Abstract
The current therapies for endometriosis are restricted by various side effects and treatment outcome has been less than satisfactory. Shaofu Zhuyu Decoction (SZD), a classic traditional Chinese medicinal (TCM) prescription for dysmenorrhea, has been widely used in clinical practice by TCM doctors to relieve symptoms of endometriosis. The present study aimed to investigate the effects of SZD on a rat model of endometriosis. Forty-eight female Sprague-Dawley rats with regular estrous cycles went through autotransplantation operation to establish endometriosis model. Then 38 rats with successful ectopic implants were randomized into two groups: vehicle- and SZD-treated groups. The latter were administered SZD through oral gavage for 4 weeks. By the end of the treatment period, the volume of the endometriotic lesions was measured, the histopathological properties of the ectopic endometrium were evaluated, and levels of proliferating cell nuclear antigen (PCNA), CD34, and hypoxia inducible factor- (HIF-) 1α in the ectopic endometrium were detected with immunohistochemistry. Furthermore, apoptosis was assessed using the terminal deoxynucleotidyl transferase (TdT) deoxyuridine 5′-triphosphate (dUTP) nick-end labeling (TUNEL) assay. In this study, SZD significantly reduced the size of ectopic lesions in rats with endometriosis, inhibited cell proliferation, increased cell apoptosis, and reduced microvessel density and HIF-1α expression. It suggested that SZD could be an effective therapy for the treatment and prevention of endometriosis recurrence.
Highlights
Endometriosis is a hormone-dependent benign disease that is characterized by the implantation and growth of endometrium-like glandular and stromal cells outside the uterine cavity, often associated with pelvic pain, chronic inflammation, and infertility
At the end of the treatment (8 weeks after transplantation), the mean volumes of the lesions were lower in the Shaofu Zhuyu Decoction (SZD)-treated group than they were in the vehicle group
The definite mechanisms underlying the development of endometriosis are far from clear, which challenges the development of a proper curative agent
Summary
Endometriosis is a hormone-dependent benign disease that is characterized by the implantation and growth of endometrium-like glandular and stromal cells outside the uterine cavity, often associated with pelvic pain, chronic inflammation, and infertility. The reported prevalence of endometriosis is 6–10% in the general population, while it reaches up to 50% in women with infertility [1]. The pathophysiology of endometriosis is still uncertain, which poses a major obstacle in the search for a definitive treatment. Laparoscopic surgery and pharmacological treatment are the standard therapeutic options for endometriosis. These treatments aim to relieve pain, optimize fertility, and delay recurrence [2]. Pharmacological treatments for endometriosis include nonsteroid anti-inflammatory drugs (NSAIDs) and hormonally active drugs such as combined oral contraceptive pills, gestrinone, danazol, and gonadotropin-releasing hormone agonists (GnRH-a). NSAIDs are used universally in women with dysmenorrhea, but there is currently no definite evidence supporting their efficacy in relieving endometriosis-induced dysmenorrhea [3]
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