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Dear Colleagues,

Most ovarian disorders are benign, with the majority being functional ovarian cysts and benign neoplasms, including endometriosis and polycystic ovarian syndrome (PCOS). Although these are very frequent findings in general gynecology, there is an insufficient amount of evidence about molecular pathophysiology and subsequent therapeutic advances.

This Special Issue aims to focus on basic and translational research, as well as molecular and hormonal evidence of the pathophysiology of various ovarian disorders that are related to fertility and/or metabolic/endocrine conditions. Original research articles as well as narrative and systematic reviews, including perspectives, are encouraged to improve our overall knowledge about the molecular basis of and therapeutic advances in ovarian disorders.

Dr. Mislav Mikuš
Dr. Antonio Simone Laganà
Guest Editors

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Keywords

polycystic ovary syndrome
ovarian steroidogenesis
adipose tissue steroidogenesis
excess androgen synthesis
insulin resistance
theca cell dysfunction
chronic inflammation
insulin sensitizing agents

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Review

9 pages, 1024 KiB

Open AccessReview

CTLA4-Linked Autoimmunity in the Pathogenesis of Endometriosis and Related Infertility: A Systematic Review

by Mislav Mikuš, Marina Šprem Goldštajn, Ivan Brlečić, Stipe Dumančić, Antonio Simone Laganà, Vito Chiantera, Goran Vujić and Mario Ćorić

Int. J. Mol. Sci. 2022, 23(18), 10902; https://doi.org/10.3390/ijms231810902 - 18 Sep 2022

Cited by 13 | Viewed by 2996

Abstract

Several studies, although with conflicting results, have sought to determine the concentration of soluble CTLA4 antigens in peripheral blood plasma and peritoneal fluid in patients with endometriosis-related infertility. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) through a search of the following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database and Web of Science, and Clinical Trials research register. We included observational or prospective human and animal studies with any features related to endometriosis and/or infertility studies involving CTLA4-related pathogenesis published in English. The results of studies in which the size and characteristics of the observed groups were not stated were excluded. From the initial pool of 73 publications identified and screened, we finally included 5 articles to summarize the most recent knowledge about CTLA4-linked autoimmunity in the pathogenesis of endometriosis and related infertility. Evidence from clinical studies shows that CTLA4-based autoimmunity is involved in the maintenance of chronic inflammation in the peritoneal environment, with pre-clinical evidence of anti-CTLA antibodies as a potential novel target therapy for endometriosis. However, CTLA4 gene analyses do not support findings of CTLA4-linked autoimmunity as a primary determinant of the pathogenesis of endometriosis. These findings underlie the role of complex interactions within the family of immune checkpoint molecules involved. Further studies are needed to investigate the clinical relevance of anti-CTLA target therapy, taking into account the potential adverse events and repercussions of novel immunologic therapy modalities. However, with the general scarcity of studies investigating this topic, the clinical importance of CTLA4 autoimmunity still remains unclear. Full article

(This article belongs to the Special Issue Ovarian Disorders: From Molecular Basis to Therapeutic Advances)

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