Pain Mechanisms in Peritoneal Diseases Might Be Partially Regulated by Estrogen

Abstract

To identify factors influencing the differential pain pathogenesis in peritoneal endometriosis (pEM) and peritoneal carcinomatosis in ovarian cancer (pOC), we undertook an experimental study. Tissue samples of 18 patients with pEM, 15 patients with pOC, and 15 unaffected peritoneums as controls were collected during laparoscopy or laparotomy. Immunohistochemical stainings were conducted to identify nerve fibers and neurotrophins in the tissue samples. Additionally, 23 pEM fluids, 25 pOC ascites fluids, and 20 peritoneal fluids of patients with myoma uteri as controls were collected. In these fluids, the expression of neurotrophins was evaluated. The effects of peritoneal fluids and ascites on the neurite outgrowth of chicken sensory ganglia were estimated by using a neuronal growth assay. An electrochemiluminescence immunoassay was carried out to determine the expression of estrogen in the peritoneal fluids and ascites. The total and sensory nerve fiber density was significantly higher in pEM than in pOC ( P < .001 and P < .01). All neurotrophins tested were present in tissue and fluid samples of pEM and pOC. Furthermore, the neurotrophic properties of pEM and pOC fluids were demonstrated, leading to sensory nerve fiber outgrowth. Estrogen concentration in the peritoneal fluids of pEM was significantly higher compared to ascites of pOC ( P < .001). The total and sensory nerve fiber density in the tissue samples as well as the estrogen expression in the peritoneal fluid of pEM was considerably higher than that in pOC, representing the most notable difference found in both diseases. This might explain the differential pain perception in pEM and pOC. Therefore, estrogen might be a key factor in influencing the genesis of pain in endometriosis.

Exploration and prognostic analysis of two types of high-risk ovarian cancers: clear cell vs. serous carcinoma: a population-based study

“…However, OCCC patients exhibit a highly heterogeneous prognosis [21]. Endometriosis is reported to be an independent risk factor for OCCC and ovarian endometriotic epithelial cells are considered as the cellular source of OCCC [22,23]. Even so, the mechanism of tumorigenesis has not been fully elucidated.…”

Network pharmacology prediction and experimental verification of Rhubarb-Peach Kernel promoting apoptosis in endometriosis

“…The pathological manifestation of EMs is characterized by extra-uterine growth of endometrial tissues. Apoptosis and proliferation imbalance [ 6 – 8 ], endocrine tolerance [ 9 , 10 ], oxidative stress [ 11 , 12 ], inflammation and immunity [ 13 ] and their interaction contribute to the high invasive ability of EMs cells. Although several medication lines including surgery, non-steroidal anti-inflammatory drugs, and hormones have been studied aiming at its definitive treatment, these therapies are difficult to avoid a range of side effects and high recurrence rates [ 14 , 15 ].…”