External Genital Endometriosis Research Articles

Correlation of changes in cellular bioregulators in case of external genital endometriosis in the patients of reproductive age

Correlation of changes in cellular bioregulators in case of external genital endometriosis in the patients of reproductive age

The role of transforming growth factor-β and of matrix metalloproteinase 9 in immunopathogenesis of endometriosis associated with infertility

In the development of endometriosis and infertility, associated with it, immunological processes play an important role, ant they are characterized by high activity of cytokines and growth factors (e.g., transforming growth factor -β (TGF-β)) and increased invasiveness of ectopic endometrium, including activity of matrix metalloproteinases (MMP). TGF-β exhibits different biological properties and plays a key role in the migration, proliferation and differentiation of cells. The concentration of TGF-β in serum and peritoneal fluid of 65 women with external genital endometriosis and infertility has been studied. We found an increase of TGF -β in peritoneal fluid, which is associated with an increased activity of MMP9 in the ectopic endometrium.

Matrix metalloproteinases’s association of polymorphisms of MMP3 and MMP9 with development of genital endometriosis

We present a comparative analysis of the allelic polymorphisms of the matrix metalloproteinase (MMP) gene family, including MMP3 (rs3025058), MMP7 (rs11568818), MMP9 (rs17576, rs2250889), MMP12 (rs2276109), and MMP13 (rs2252070), in patients with external genital endometriosis (EGE) and in a control group of healthy women proven to be free of disease by laparoscopic inspection. We found significant differences in the incidence of particular MMP3 and MMP9 alleles, which substantiate the role of matrix metalloproteinases in EGE pathogenesis. We used the Multifactor Dimensionality Reduction (MDR) analysis to show that 14 allelic combinations of the MMP containing MMP3 (rs3025058) × MMP7 (rs11568818) × MMP9 (rs17576) alleles showed a statistically significant association with an increased risk of EGE, while 10 other combinations correlated with a reduced risk of the disease. MDR analysis produced two statistically significant models for MMP allelic combinations involved in EGE progression, both with 100% penetrance and 83 and 78% accuracy.

Влияние диеногеста на морфофункциональное состояние эндометрия при наружном генитальном эндометриозе

In this paper we investigate the effect of dienogest on endometrial morphology and function in patients with external genital endometriosis. It is shown that dienogest is effective in reducing pain in patients with external genital endometriosis and endometrial morphology and function improves, suppresses manifestations of inflammation in the lining of the uterus.

Genital endometriosis as a cause of female infertility

Cited data review of literature in relation to the role of external genital endometriosis in the structure of gynaecological morbidity in a reproductive period and tactician of treatment of the sterility associated with a genital endometriosis.

Complex therapy of external genital endometriosis with immunomodylators

In the study of cytokine production in patients with endometriosis after 1 month the cytokine production levels did not change significantly. The level of TNF-α and IL-6 in these patients after combined treatment (hormone therapy) decreased by 21% and IL-8 to 3 times. There was not recurrence of the disease after using immunomodulators in the comparison groups. The use of natural low molecular weight immunomodulator Immunomax in the treatment of endometriosis normalized indicators of immunograms. Combined therapy with the use of immunomodulators improved prognosis and prevent endometriosis recurrence.

Clinical and pathogenetic parallels of the course of different endometrioid forms

A comparative analysis of the clinical manifestations of adenomyosis and external endometriosis showed the dependence of the intensity lesion on the duration of disease, presence of concomitant gynecological pathology, chronic virus infection and burdened genetic history. The role of polymorphisms of genes VEGF, GSTM1, ІL-8, IL-6 and TNF-α in the determination of risk external genital endometriosis (RR 2.31, CI 95% 1,1-3,6, p < 0.05). It was shown that the cytokine balance in women with adenomyosis and external endometriosis characterized by changes in the form of overproduction of proinflammatory cytokines TNF-α, IL-6, which correlates with the severity of clinical symptoms (r = 0,74, p < 0,01). In a clinical study demonstrated the effectiveness of the use of drugs with severe procytokine activity in treatment of endometriosis.

OP11.05: ‘Muscle thickness’ symptom in case of external genital endometriosis

OP11.05: ‘Muscle thickness’ symptom in case of external genital endometriosis

Bauchdeckenendometriose: Diagnostisches und therapeutisches Management

PURPOSE: Abdominal wall endometriosis is a rare type of extragenital endometriosis. There are no large cohorts in the literature providing for evidenced-based management of such lesions. PATIENTS: We present 16 patients with endometriosis of the abdominal wall. In addition, we performed a review of the literature. RESULTS: 4 patients had primary umbilical endometriosis. 12 patients had abdominal wall endometriosis located in scar tissue after surgery (8 times after caesarean section, 4 times after laparoscopy). Diagnoses were based on history, examination, ultrasound and MRI. Therapeutic management was planned on an individual basis, depending on symptoms, the extent of the lesion, and the presence or absence of other forms of endometriosis. Local resection was performed in 3 cases and umbilical excision with umbilical reconstruction in 3 cases. In 9 cases systemic hormonal treatment was administered with effective results. The recurrence rate after complete resection was low. An association with external genital endometriosis was observed in the cases of primary umbilical endometriosis or scar endometriosis after surgery for endometriosis. In cases with scar endometriosis after caesarean section an association with external genital endometriosis was uncommon. CONCLUSION: Endometriosis of the abdominal wall is a rare type of endometriosis. Clinical management must be planned on an individual basis and must take account of other factors such as symptoms, the extent of the lesion and the presence or absence of external genital endometriosis. Operative and endocrine treatment could be effective. Knowledge of the lesion's extent is mandatory for adequate treatment planning, and an interdisciplinary approach is helpful, particularly if plastic surgery is needed.

Study of Cytokine Profile and Angiogenic Potential of Peritoneal Fluid in Patients with External Genital Endometriosis

The concentrations of proinflammatory cytokines (IL-1beta, IL-6), vascular endothelium growth factor, tumor growth factor-beta, and insulin-like growth factor-1 were measured in the peritoneal fluid of patients with external genital endometriosis and healthy women by enzyme immunoassay. The effect of peritoneal fluid from patients with external genital endometriosis on proliferative activity of EA.Hy926 human endothelial cells was evaluated by the method based on the analysis of cell cycle by flow cytometry. The concentrations of IL-1beta, IL-6, and insulin-like growth factor-1 were increased in patients with endometriosis in comparison with healthy women. The peritoneal fluid from patients with endometriosis (but not from healthy women) significantly increased mitotic activity of endothelial cells and exhibited high angiogenic potential, which can promote implantation and growth of endometrial transplants. Presumably, insulin-like growth factor-1 stimulates this process.

Systemic and local levels of regulation of immunopathogenetic processes in patients with external genital endometriosis

The article represents the authors data, gained during studies of systemic and local mechanisms of regulation of immune processes in pathogenesis of external genital endometriosis. Research was carried out into spectrum and production of some cytokines, growth factors by endometrioid heterotopias under condition of organotypic cultivation compared to secretary activity of cells in peritoneal fluid and endometrial tissue in women with endometriosis.

Local Production of Interleukins and Growth Factors in External Genital Endometriosis

Secretion of some IL and growth factors (VEGF, IGF-I, TGFbeta) by endometrial tissues and endometrioid heterotopies was studied in vitro in patients with external genital endometriosis of different severity. The production of IL-1beta, IL-2, IL-6, and VEGF in the endometrium increased in severe external genital endometriosis, while the secretion of TGFbeta decreased; hyperproduction of IL-2, IL-6, VEGF and decreased production of TGFbeta were detected in endometrioid foci. Presumably, local cytokine imbalance and increased proliferative activity of endometrial cells are involved in the mechanisms of formation and functioning of endometrioid foci.

Cytokine production by immunocompetent cells of peritoneal fluid in women with external genital endometriosis.

The content of some cytokines in the peritoneal fluid and the level of their in vitro production by peritoneal macrophages and lymphocytes were evaluated in women with external endometriosis. The ratio of peritoneal lymphocytes and macrophages in the peritoneal fluid was changed in endometriosis because of increased percentage of lymphoid cells and decreased content of macrophages, in the presence of high absolute counts of both types of cells. The cytokine status of women with endometriosis was characterized by higher levels of IL-1beta, TNF-alpha, and epidermal growth factors both in the peritoneal fluid and supernatants of 24-h cultures of peritoneal macrophages; the content of IFN-alpha remained unchanged. The concentrations of IFN-gamma in the peritoneal fluid did not change in endometriosis, but increased in the supernatants of peritoneal lymphocyte cultures.

Early diagnosis of external genital endometriosis in women with infertility

The article reports on the results of the analysis of the reliability of symptoms of external genital endometriosis. Mathematical processing of these signs using the total probability formula made it possible to calculate the statistical probability of endometriosis in the presence of each sign individually or in their random combination in a woman with infertility and a regular ovulatory menstrual cycle.

Immunocompetent cells in the endometrium of patients with infertility and external genital endometriosis

The article reports on the results of an immunohistochemical study of the endometrium of patients with infertility and external genital endometriosis. The analysis of the dynamics of the distribution of immunocompetent cells in the endometrium of patients with infertility due to external genital endometriosis in comparison with patients with infertility of tubo-peritoneal genesis was carried out.

Fertility-associated Λ2-microglobulin (AMGF) as a possible marker of external genital endometriosis

A highly sensitive and nonradioactive microplate hybridization assay for the detection of Epstein–Barr virus (EBV)-specific polymerase chain reaction (PCR) product was developed. The PCR product is labelled by adding digoxigenin-dUTP directly to the reaction mixture and, after denaturation, is captured by a microtitre plate coated with an extravidin-linked biotinylated probe. Captured products are reacted with a peroxidase-conjugated anti-digoxigenin antibody and detected using tetramethylbenzidine. The assay detected less than ten EBV genomes in a background EBV-negative DNA of 0.75 μg and, when tested on clinical samples, it was able to define the viral load in throat washings of patients with acute infectious mononucleosis, immunosuppressed patients with HIV infection, and rare normal individuals who shed the virus in the oropharynx.

Metabolic effects and general side effects in the treatment of endometriosis with an LHRH agonist

Between 1983 and 1986 40 patients were treated for external genital endometriosis with the LHRH agonist buserelin. Ovarian suppression was achieved for a period of six months with a dose of 900 to 1,800 mcg per day. In addition to gynecological findings, liver and kidney function and lipid metabolism were checked prior to treatment and at regular intervals during treatment. No deviations from normal ranges were found. The general side effects observed during treatment were as a rule attributable to the buserelin-induced relative estrogen deficiency. The efficacy of the medication in the treatment of endometriosis was demonstrated by control pelviscopy. Since no undesirable metabolic side effects have so far been observed with buserelin, it may be considered an effective new alternative treatment for endometriosis.