جستجوی مقالات مرتبط با کلیدواژه « اندومتریوز » در نشریات گروه « پزشکی »

Natural killer (NK) cells play a critical role in the pathogenesis of endometriosis. Moreover, a normal vitamin D level is remarkably associated with an optimal immune response. So, there may be a probable relationship between these factors and the endometriotic women.

This study aimed to evaluate the percentage of NK cells and their subsets and their relationship with serum levels of vitamin D and interferon gamma (IFN-γ) in women with endometriosis.

In this case-control study, 29 women with stage III-IV endometriosis and 30 healthy controls were enrolled. The study was conducted in the Immunology Department of Isfahan University of Medical Sciences, Isfahan, Iran between November 2021 and June 2022. The percentage of NK cells and their subsets, including CD56dim CD16+, CD56bright CD16- and CD56bright CD16bright were measured in the peripheral blood samples using flow cytometry. Serum levels of vitamin D and IFN-γ were also measured using the enzyme-linked immunosorbent assay.

The mean percentage of NK cells in women with endometriosis increased significantly compared to the control group (p = 0.03). The percentage of CD56dim CD16+ (p = 0.007) and CD56bright CD16 bright (p = 0.043) increased significantly in women with endometriosis in comparison with the control group, but the percentage of CD56bright CD16- subset was not significantly different. No relationship was observed between NK cells and their subsets with vitamin D and IFN-γ in the studied groups.

The study of NK cell subsets and their related factors can be useful in assessing and treating women suffering from endometriosis. However, more comprehensive studies are required to draw definitive conclusions about these observations.

The lack of improvement in some endometriotic people’s pain after surgery even while using hormone treatment may suggest an inappropriate response to routine hormonal therapies.

This study aimed to determine a cut-off point for selecting the most appropriate treatment based on the hormone receptors of endometriotic lesions.

In this cross-sectional study, by reviewing the medical records of participants and testing their archive samples and phone interviews (if needed), 86 symptomatic women after endometriosis surgery who were operated into governmental hospitals, Shahid Faghihi and Hazrate Zeinab Shiraz Iran were enrolled between March 2017 and March 2019. Women were divided into 2 groups: responsiveness (n = 73 for dysmenorrhea, n = 60 for dyspareunia) to medical treatment and surgery, and unresponsiveness (n = 13, n = 7). We examined the pathological slides of 86 women to determine the amount of hormone receptors and the relationship between the type of medical treatment and the level of hormone receptors on pain relief within 1 yr after surgery.

Based on the receiver operating characteristic curve, dysmenorrhea in the presence of tissue estrogen receptors > 60% (p = 0.1065), and dyspareunia in the presence of tissue progesterone receptors > 80% (p = 0.0001) responded well to medical treatment after surgery. In the presence of endometrioma-dysmenorrhea showed the best response to oral contraceptive pills (69.4%), while in deep infiltrative endometriosis-dyspareunia showed the best response to progesterone treatment (75%).

Prescribing an appropriate hormone therapy based on a specific immunohistochemistry staining pattern can improve the life quality of postoperative endometriosis individuals.

Endometriosis is a chronic, gynecological disorder, and the disease's pathogenesis is still debatable. Genes related to apoptosis have been revealed to be deregulated in endometriosis.

This study investigates the relationship between polymorphic variants of Bax -248G>A and Bcl-2 -938C>A promoter regions with endometriosis risk in an Iranian population.

In this case-control study, the polymorphisms of Bax -248G>A and Bcl-2 -938C>A promoter regions were analyzed in 127 Iranian cases and 125 controls who were referred to Ali-ibn-Abi Taleb Educational hospital, Zahedan, Iran between May 2022 and February 2023. The genotypic analysis was performed for all the subjects using the polymerase chain reaction-restriction fragment length polymorphism method.

The frequencies of mutant allele A carriers and the A allele of Bax -248G>A polymorphism showed about 2-fold significant increase of endometriosis risk (p = 0.04; p = 0.01, respectively). The frequencies of the mutant genotype AA and A allele carriers of Bcl-2 -938C>A polymorphism were approximately 4 and 2.5-fold higher in endometriosis compared to the control women, which were highly significant (p > 0.001). Moreover, the allele A frequency of Bcl-2 -938C>A was associated with a 2-fold higher risk of endometriosis (p > 0.001). Furthermore, the combination effects of these 2 single nucleotide polymorphisms showed that women with Bax -248G>A GG and Bcl-2 -938C>A AA variant alleles were associated with about 5 times higher risk of endometriosis (p > 0.001). Notably, a significant difference was observed in mutant allele distribution between minimal/mild (stage I and II) and moderate/severe (stage III and IV) women with endometriosis disease.

The results of our study provide evidence that Bcl-2 -938C>A and Bax -248G>A single nucleotide polymorphisms might be associated with the risk of endometriosis.

The association between endometriosis and the outcome of pregnancy is one of the interesting topics. Endometriosis-related pain is alleviated with pregnancy; however, it is known to cause adverse outcomes in pregnancy. The main cause is systemic chronic inflammation caused by higher levels of cytokines, growth factors, and angiogenesis factors.

This study aimed to clarify the relationship between endometriosis, deep endometriosis, adenomyosis, surgical treatment, and poor maternal consequences.

In this case-control study, data from 250 women who gave birth in Hazrat Rasoul Akram hospital, Tehran, Iran from February 2015 to December 2019 was extracted from the hospital information system in January 2020. Participants were divided into 2 groups: 125 women with endometriosis and 125 women without endometriosis. We looked at how endometriosis affected mothers and newborn babies. Data on pregnancy, delivery, and newborns of both groups was extracted.

The mean age of participants was 32.74 ± 4.10 and 31.7 ± 5.53 yr in endometriosis and control group, respectively. In terms of pregnancy complications, placenta previa, placenta accreta, placenta abruption, pre-eclampsia, gestational diabetes mellitus, and postpartum hemorrhage remarkably increased in the endometriosis group compared to the control group. Small for gestational age was significantly higher in rectal endometriosis than women without rectal endometriosis (p = 0.03). The neonatal intensive care unit admission rate was notably higher in infants of the endometriosis group compared to controls (40.7% vs. 24.8%, p = 0.009).

Our findings showed women with endometriosis are at a higher risk for important adverse maternal outcomes.

Lesions originating from endometrial tissue in extrauterine organs such as pelvic peritoneum, ovaries and intestines are called endometriosis. This condition, which is related to infertility, is associated with chronic pain in most women. Although the exact cause of this condition has not yet been fully determined, the immunological, hormonal and neurological factors are involved in the mechanisms that cause its symptoms. The gold standard method for diagnosing this disease is laparoscopy, which, due to its invasiveness nature, delays the diagnosis of this disease by 7-11 years, and may lead to irreversible consequences. Therefore, there is always a need for non-invasive biomarkers for early diagnosis of the disease. In this review, the diagnostic value of MicroRNAs (MiRs) in endometriosis was discussed. The expression of a number of MiRs in the tissue and serum of patients with endometriosis increases for various reasons, and the rapid investigation of these biomarkers can help in the early and non-invasive diagnosis of this disease by preventing harmful complications. In general, although it is difficult to identify genes that are related to endometriosis, it can be very helpful in the diagnosis, prognosis and treatment management of this disease.In this narrative review, at first, the classification and investigation of clinical symptoms as well as some hypotheses about the cause of endometriosis are examined, and finally, some biomarkers that have acceptable sensitivity and characteristics for the diagnosis and treatment of endometriosis are introduced.

Endometriosis is a challenging gynecological disease and a debilitating condition that profoundly affects the individual’s quality of life. Besides pathological confirmation, diagnostic laparoscopy has been internationally accepted as the standard method to identify the accurate mapping of endometriosis. Transvaginal sonography (TVS) is the first non-invasive imaging modality to estimate the severity of endometriosis.

This study aimed to evaluate the accuracy of TVS in affected women compared with surgical findings.

This retrospective cross-sectional study surveyed 170 women with deep infiltrating endometriosis (DIE) referred to the endometriosis part of the Avicenna Infertility Center, Tehran, Iran and they underwent TVS followed by laparoscopy. Recorded data of individuals under study in the medical database system were reviewed. Finally, the agreement rate was calculated for ultrasound reports and intraoperative (IO) findings regarding ovarian endometrium, ovarian adhesion, involvement of cul-de-sac, rectovaginal septum, and bowel and ureter.

170 women with DIE entered the study. The agreement of TVS and IO findings were 86.76% for left ovarian endometriosis and 70.86% for right ovarian endometriosis, 93.90% for left ovarian adhesion, and 88.90% for right ovarian adhesion, 88.90% for a cul-de-sac, and 84.82% for bowel nodules. The findings, based on a laparoscopic assessment of the pelvic floor, were completely compatible with ultrasound reports (100%).

TVS allows a preoperative evaluation in planning the surgical policy associated. TVS is beneficial for dedicated mapping of DIE; thus, an expert radiologist can aid the surgeon in preoperative evaluation and IO management.

Endometriosis is a disease that affects women throughout their sexual life. Sexual health is, therefore, a major concern for these women.

This study aimed to assess the effects of the sensate focus technique and position changing on the sexual function of women with deep-infiltrating endometriosis 3-6 months after surgery.

This clinical trial study was performed on 80 women with deep endometriosis, aged 18-45 yr, who were referred to the endometriosis clinic of Avicenna fertility center, Tehran, Iran for follow-up after surgery from January to September 2021. They were divided randomly into 2 groups. In the intervention group, 2-hr virtual training sessions were held and the control group only completed the questionnaires without any intervention. Sexual function was evaluated after 4 and 8 wk.

8 wk after the intervention, the mean score of sexual function in the intervention group was significantly improved (p < 0.001). The mean total score of sexual function in the pre-intervention period reached from 24.16 to 28.31 in 4 wk after the intervention and 29.85, 8 wk after the intervention. The mean score of sexual pain during the follow-up periods was significantly improved in the intervention group (p < 0.001).

Sensate focus technique and sexual position changing improved sexual function in women with deep endometriosis after surgery.

 Fewer studies were on micronutrient intake in women with endometriosis, and the etiology of endometriosis remains unclear between dietary micronutrients and the risk of endometriosis.

 This study aimed to investigate the relationship between dietary micronutrients and the risk of endometriosis.

 This case-control study was conducted on 156 women (18-45 yr) with and without endometriosis in the gynecology clinic of Arash hospital between May 2017 and May 2018 in Tehran, Iran. According to the laparoscopic findings, the participants were divided into 2 groups (n = 78/each), women with pelvic endometriosis as the case group and women without endometriosis pelvic as the control group. Dietary data were collected using a validated 168-item semiquantitative food frequency questionnaire with the standard serving. A logistic regression model was used to determine the association between micronutrients and the risk of endometriosis.

 Data analysis showed a significant relationship between micronutrients such as: potassium (OR: 0.74; CI: 0.56-0.99; p = 0.01), calcium (OR: 0.70; CI: 0.52-0.94; p = 0.003), and also among the vitamin C (OR: 0.70; CI: 0.52-0.94; p = 0.02), B2 (OR: 0.73; CI: 0.55-0.98; p = 0.01), and B12 (OR: 0.71; CI: 0.53-0.95; p = 0.02) with endometriosis, so those who used fewer micronutrients were at higher risk of endometriosis.

 The findings showed that the dietary intakes of calcium, potassium, vitamins B12, B2, B6, and C are inversely related to the risk of endometriosis.

Endometriosis and infertility are caused by reactive oxygen species or free radicals, which promote endometrial cell growth and adhesion in the peritoneal cavity. Genistein has been proven to protect cells against reactive oxygen species by scavenging free radicals and decreasing the expression of genes-associated stress responses.

This study was conducted to determine whether genistein also acts as an antioxidant by elevating superoxide dismutase (SOD) and glutathione peroxidase (GPx) in the peritoneal fluid of the endometriosis mice model.

This experimental study involved 32 healthy female mice (Mus musculus), aged between 2-3 months and weighing 20-30 gr. They were divided into negative control group (healthy mice without genistein), endometriosis group (endometriosis mice without genistein), treatment group that was given different doses of genistein, that is, 0.13; 0.26; 0.52; 0.78; 1.04; and 1.3 mg/day (n = 4/each). SOD level in the peritoneal fluid was measured using the quantitative colorimetric determination method, and a colorimetric assay measured the GPx levels.

Results showed that the endometriosis model has lower SOD and GPx levels than the control group. The administration of genistein significantly normalized these changes. Genistein significantly increased SOD levels in the 0.13 mg and 0.26 mg treatment groups. Genistein also increased GPx levels significantly in all treatment groups.

Genistein increases SOD and GPx levels in the peritoneal fluid of an endometriosis mice model, and the change is dose-dependent.

According to stem cell theory, it seems that the proliferation/differentiation imbalance in endometrial mesenchymal stem cells (eMSCs) is the leading cause of endometriosis, so targeting them to modulate stemness-relevant factors seems to be a wise choice for endometriosis treatment.

We aimed to investigate the effects of metformin on stemness properties of eMSCs by evaluating the expression profile of stemness-related genes and microRNAs (miRNAs).

In this case-control study, MSCs were isolated from the eutopic endometrium of 3 endometriotic and 3 healthy women. After their characterization and culture, they were treated with 0.1, 1, and 10 mM metformin for 72 hr. Finally, the expression of octamer-binding transcription factor (OCT) 4A, OCT4B, OCT4B1, sex determining region Y-Box transcription factor 2, nanog homeobox, microRNA-200b, microRNA-145, and lethal-7b were analyzed by quantitative reverse transcription-polymerase chain reaction.

Metformin modulated the expression of stemness-related genes and miRNAs, OCT4A, OCT4B, OCT4B1, sex determining region Y-Box transcription factor 2, nanog homeobox, microRNA-200b, microRNA-145, and lethal-7b in eMSCs, especially at 1 and 10 mM concentration. Notably, metformin had a paradoxical effect on normal eMSCs.

We showed that metformin could modulate the expression of deregulated genes and miRNAs in faulty eMSCs, and restore their skewed self-renewal/differentiation balance, so it might be a promising drug for endometriosis treatment. The paradoxical effect of metformin on eMSCs and normal eMSCs might be because of their different metabolic patterns, so it requires further investigation to illustrate.

The relationship between the biochemical characteristics of follicular fluid (FF), oocyte quality and embryonic development has not yet been elucidated. We compared samples of FF with a normal metabolic profile against samples with metabolic abnormalities to identify potential predictive biomarkers of reproductive success.

To analyze peptide activity in the FF of women undergoing in vitro fertilization using 3 samples of FF per individual.

FF samples were obtained by ovum pick-up. Pathological samples were defined as samples of FF obtained from women with a gynecological condition or with infertility. A total of 30 women participated in this study. 3 samples of FF were obtained per individual (90 samples), but 8 samples were excluded because they were hemolyzed. The samples (n = 82 FF) included controls (n = 36, donors without fertility problems), women with endometriosis (n = 15), unexplained infertility (n = 19), and aged > 39 (n = 12). We assessed local encephalinergics: aminopeptidase-N (puromycin sensitive aminopeptidase and neutral endopeptidase; and components of the angiotensin system of the reproductive tract: prolyl-endopeptidase, APN, aspartate-aminopeptidase, and basic-aminopeptidase.

No differences were observed in peptide metabolism based on the presence or absence of oocytes in the FF. Women with endometriosis and aged > 39 yr showed alterations in puromycin sensitive aminopeptidase (p = 0.01), aminopeptidase-B (p = 0.01), aspartate-aminopeptidase (p < 0.001) and neutral endopeptidase (p < 0.001).

This study reveals alterations in the metabolism of enkephalin and angiotensin in pathological FF, which points to these components as potential diagnostic biomarkers.

Endometriosis is a multifaceted gynecological disorder defined as a benign estrogen-dependent chronic inflammatory process in which endometrial glands and stroma-like tissues are located outside the uterine cavity. It affects around 2-10% of all women during their reproductive years.  

This study aimed to evaluate the traffic of mesenchymal stem cells and inflammatory factors toward the lesions.

10 samples of normal endometrium and eutopic endometrium were studied as a control group and 10 ectopic samples were considered as a case group. Hematoxylin and eosin staining was used to evaluate stromal cells and inflammatory cells. Immunohistochemical staining was performed to show the presence of proliferating cell nuclear antigen in the lesions. The cells were digested and cultured in the laboratory to study cell proliferation. The number of cells and vessels were counted with Image J software, and data analysis was performed with Prism software.

Data analysis showed that the number of stromal cells and vessels in ectopic tissue were significantly higher than the control group (p < 0.001). Also, the number of inflammatory cells, including neutrophils, monocytes, lymphocytes, and macrophages, in the ectopic group was much higher than in the control group (p < 0.005).

By expanding the number of blood vessels, blood flow increases, and cell migration to tissues is facilitated. The accumulation of inflammatory cells, especially macrophages, stimulates the growth of stem cells and helps implant cells by creating an inflammatory process.

Infertility is one of the issues affecting sexual function (SF). Infertility is also one of the complications of polycystic ovary syndrome (PCOS) and endometriosis.

This research seeks to assess and compare SF and the prevalence of sexual dysfunction in infertile women with PCOS and endometriosis.

A cross-sectional study was carried out with a sample of 630 (210 infertile women with endometriosis, 210 infertile women with PCOS, and 210 healthy women of childbearing age as the control group). SF was assessed by the female sexual function index (FSFI). Descriptive statistics and inferential statistics were used to analyze the data. The primary outcome measured was FSFI score. Secondary outcome was hospital anxiety and depression scale score.

The results showed that the mean score of the total FSFI in the 2 groups of PCOS and endometriosis was lower than the control group (p < 0.001). In addition, women with higher education (university education) had a higher total FSFI.

Sexual dysfunction rates are high in infertile women with endometriosis and PCOS. Infertility service providers in infertility centers need to pay attention to this issue.