Endometriosis: recent advances that could accelerate diagnosis and improve care

Trends in Molecular Medicine, Journal Year: 2024, Volume and Issue: 30(9), P. 875 - 889

Published: July 10, 2024

Endometriosis is a common disorder associated with pain, gastrointestinal and urinary symptoms, infertility, fatigue. It defined by the presence of endometrial-like lesions found predominantly in pelvis. Mechanisms that contribute to disease aetiology include changes hormonal, inflammatory, pain pathways. In this article, we focus on recent developments imaging technologies, our improved understanding mechanisms contributing drug therapies are clinical trials, insights from studies gut offer potential support self-management strategies. We postulate improvements quality life patients will be accelerated reframing endometriosis as multi-system learning treatments targeting symptoms shared between endometriosis, neuroinflammatory, disorders.

Language: Английский

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Update on the pathogenesis of endometriosis-related infertility based on contemporary evidence

Frontiers in Endocrinology, Journal Year: 2025, Volume and Issue: 16

Published: March 10, 2025

Endometriosis, the most prevalent cause of infertility, is associated with anatomical distortion leading to adhesions and fibrosis, as well endocrine abnormalities immune disorders. This review discusses mechanisms underlying endometriosis-related infertility. Firstly, alterations in hypothalamic-pituitary-ovarian axis lead secretion gonadotropins steroid hormones, adverse effects on ovulation implantation, fertility decline. Secondly, dysregulation hypothalamic-pituitary-adrenal induces elevated serum cortisol prolactin levels patients endometriosis, accounting for its regulation stress, depression, anxiety. Abnormal interactions between endometrial cells system change local microenvironment, resulting epithelial-mesenchymal transition inflammation. Activated epithelial cells, stromal immunocytes produce various chemokines, cytokines, or autoantibodies, creating an unfavorable environment embryo implantation. These findings suggest that spectrum play a crucial role Thirdly, oxidative stress has ovarian reserve subsequent embryonic development, predicting another promising strategy An unbalanced redox state, including impaired mitochondrial function, dysregulated lipid metabolism, iron-induced generates pro-oxidative which negatively impacts oocyte quality sperm viability. Thus, updated understanding involved this disease will help develop effective strategies manage

Language: Английский

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The impact of the microbiota-gut-brain axis on endometriosis-associated symptoms: mechanisms and opportunities for personalised management strategies

Reproduction and Fertility, Journal Year: 2024, Volume and Issue: 5(2)

Published: April 1, 2024

Graphical abstract Abstract Endometriosis is a chronic inflammatory condition affecting one in ten women and those assigned female at birth, defined by the presence of endometrial-like tissue outside uterus. It commonly associated with pain, infertility, mood disorders, often comorbid other pain conditions, such as irritable bowel syndrome. Recent research has identified key role for microbiota–gut–brain axis health range neurological prompting an exploration its potential mechanistic endometriosis. Increased awareness impact gut microbiota within patient community, combined often-detrimental side effects current therapies, motivated many to utilise self-management strategies, dietary modification supplements, despite lack robust clinical evidence. Current characterised endometriosis patients animal models. However, small cohorts differing methodology have resulted little consensus on data. In this narrative review, we summarise studies that investigated their metabolic products development progression lesions, before summarising insights from into co-morbid conditions discussing reported strategies symptoms Finally, suggest ways which promising field could be expanded explore specific bacteria, improve access ‘microbial’ phenotyping, develop personalised advice reduction bloating. Lay Summary tissue, similar womb lining, growing womb. Symptoms include pelvic period during sex when going toilet, digestive disturbance bloating, depression, anxiety. Standard treatments, including surgery hormone-altering drugs, negative effects. Many use control symptoms, changing diet or taking supplements. Although some reports are helpful, there limited high-quality evidence support use. Here, discuss how adaptations impacting endometriosis-associated via changes bacteria gut. Gut communicate brain influence inflammation throughout body. Therefore, altering through can potentially benefit variety symptoms.

Language: Английский

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Female reproductive disease, endometriosis: From inflammation to infertility

Molecules and Cells, Journal Year: 2024, Volume and Issue: unknown, P. 100164 - 100164

Published: Nov. 1, 2024

Language: Английский

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The inconsistent pathogenesis of endometriosis and adenomyosis: insights from endometrial metabolome and microbiome

mSystems, Journal Year: 2025, Volume and Issue: unknown

Published: April 22, 2025

ABSTRACT Endometriosis (EM) and adenomyosis (AM) are interrelated gynecological disorders characterized by the aberrant presence of endometrial tissue frequently linked with chronic pelvic pain infertility, yet their pathogenetic mechanisms remain largely unclear. In this cross-sectional study, we analyzed samples from 244 participants, split into 91 EM patients, 56 AM 97 healthy controls (HC). We conducted untargeted liquid chromatography-mass spectrometry (LC-MS) 5R 16S rRNA sequencing to examine metabolome microbiome profiles. Additionally, integrated transcriptomic analysis using nine data sets investigate biological basis these conditions. Metabolomic profiling revealed distinct metabolic microbial signatures. Specific pathways, including linoleic acid glycerophospholipid metabolism, show significant alterations in both Notably, four metabolites, phosphatidylcholine 40:8 [PC(40:8)], exhibited marked changes AM, suggesting shared pathological features. Furthermore, taxonomic identified unique bacterial species associated each condition, particularly those belonging phylum Proteobacteria, which correlated altered Machine learning models demonstrated high predictive accuracy for differentiating between EM, HC based on Integrative highlighted pathways related immune response signaling transduction condition. Our study provides fresh insights pathogenesis through a multi-omic approach, potential inconsistencies underlying mechanisms. IMPORTANCE Existing research connection endometriosis (AM), underscoring overlapping symptoms pathophysiological Although role microbiota inflammatory conditions has been acknowledged, comprehensive investigations cases have limited. Previous studies communities conditions; however, they were constrained small sample sizes lack analyses metabolomics. ongoing debate over whether should be classified as separate diseases or phenotypes emphasizes necessity further exploration molecular interactions. uncovers signatures revealing that may contribute pathogenesis. integration offers valuable complex interactions disorders.

Language: Английский

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Human Leukocyte Antigen Haplotypes Predisposing to Celiac Disease in Patients With Endometriosis

American Journal of Reproductive Immunology, Journal Year: 2025, Volume and Issue: 93(4)

Published: April 1, 2025

ABSTRACT Problem Immunological abnormalities are well recognized in the pathogenesis of endometriosis and co‐existence with inflammatory bowel disease (IBD) celiac (CD), along other systemic immune disorders, is clinically relevant. Recent genetic studies revealed some shared traits associated co‐occurrence different gastrointestinal or autoimmune highlighting common biological pathways. Since class II human leukocyte antigen (HLA) genes, HLA‐DQ2 ‐DQ8, show strongest best‐characterized susceptibility for CD, present study aims to explore presence these haplotypes non‐celiac patients endometriosis. Method Study A group ( n = 126) participated were compared healthy women 379), as controls. Subjects who diagnosed CD tested positive antibodies excluded. All controls genotyped HLA predisposing (DQ2, DQ8). In DQ2 and/or DQ8, symptoms also investigated. Results At least one ‐DQ8 genotypes was detected 43.3% (OR: 1.82, 95% CI: 1.11–2.81), whereas 29.5% p < 0.01) presented CD. patients, no significant difference shown between negative terms phenotype, gynecological, non‐gynecological symptoms. Conclusions Our data a significantly greater prevalence endometriosisthan subjects, suggesting that background may explain

Language: Английский

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Polygenic risk score phenome-wide association study reveals an association between endometriosis and testosterone

BMC Medicine, Journal Year: 2023, Volume and Issue: 21(1)

Published: Dec. 5, 2023

Abstract Background Endometriosis affects 1 in 9 women, yet it is poorly understood with long diagnostic delays, invasive diagnoses, and poor treatment outcomes. Characterised by the presence of endometrial-like tissue outside uterus, its main symptoms are pain infertility. often co-occurs other conditions, which may provide insights into origins endometriosis. Methods Here a polygenic risk score phenome-wide association study endometriosis was conducted UK Biobank to investigate pleiotropic effects genetic liability The relationship between for health blood urine biomarkers reproductive factors were investigated separately females, males females without an diagnosis. further using correlation Mendelian randomisation approaches identify causal relationships. Results Multiple associated each group, indicating many comorbidities not dependent on physical manifestation Differences traits highlighted importance sex-specific pathways overlap traits. Notably, lower testosterone levels identified. Follow-up analysis utilising suggested be both clear cell ovarian cancer. Conclusions This highlights diversity irrespective diagnosis A key finding identification effect randomisation.

Language: Английский

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Mutual influence of clinical manifestations of intestinal disorders and intestinal microbiot indicators in patients with deep endometriosis

Vestnik ohrany materinstva i mladenčestva., Journal Year: 2025, Volume and Issue: 1(3), P. 10 - 24

Published: Jan. 13, 2025

Summary. Endometriosis is a chronic multifactorial disease that affects more than 170 million women of reproductive age worldwide, causing pelvic pain syndrome, dyspareunia, and symptoms gastrointestinal dyspepsia, thereby having negative impact on the psycho-emotional state patients. Despite wide range medical surgical treatments, relapse rate reaches 50%, which global economic social problem. The purpose study. to evaluate mutual influence clinical manifestations intestinal disorders microbiota in patients with deep endometriosis. Materials methods. study included 83 who underwent treatment common forms external genital first group consisted 32 repeated due infiltrative endometriosis, second — 51 without one year after primary operation, third 30 age. not suffering from An analysis somatic anamnesis was carried out, as well questionnaire data visual analogue scale (VAS) functional bowel infiltrating depending status disease. composition assessed by quantitative real-time PCR using test system for determining DNA intestinal-associated microorganisms. Results discussion. results demonstrate bidirectional relationships between microbiological parameters recurrent course Patients main significantly often suffered diseases tract, spectrum represented gastritis irritable syndrome. Correlation indicators Bacillota domain anamnestic pathology, values scales endometriosis moderate positive weight number Lachnospiraceae (r = 0.63299), bloating Streptococcus spp (r=0.67402). Bacteroidota corresponding strong amount E.Coli level VAS 1 0.62366) 3 months 0. 72598) surgery. Moderate correlations were revealed Enterobacterales (r=0.58169) (r=0.57706) Conclusions. accompanied disorders, persist treatment, mediated changes microbiota. In decrease species taxonomic diversity found, an increase Bacillota/Bacteroidota ratio, pathobionts, commensal bacteria genus Bifidobacterium spp. These parallels need harmonize comprehensive prevention relapse.

Language: Английский

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FOXA2 loss results in an increase of endometriosis development and LIF reveals a therapeutic effect for endometriosis

The FASEB Journal, Journal Year: 2025, Volume and Issue: 39(5)

Published: March 1, 2025

Abstract Endometriosis, characterized by the growth of uterine‐like tissue outside uterus, causes chronic pain and infertility. Current diagnostic therapeutic strategies have notable limitations, including delayed diagnosis adverse effects. The transcription factor forkhead box A2 (FOXA2), which is exclusively expressed in uterine glandular epithelium, regulates key genes involved endometrial proliferation, differentiation, fertility, hormone response. While FOXA2 expression reduced women with endometriosis, its pathophysiological role disease not well understood. In this study, we report that endometriosis significantly eutopic endometrium mice compared to sham controls, accompanied decreased downstream gene, CXCL15. To evaluate effect loss surgically induced transplanting control Rosa26 mTmG/+ or Pgr cre/+ Foxa2 f/f ( d/d ) into peritoneal cavity mice. number weight ectopic lesions were increased controls. Furthermore, progesterone receptor was epithelium from lesions. Importantly, treatment leukemia inhibitory (LIF), a cytokine regulated FOXA2, lesion formation vehicle‐treated This study demonstrates results an increase incidence LIF offers novel promising approach for endometriosis.

Language: Английский

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Clinical and anamnestic features of women with genital endometriosis depending on the presence or absence of infertility

Meditsinskiy sovet = Medical Council, Journal Year: 2025, Volume and Issue: 5, P. 126 - 135

Published: May 4, 2025

Introduction. Genital endometriosis makes the “top three” gynecologic disorders and is of high social significance. According to various authors, from 30 50% patients with suffer infertility. As today, there are many theories describing occurrence endometriosis-associated infertility, however, no direct evidence infertility due endometriosis. Aim. To carry out a detailed analysis medical-biological clinical-anamnestic features genital depending on presence or absence Materials methods. This study included 395 (132 women concomitant 263 – without infertility). The diagnosis was established based results morphological examination after surgical treatment. Results. It found that among early reproductive age (from 20 35 years old, 56.06%) body weight deficiency prevailed. group characterized by higher incidence acute pelvic pain (1.9 times), premenstrual syndrome (1.8 constipation (1.3 earlier sexual debut (14 18 years). A single abortion more often recorded; an artificially performed abortions years, revealed; sexually transmitted diseases (STDs) were registered (2.7 times) than in Surgical interventions ovaries individuals 3.2 times frequent, ectopic pregnancies 4 frequent. Conclusion. conducted allowed revealing significant differences biomedical characteristics which should be taken into account clinical management patients.

Language: Английский

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