Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment

Endocrine Reviews, Journal Year: 2021, Volume and Issue: 43(4), P. 678 - 719

Published: Nov. 6, 2021

Abstract Uterine fibroids are benign monoclonal neoplasms of the myometrium, representing most common tumors in women worldwide. To date, no long-term or noninvasive treatment option exists for hormone-dependent uterine fibroids, due to limited knowledge about molecular mechanisms underlying initiation and development fibroids. This paper comprehensively summarizes recent research advances on focusing risk factors, origin, pathogenetic mechanisms, options. Additionally, we describe current interventions Finally, future perspectives studies summarized. Deeper mechanistic insights into tumor etiology complexity can contribute progress newer targeted therapies.

Language: Английский

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Racial disparities in uterine fibroids and endometriosis: a systematic review and application of social, structural, and political context

Fertility and Sterility, Journal Year: 2023, Volume and Issue: 119(3), P. 355 - 363

Published: Jan. 20, 2023

Language: Английский

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Gut microbiota and microbiota-derived metabolites promotes endometriosis

Cell Death Discovery, Journal Year: 2023, Volume and Issue: 9(1)

Published: Jan. 25, 2023

Endometriosis is a pathological condition of the female reproductive tract characterized by existence endometrium-like tissue at ectopic sites, affecting 10% women between age 15 and 49 in USA. However, currently there no reliable non-invasive method to detect presence endometriosis without surgery many find hormonal therapy as ineffective avoiding recurrences. There lack knowledge on etiology factors that contribute development endometriosis. A growing body recent evidence suggests an association gut microbiota pathophysiology. direct impact microbiota-derived metabolites disease progression largely unknown. To understand causal role endometriosis, we have implemented novel model using antibiotic-induced microbiota-depleted (MD) mice investigate progression. Interestingly, found MD showed reduced endometriotic lesion growth and, transplantation oral gavage feces from with rescued growth. Additionally, germ-free donor mice, indicated uterine dispensable for mice. Furthermore, modulates immune cell populations peritoneum lesions-bearing Finally, signature were significantly altered one metabolite, quinic acid promoted survival epithelial cells vitro vivo, suggesting disease-promoting potential metabolites. In summary, these data suggest metabolome possibly through adaptations. Of translational significance, findings will aid designing diagnostics stool

Language: Английский

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Endometriosis and the Role of Pro-Inflammatory and Anti-Inflammatory Cytokines in Pathophysiology: A Narrative Review of the Literature

Diagnostics, Journal Year: 2024, Volume and Issue: 14(3), P. 312 - 312

Published: Jan. 31, 2024

Endometriosis is a chronic inflammatory disease, which explains the pain that such patients report. Currently, we are faced with ineffective, non-invasive diagnostic methods and treatments come multiple side effects high recurrence rates for both disease pain. These reasons why exploring possibility of involvement pro-inflammatory anti-inflammatory molecules in process appearance endometriosis. Cytokines play an important role progression endometriosis, influencing cell proliferation differentiation. Pro-inflammatory found intrafollicular fluid. They have impact on number mature optimal-quality oocytes. affects fertility, endometriosis embryo transfer during vitro fertilization (IVF) being investigated several studies. Furthermore, reciprocal influence between cytokines their pathogenesis has been assessed. Today, can affirm roles survival, growth, differentiation, invasion, angiogenesis, immune escape, provides perspective approaching future clinical implications be used as biomarkers or therapy.

Language: Английский

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Diet and Nutrition in Gynecological Disorders: A Focus on Clinical Studies

Nutrients, Journal Year: 2021, Volume and Issue: 13(6), P. 1747 - 1747

Published: May 21, 2021

A healthy lifestyle and a balanced diet play paramount role in promoting maintaining homeostatic functions preventing an array of chronic debilitating diseases. Based upon observational epidemiological investigations, it is clear that nutritional factors dietary habits significant gynecological disease development, including uterine leiomyoma, endometriosis, polycystic ovary syndrome, malignancies. Diets rich fruits vegetables, Mediterranean diets, green tea, vitamin D, plant-derived natural compounds may have long-term positive impact on diseases, while fats, red meat, alcohol, coffee contribute to their development. Data regarding the association between disorders are, at times, conflicting, with potential confounding factors, food pollutants, reduced physical activity, ethnic background, environmental limiting overall conclusions. This review provides synopsis current clinical data biological basis available data, along biology pathophysiology different disorders, as well outlook future directions will guide further investigational research.

Language: Английский

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Epigenetic Dysregulation in Endometriosis: Implications for Pathophysiology and Therapeutics

Endocrine Reviews, Journal Year: 2023, Volume and Issue: 44(6), P. 1074 - 1095

Published: July 6, 2023

Abstract Endometriosis is a prevalent gynecological condition associated with pelvic pain and infertility. Despite more than century of research, the etiology endometriosis still eludes scientific consensus. This lack clarity has resulted in suboptimal prevention, diagnosis, treatment options. Evidence genetic contributors to interesting but limited; however, significant progress been made recent years identifying an epigenetic role pathogenesis through clinical studies, vitro cell culture experiments, vivo animal models. The predominant findings include endometriosis-related differential expression DNA methyltransferases demethylases, histone deacetylases, methyltransferases, regulators chromatin architecture. There also emerging for miRNAs controlling endometrium endometriosis. Changes these result organization methylation, consequences gene independent sequence. Epigenetically altered genes related steroid hormone production signaling, immune regulation, endometrial identity function have all identified appear play into pathophysiological mechanisms resulting review summarizes critically discusses early seminal findings, ever-growing evidence contributions pathophysiology endometriosis, implications proposed epigenetically targeted therapeutics.

Language: Английский

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Endometriosis Treatment: Role of Natural Polyphenols as Anti-Inflammatory Agents

Nutrients, Journal Year: 2023, Volume and Issue: 15(13), P. 2967 - 2967

Published: June 30, 2023

Endometriosis is an estrogen-dependent common chronic inflammatory disease defined by the presence of extrauterine endometrial tissue that promotes pelvic pain and fertility impairment. Its etiology complex multifactorial, several not completely understood theories have been proposed to describe its pathogenesis. Indeed, this affects women’s quality life their reproductive system. Conventional therapies for endometriosis treatment primarily focus on surgical resection, lowering systemic levels estrogen, with non-steroidal anti-inflammatory drugs counteract response. However, although these strategies shown be effective, they also show considerable side effects. Therefore, there a growing interest in use herbal medicine endometriosis; however, date, only very limited literature present topic. Polyphenols display important anti-endometriotic properties; particular, are potent phytoestrogens parallel modulates estrogen activity exerts activity. The aim review provide overview polyphenols endometriosis.

Language: Английский

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Infertility in patients with uterine fibroids: a debate about the hypothetical mechanisms

Human Reproduction, Journal Year: 2023, Volume and Issue: 38(11), P. 2045 - 2054

Published: Sept. 28, 2023

Abstract Fibroids are benign tumours of the myometrium and most common gynaecologic abnormality. Although fibroids asymptomatic, they can cause symptoms like heavy menstrual bleeding, pelvic pain, sexual dysfunction, pressure complaints, infertility. The association between infertility has been debated for decades. It is generally acknowledged that closer fibroid to uterine cavity endometrium lining, more unfavourable effect it might have on fertility, reducing odds successful implantation gestation. Based limited available literature, we propose discuss seven hypotheses underlying mechanism by which may reduce fertility. (i) as dyspareunia, prolonged could interfere with arousal a consequence frequency intercourse, resulting in reduced probability conception. (ii) Mechanical compression theinterstitial part fallopian tubes or deformation disturb oocyte sperm transport. (iii) peristalsis junctional zone myometrium, negatively influence transport well implantation. In addition, induce detrimental environment other ways, by: (iv) changing vagino-uterine microbiome; (v) disturbing levels inflammation autophagy; (vi) inducing molecular changes endometrium; (vii) aberrant angiogenesis altering endometrial blood supply. After discussion these hypotheses, implication early pregnancy loss discussed. Surgical treatment not tailored nor focussed pathophysiology fibroid; consequently be accompanied recurrence risks complications. Unravelling pathogenic mechanisms about how fertility essential evolve classic surgical treatment. Instead fibroid-related symptoms, research should supports development fibroid-targeted (pharmaceutical) compatible an active wish become pregnant.

Language: Английский

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Oxidative Stress and Antioxidants in Uterine Fibroids: Pathophysiology and Clinical Implications

Antioxidants, Journal Year: 2023, Volume and Issue: 12(4), P. 807 - 807

Published: March 26, 2023

In the last few decades, our understanding of complex pathobiology uterine fibroid development has grown. While previously believed to be a purely neoplastic entity, we now understand that fibroids possess different and equally important aspects their genesis. An increasing body evidence suggests oxidative stress, imbalance between pro- antioxidants, is an factor in development. Oxidative stress controlled by multiple, interconnecting cascades, including angiogenesis, hypoxia, dietary factors. turn influences through genetic, epigenetic, profibrotic mechanisms. This unique aspect introduced several clinical implications, both diagnostic therapeutic, can aid us managing these debilitating tumors using biomarkers as well pharmaceutical antioxidants for diagnosis treatment. review strives summarize add current revealing relationship elucidating proposed mechanisms implications.

Language: Английский

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Circulating Inflammatory Cytokines and Female Reproductive Diseases: A Mendelian Randomization Analysis

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2023, Volume and Issue: 108(12), P. 3154 - 3164

Published: June 23, 2023

Extensive studies have provided considerable evidence suggesting the role of inflammation in development female reproductive diseases. However, causality has not been established.

Language: Английский

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