis 4.0)

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