Conservative surgical and drug therapies for adenomyosis Medicine

Fan, Yiyue; Zhu, Shaomi; Liang, Xin

doi:10.1016/j.repbio.2022.100664

Cited by 6 publications

(3 citation statements)

References 48 publications

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“…There is no clear and unified standard for how to treat patients with adenomyosis who have fertility requirements. [ 8 ] The patient in our case without infertility and miscarriage underwent surgical management of adenomyosis in 5-year prior, which increased her risk of future complications including ectopic pregnancy, placental adhesive disorders and uterine dehiscence in future pregnancies. Patients with adenomyosis who have fertility requirements should carefully choose surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report

Peng

Dai

et al. 2022

Medicine

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Rationale: Intramural ectopic pregnancy (IMP) is a rare ectopic pregnancy with an unclear etiology, and standard treatment guidelines currently remain unclear. The main treatment option is local excision of IMP via laparoscopy or laparotomy. Patient concerns: A 32-year-old woman with adenomyosis presented with amenorrhea for 7 weeks and a serum β-human chorionic gonadotropin (HCG) level of 6882 IU/L. The patient had a history of laparotomy for adenomyosis 5 years previously. Three-dimensional ultrasonography showed a live gestational sac (GS) of 9 × 15 × 18 mm located in the left posterior wall of the uterus and a sinus tract connecting the sac and the endometrial cavity. MRI revealed the GS located in the adenomyosis and a 1.0-cm sinus tract connecting the GS and the endometrial cavity. Diagnoses: IMP with adenomyosis. Interventions: High-intensity focused ultrasound (HIFU) treatment combined with systemic methotrexate (MTX) was performed to treat IMP, which would avoid operation and massive bleeding. Outcomes: Serum β-HCG levels decreased to normal 4 weeks after HIFU treatment and the GS was not found on MRI after 4 months. The sinus tract was significantly shortened after the HIFU treatment. Lessons: HIFU ablation combined with systemic MTX is effective for the treatment of IMP and is favorable for maintaining fertility.

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Section: Discussionmentioning

confidence: 99%

High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report

Peng

Dai

et al. 2022

Medicine

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“…Refractory dysmenorrhea and chronic pelvic pain in AM represent a challenge for medical support. The development of more efficacious, non-hormonal therapeutics for AM is still an unmet medical need begging to be fulfilled ( Nirgianakis et al, 2021 ; Fan et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Dahuang—Taoren, a botanical drug combination, ameliorates adenomyosis via inhibiting Rho GTPases

Lei

Fu²,

Chen³

et al. 2023

Front. Pharmacol.

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Introduction: Dahuang-Taoren (DT) is a classic combination of botanical drugs applied to treat pain-related diseases in ancient China. Today, DT is frequently applied for dysmenorrhea of adenomyosis (AM) in the clinic. Growing evidence indicates Rho GTPases may play an essential role in AM progression. However, the potential mechanism of DT on Rho GTPases in AM remains unclear.Methods: The expressions of Rho GTPases in the patients with AM were evaluated. Further, pituitary transplantation-induced AM mice and the primary AM endometrial stromal cells (AMESCs) were subjected to DT intervention.Results: The results revealed that the expressions of Rho GTPases were significantly upregulated in both AM patients and AM mice. The DT could reduce pathological infiltration, relieve hyperalgesia, and alleviate cytoskeleton remodeling in AM mice. Besides, the migration and invasion of AMESCs were markedly inhibited after exposure to DT.Discussion: These effects may be linked to the decreased Rho GTPases expression. The results may offer a novel explanation of DT against AM.

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“…Due to the unknown mechanisms, no drug is currently labeled for adenomyosis and there are no speci c guidelines to follow for the best management [3]. Hysterectomy is currently considered the most effective treatment for adenomyosis, however, it is only applicable to older, nearly menopausal women with no fertility requirements [4]; drug treatment using suppressive hormone aiming for the hypothalamicpituitary-ovarian (HPO) axis could induce regression of adenomyosis and improve the symptoms, but symptom recurrence after drug discontinuation, obvious side effects and pregnancy limitation becomes the principal drawbacks of these medical options [5]. Supraphysiologic estrogen production in the endometrium is widely considered to be closely related to the occurrence of adenomyosis [6].…”

Section: Introductionmentioning

confidence: 99%

Estrogen Regulates Scribble Localization in Endometrial Epithelial Cells Through Acyl Protein Thioesterase (APT)-Mediated S-Palmitoylation in Adenomyosis

Jin,

Wang,

Chen

2023

Reprod. Sci.

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Despite its prevalence and the severity of symptoms, little is known about the pathogenesis and etiology of adenomyosis. In our previous study, Scribble localization has been found to be partially translocated to cytoplasm, however, its regulatory mechanism is known. In consideration of the important role of supraphysiologic estrogen production in the endometrium in the development of adenomyosis, we analyzed the effect and mechanism of estrogen on Scribble localization in vivo and in vitro. Firstly, we found Scribble translocation from the basolateral membrane to the cytoplasm was easily to be seen in women and mice with adenomyosis (68% vs 27%, 60% vs 10% separately). After treatment with the Spalmitoylation inhibitor 2-Bromopalmitate for 48H, cytoplasmic enrichment of Scribble and the reduced level of palm-Scribble was observed by immuno uorescence, Western blot and acyl-biotin exchange palmitoylation assay. High estrogen exposure could not only induce partially cytoplasmic translocation of Scribble but also decrease the expression level of palm-Scribble, which can be recovered by estrogen receptor inhibitor ICI182,780. Based on following experiments, we found that estrogen regulated Scribble localization by APT through S-palmitoylation of Scribble protein. At last, IHC was performed to verify the expression of APT1 and APT2 in human clinical tissue specimens and found that they were all increased dramatically. Furthermore, positive correlations were found between APT1 or APT2 and aromatase P450. Therefore, our research may provide a new understanding of the pathogenesis of adenomyosis.

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Conservative surgical and drug therapies for adenomyosis Medicine

Cited by 6 publications

References 48 publications

High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report

High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report

Dahuang—Taoren, a botanical drug combination, ameliorates adenomyosis via inhibiting Rho GTPases

Estrogen Regulates Scribble Localization in Endometrial Epithelial Cells Through Acyl Protein Thioesterase (APT)-Mediated S-Palmitoylation in Adenomyosis

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