Abstract

Endometriosis is characterized by ectopic endometrial tissue implantation, mostly within the peritoneum, and affects women in their reproductive age. Studies have been done to clarify its etiology, but the precise molecular mechanisms and pathophysiology remain unclear. We downloaded genome-wide mRNA expression and clinicopathological data of endometriosis patients and controls from NCBI’s Gene Expression Omnibus, after a systematic search of multiple independent studies comprising 156 endometriosis patients and 118 controls to identify causative genes, risk factors, and potential diagnostic/therapeutic biomarkers. Comprehensive gene expression meta-analysis, pathway analysis, and gene ontology analysis was done using a bioinformatics-based approach. We identified 1590 unique differentially expressed genes (129 upregulated and 1461 downregulated) mapped by IPA as biologically relevant. The top upregulated genes were FOS, EGR1, ZFP36, JUNB, APOD, CST1, GPX3, and PER1, and the top downregulated ones were DIO2, CPM, OLFM4, PALLD, BAG5, TOP2A, PKP4, CDC20B, and SNTN. The most perturbed canonical pathways were mitotic roles of Polo-like kinase, role of Checkpoint kinase proteins in cell cycle checkpoint control, and ATM signaling. Protein–protein interaction analysis showed a strong network association among FOS, EGR1, ZFP36, and JUNB. These findings provide a thorough understanding of the molecular mechanism of endometriosis, identified biomarkers, and represent a step towards the future development of novel diagnostic and therapeutic options.

Highlights

  • Endometriosis is a painful gynecological ailment marked by the presence of endometrial tissue outside the uterine cavity, commonly involving the uterus, ovaries, fallopian tubes, and pelvic tissues [1]

  • Our results provide some insight into the molecular mechanisms underlying endometriosis pathogenesis

  • We found high expression of early and immediate early-response genes such as FBJ murine osteosarcoma viral oncogene homolog or Fos proto-Oncogene (FOS), FosB Proto-Oncogene (FOSB), Early Growth Response 1 (EGR1), ZFP36 Ring Finger Protein (ZFP36), Immediate Early Response 2 (IER2), Immediate Early Response 3 (IER3), Jun B Proto-Oncogene (JUNB), and Transcription Factor SOX-13 (SOX 13)

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Summary

Introduction

Endometriosis is a painful gynecological ailment marked by the presence of endometrial tissue outside the uterine cavity, commonly involving the uterus, ovaries, fallopian tubes, and pelvic tissues [1] It is a complex and chronic estrogen-dependent disorder, wherein abnormal growth of uterine-lining (endometrium) tissue occurs outside the uterus, which can lead to serious complications like diabetes, obesity, mood disorders, dysmenorrhea, chronic pelvic pain, or even fatal endometrial cancer and cardiovascular disorders if left untreated for long. Invasive surgery and the lack of a disease biomarker presently causes a mean latency of 7–11 years from symptom onset to definitive diagnosis. This substantial lag possibly has negative consequences in terms of disease progression

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