International Journal of Molecular Sciences

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The Pathogenesis and Therapy of Endometriosis

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Dear Colleagues,

Currently, the diagnosis of endometriosis can be challenging because symptoms can vary from woman to woman and can be similar to other medical conditions. There are several limitations to the diagnosis of endometriosis, including a delay in diagnosis, dependence on surgical intervention (a definitive diagnosis of endometriosis often requires surgery), lack of standardization in required imaging and its interpretation, variation in symptoms and lack of pathognomonic biomarkers. This may all be due to the still limited knowledge of the pathogenesis of endometriosis. The actual pathogenesis of the pathology remains mysterious to this day, and there are no indicators to prevent the evolution of this condition or to account for the heterogeneity with which the pathology manifests itself. Moreover, the chronic nature of its pathology increases the complexity of its management and complicates its treatment. Likewise, we have few tools to measure a response to medical treatment. Finally, technological advances make treating this pathology increasingly less invasive and more effective, uncovering differences between approaches that deserve to be investigated further. Our Special Issue was created to present the latest findings in these areas. Therefore, we invite our authors to contribute their most essential testimonials in terms of case reports, original articles, review articles, and meta-analyses.

Dr. Pasquale De Franciscis
Dr. Carlo Ronsini
Guest Editors

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Keywords

endometriosis
early diagnosis
progestinic treatment
gynecological surgery
fertility

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Research

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13 pages, 667 KiB

Open AccessArticle

Potential Significance of Serum Autoantibodies to Endometrial Antigens, α-Enolase and Hormones in Non-Invasive Diagnosis and Pathogenesis of Endometriosis

by Irina V. Menzhinskaya, Stanislav V. Pavlovich, Arika G. Melkumyan, Vladimir D. Chuprynin, Ekaterina L. Yarotskaya and Gennady T. Sukhikh

Int. J. Mol. Sci. 2023, 24(21), 15578; https://doi.org/10.3390/ijms242115578 - 25 Oct 2023

Cited by 2 | Viewed by 1202

Abstract

The objective of the study was to evaluate the profile of serum autoantibodies and their diagnostic and pathogenetic significance in ovarian endometrioma (OEM) and deep infiltrative endometriosis (DIE). The study enrolled 74 patients with endometriosis (Group 1), including 53 patients with OEM (Subgroup 1a); 21 patients with DIE without ovarian lesions (Subgroup 1b); and 27 patients without endometriosis (Group 2). The diagnosis was confirmed by laparoscopic surgery and histologic examination of resected tissues. Antibodies (M, G) to tropomyosin 3 (TPM), tropomodulin 3 (TMOD), α-enolase (ENO), estradiol (E2), progesterone (PG), and human chorionic gonadotropin (hCG) were identified in blood serum using modified ELISA. In endometriosis, antibodies to endometrial antigens, hormones, and ENO were detected more often than antiphospholipid and antinuclear antibodies. Higher levels of IgM to TPM, hCG, E2, and PG and IgG to TMOD, ENO, E2, and hCG were found in Subgroup 1a compared to Group 2. IgM to TPM, hCG, E2, PG, and IgG to E2 and ENO had a high diagnostic value for OEM (AUC > 0.7), with antibodies to TPM having the highest sensitivity and specificity (73.6% and 81.5%). In Subgroup 1b, only the levels of IgM to TPM and hCG were higher than in Group 2. These antibodies had a high diagnostic value for DIE. Thus, endometriosis is associated with autoantibodies to endometrial antigens, α-enolase, steroid, and gonadotropic hormones. A wider spectrum of antibodies is detected in OEM than in DIE. These antibodies have a high diagnostic value for OEM and DIE and potential pathogenetic significance for endometriosis and associated infertility. Full article

(This article belongs to the Special Issue The Pathogenesis and Therapy of Endometriosis)

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28 pages, 1935 KiB

Open AccessReview

How Do Microorganisms Influence the Development of Endometriosis? Participation of Genital, Intestinal and Oral Microbiota in Metabolic Regulation and Immunopathogenesis of Endometriosis

by Anna Sobstyl, Aleksandra Chałupnik, Paulina Mertowska and Ewelina Grywalska

Int. J. Mol. Sci. 2023, 24(13), 10920; https://doi.org/10.3390/ijms241310920 - 30 Jun 2023

Cited by 3 | Viewed by 2675

Abstract

Microorganisms inhabiting the human body play an extremely key role in its proper functioning, as well as in the development of the immune system, which, by maintaining the immune balance, allows you to enjoy health. Dysbiosis of the intestinal microbiota, or in the oral cavity or reproductive tract, understood as a change in the number and diversity of all microorganisms inhabiting them, may correlate with the development of many diseases, including endometriosis, as researchers have emphasized. Endometriosis is an inflammatory, estrogen-dependent gynecological condition defined by the growth of endometrial cells outside the uterine cavity. Deregulation of immune homeostasis resulting from microbiological disorders may generate chronic inflammation, thus creating an environment conducive to the increased adhesion and angiogenesis involved in the development of endometriosis. In addition, research in recent years has implicated bacterial contamination and immune activation, reduced gastrointestinal function by cytokines, altered estrogen metabolism and signaling, and abnormal progenitor and stem cell homeostasis, in the pathogenesis of endometriosis. The aim of this review was to present the influence of intestinal, oral and genital microbiota dysbiosis in the metabolic regulation and immunopathogenesis of endometriosis. Full article

(This article belongs to the Special Issue The Pathogenesis and Therapy of Endometriosis)

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