Abstract
Accumulating evidence indicates the active role of oxidative stress in the development of endometriosis; however, the mechanism of reactive oxygen species generation is poorly understood. Metabonomics/metabolomics is a scientific discipline that can be used to study changes in metabolite ensembles associated with disease pathophysiology. The present study focuses on the use of proton nuclear magnetic resonance spectroscopy based targeted metabolite profiling approach to explore dysregulation in metabolites expression in women with endometriosis. Further, association of oxidative stress with the metabolite ensembles, if any, is investigated. Using multivariate statistics, partial least square discriminant analysis model was generated which could classify endometriosis patients with sensitivity and specificity of 92.83% and 100%, respectively, and with a classification rate of 96.4%. In conjunction with increased glucose metabolism, citrate and succinate were found to be elevated in endometriosis patients. Higher levels of reactive oxygen species, lipid peroxidation, and advanced oxidation protein products and lower levels of total antioxidant capacity, superoxide dismutase, catalase, and glutathione were also observed. Increased glucose metabolism and defects in the mitochondrial respiratory system are suggested to be the possible sources of excessive reactive oxygen species generation in endometriosis.
Highlights
Endometriosis is classically defined as the growth of endometrial glands and stroma at extrauterine sites, most commonly implanted over visceral and peritoneal surfaces within the female pelvis
reactive oxygen species (ROS), lipid peroxidation (LPO), and advanced oxidation protein products (AOPP) were observed to be increased significantly whereas total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase, and GSH levels were significantly less in endometriosis women as compared to controls
Organic acids, and other molecules were identified in serum using 1H Nuclear magnetic resonance (NMR) metabolic profiling
Summary
Endometriosis is classically defined as the growth of endometrial glands and stroma at extrauterine sites, most commonly implanted over visceral and peritoneal surfaces within the female pelvis. In India, approximately 1% women undergoing major gynecological surgery, 6%–43% undergoing sterilization, 12%–32% undergoing laparoscopy for pelvic pain, of 21%–48% undergoing laparoscopy for infertility are diagnosed with endometriosis [1]. It is a fairly common gynecological disorder affecting almost 10% of women of reproductive age [2]. The correct approach for endometriosis management is still unclear. The risks and the diagnostic limitations of laparoscopy and the inaccuracy of clinical examination justify the considerable efforts made to improve the diagnosis with noninvasive techniques. The therapeutic approach still focuses on management of clinical symptoms of the disease rather than on the disease itself. A thorough understanding of the pathophysiology of endometriosis is essential to the development of novel diagnostic and treatment approaches for this debilitating condition
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