Abstract:Endometriosis is one of the main common gynecological disorders, which is characterized by the presence of glands and stroma outside the uterine cavity. Some findings have highlighted the main role of inflammation in endometriosis by acting on proliferation, apoptosis and angiogenesis. Oxidative stress, an imbalance between reactive oxygen species and antioxidants, could have a key role in the initiation and progression of endometriosis by resulting in inflammatory responses in the peritoneal cavity. Neverthel… Show more
“…Homeostasis maintenance of tissue is mainly regulated by cell death and some studies have shown that apoptosis increases during the menstrual cycle to retain cell homeostasis, removing aged cells from the functional layer of the endometrium [ 33 ]. The rate of apoptosis is decreased in endometrial cells of women with endometriosis, and therefore, it may contribute to the pathogenesis of the disease [ 34 , 35 , 36 , 37 , 38 ].…”
The etiology of endometriosis is highly complex, and although it is a benign disease, it has several biological behaviors similar to malignant lesions, including cell invasion, neo-angiogenesis, and decreased apoptosis. Survivin is a protein encoded by the BIRC5 gene that plays a role in cell division by inhibiting apoptosis and regulating the process of mitosis in embryonic and cancer cells. Therefore, we aimed to evaluate the expression of BIRC5 in samples of peripheral blood of women with and without endometriosis. This study comprised of 40 women with endometriosis and 10 healthy women as controls. Peripheral blood samples were collected in the three phases of the menstrual cycle (follicular, ovulatory, and luteal). The expression of the BIRC5 gene was evaluated by RT-qPCR using the TaqMan methodology. The BIRC5 expression was significantly higher in all phases of the menstrual cycle in women with endometriosis, regardless of the disease stage. The accuracy of BIRC5 expression in the peripheral blood for the diagnosis endometriosis presented AUC of 0.887 (p < 0.001), with 97.2% of sensitivity and specificity of 65.5% considering the overall endometriosis group. Regarding the minimal/mild endometriosis group, the AUC presented a value of 0.925 (p < 0.001), with 100% of sensitivity and 79.3% of specificity, whereas in the moderate/severe endometriosis group the AUC was 0.868 (p < 0.001), with a sensitivity of 95.8% and specificity of 65.5%. These findings suggest that the expression of BIRC5 may be a potential noninvasive biomarker for the diagnosis of endometriosis.
“…Homeostasis maintenance of tissue is mainly regulated by cell death and some studies have shown that apoptosis increases during the menstrual cycle to retain cell homeostasis, removing aged cells from the functional layer of the endometrium [ 33 ]. The rate of apoptosis is decreased in endometrial cells of women with endometriosis, and therefore, it may contribute to the pathogenesis of the disease [ 34 , 35 , 36 , 37 , 38 ].…”
The etiology of endometriosis is highly complex, and although it is a benign disease, it has several biological behaviors similar to malignant lesions, including cell invasion, neo-angiogenesis, and decreased apoptosis. Survivin is a protein encoded by the BIRC5 gene that plays a role in cell division by inhibiting apoptosis and regulating the process of mitosis in embryonic and cancer cells. Therefore, we aimed to evaluate the expression of BIRC5 in samples of peripheral blood of women with and without endometriosis. This study comprised of 40 women with endometriosis and 10 healthy women as controls. Peripheral blood samples were collected in the three phases of the menstrual cycle (follicular, ovulatory, and luteal). The expression of the BIRC5 gene was evaluated by RT-qPCR using the TaqMan methodology. The BIRC5 expression was significantly higher in all phases of the menstrual cycle in women with endometriosis, regardless of the disease stage. The accuracy of BIRC5 expression in the peripheral blood for the diagnosis endometriosis presented AUC of 0.887 (p < 0.001), with 97.2% of sensitivity and specificity of 65.5% considering the overall endometriosis group. Regarding the minimal/mild endometriosis group, the AUC presented a value of 0.925 (p < 0.001), with 100% of sensitivity and 79.3% of specificity, whereas in the moderate/severe endometriosis group the AUC was 0.868 (p < 0.001), with a sensitivity of 95.8% and specificity of 65.5%. These findings suggest that the expression of BIRC5 may be a potential noninvasive biomarker for the diagnosis of endometriosis.
“…Curcumin inhibited superoxide anion-induced overt pain-like behaviors, mechanical and thermal hyperalgesia and leukocyte recruitment in animal models through inhibition of MPO activity, oxidative stress, TNF-α and IL-1β production and NF-κB activation, and upregulation of IL-10, HO-1, and Nrf2 mRNA expression [89]. These evidences have highlighted the antioxidant, anti-inflammatory, and anti-angiogenic properties of curcumin in endometriosis therapeutics [90].…”
The aim of this review is to investigate the oxidant/antioxidant status and its regulatory mechanisms in patients with endometriosis and to summarize the antioxidant therapy as an alternative to hormonal therapy for endometriosis. Each keyword alone or in combination was used to search from PubMed and Embase by applying the filters of the title and the publication years between January 2000 and March 2020. Endometriosis is a chronic inflammatory disease characterized by repeated episodes of hemorrhage. Methemoglobin in repeated hemorrhage produces large amounts of superoxide anion via the autoxidation of hemoglobin. Excessive free-radical production causes redox imbalance, leading to inadequate antioxidant defenses and damage to endometrial cells, but may contribute to endometrial cell growth and survival through activation of various signaling pathways. In addition, to overcome excessive oxidative stress, estradiol participates in the induction of antioxidants such as superoxide dismutase in mitochondria. Several antioxidants that suppress free radicals may be effective in endometriosis-related pain. We searched for 23 compounds and natural substances that could reduce the pain caused by superoxide/reactive oxygen species in basic research and animal models. Next, we built a list of 16 drugs that were suggested to be effective against endometriosis other than hormone therapy in preclinical studies and clinical trials. Of the 23 and 16 drugs, 4 overlapping drugs could be potential candidates for clinically reducing endometriosis-related pain caused by superoxide anion/reactive oxygen species. These drugs include polyphenols (resveratrol and polydatin), dopamine agonists (cabergoline), and statins (simvastatin). However, no randomized controlled trials have evaluated the efficacy of these drugs. In conclusion, this review summarizes the following 2 points: superoxide anion generation by methemoglobin is enhanced in endometriosis, resulting in redox imbalance; and some compounds and natural substances that can suppress free radicals may be effective in endometriosis-related pain. Further randomized clinical trials based on larger series are mandatory to confirm the promising role of antioxidants in the nonhormonal management of endometriosis.
“…Curcumin (bis-α, β-unsaturated β-diketone) is a natural component which presents some therapeutically potential roles as anti-inflammatory guardian in the organism [17]. It can downregulate the expression of TNF-α, COX-2, IL-6 and TGF, TNF-α, IL-1, IL-6 and IL-8.…”
“…Pathological lesions mostly occur in in the ovaries, fallopian tubes, the ligaments of the uterus, the urinary tract and the rectum. Intense pain, irregular uterine bleeding, dyspareunia are main symptoms which has a negative impact on mental and physical health [1]. Mental disturbances may express as a various form of anxiety and depression.…”
Endometriosis is a silent, unseen and painful female illness which is characterized by the presence of glands and stroma outside the uterine cavity. Approximately one in ten women in a reproductive age around the world suffer from endometriosis of whom nearly half is treated due to infertility. The pathogenesis and mechanisms that determines the occurence of the disease are still unknown. Immunological factors have been observed in the initiation and development of endometriosis. An imbalance between reactive oxygen species (molecules having an unpaired electron) and antioxidants leads to the upregulation of metalloproteinases, prostaglandins, cytokines and chemokines.
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