The role of survivin in the pathogenesis of endometriosis

Bianco, Bianca; Filipchiuk, Carolina; Christofolini, Denise Maria; Barbosa, Caio Parente; Montagna, Erik

doi:10.23736/s0026-4806.19.06358-4

Cited by 7 publications

(5 citation statements)

References 81 publications

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“…The findings have suggested that there may be significant differences in the microbiome profiles of patients with and without EMs [ 13 ]; (g) Laganà AS and his colleagues have found a significant increase in the number of macrophages in patients with EMs, which may give rise to an early pro-inflammatory microenvironment and late pro-fibrotic activity [ 14 ]. In addition, it has been suggested that leukocytes and peritoneal inflammatory mediators may contribute to the microenvironment in which EMs occur and develop [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

Liu

et al. 2022

BMC Women's Health

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Background Endometriosis is a common benign gynecological disease characterized by growing-functioning endometrial tissue outside the uterus. Extra-pelvic endometriosis, which accounts for approximately 12% of endometriosis, is more challenging to diagnose because of its distance from the pelvic organs. Halban's theory of benign metastasis indicates that endometrial cells can appear in extra-pelvic organs via lymphatic and blood vessels, but endometrial lymph node metastasis cases are still rare. We report a case of endometriosis in a para-aortic lymph node whose clinical behavior mimicked a malignancy. Case presentation A 52-year-old perimenopausal woman underwent laparoscopic hysterectomy plus bilateral salpingectomy (the patient insisted on the preservation of her ovaries) at a local hospital 2 years earlier because of adenomyosis. The patient presented with a complaint of low back pain to the gastrointestinal outpatient department of our hospital. The carbohydrate antigen 125 (CA125) was abnormally elevated at 5280.20 U/ml, human epididymis 4 (HE4) was 86.0 pmol/L, while other tumor markers were normal. Serum female hormone results were in the postmenopausal range, and her gastroenteroscopy showed no abnormalities. Moreover, both enhanced magnetic resonance imaging and positron emission tomography-computed tomography showed a high possibility of a retroperitoneal malignant lymph node (metastasis possible, primary site unknown). One week after admission, she underwent laparoscopic exploratory surgery, during which we observed normal shape and size of both ovaries while the left ovary was cystic-solid. After opening the retroperitoneal space, an enlarged lymph node-like tissue measuring 8 × 4 × 3 cm3 was found near the abdominal aorta. When the surrounding adhesions were separated, lymph node-like tissue was poorly demarcated from the abdominal aorta and renal artery. Some lymph node samples and left ovary were sent for intraoperative frozen section, which revealed benign lesions, similar to endometrial tissue. The lymph node tissue was then excised as much as possible, and the second set of intraoperative frozen sections showed high probability of endometrial tissue. The final histopathology and immunohistochemistry staining reached a diagnosis of para-aortic lymph node endometriosis. Gonadotropin-releasing hormone antigen treatment was recommended every 28 days because of the high preoperative CA125 and imaging-based suspicion of malignancy. The serum CA125 subsequently decreased to normal levels, and no para-aortic lesions were detected on abdominal enhancement CT. She is being followed up regularly. Conclusion It is known that the incidence of lymph node metastasis in pelvic endometriosis is relatively rare. Our report shows that endometriotic tissue can metastasize via the lymphatic route and suggests that endometriotic tissue has the characteristics of invasion and metastasis.

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Section: Discussionmentioning

confidence: 99%

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

Liu

et al. 2022

BMC Women's Health

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“…In apoptosis inhibition, survivin has a key role in both intrinsic and extrinsic pathways of apoptosis [ 39 , 40 , 41 , 42 , 43 , 44 ]. Considering the aspects of an immune response, survivin modulates the apoptotic threshold of neutrophils and its expression increases during inflammatory reactions in these cells.…”

Section: Discussionmentioning

confidence: 99%

“…Its expression increases after the activation of naive T cells in lymphoid organs, showing the importance of survivin in the initiation of immune responses. The increased level of survivin has been documented in serum and lymphocytes of patients with different autoimmune diseases [ 20 , 42 , 43 ]. Numerous studies have shown that peritoneal leukocytes and their inflammatory mediators exert local effects, creating a microenvironment that may facilitate the development and progression of endometriotic lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have shown that peritoneal leukocytes and their inflammatory mediators exert local effects, creating a microenvironment that may facilitate the development and progression of endometriotic lesions. Besides, some authors have suggested that endometriosis may have, at least in part, an autoimmune component [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…All these findings corroborate different theories for the origin of endometriosis, such as the theory of endometrial stem cells [ 52 ] or the increase in transient progenitor cells in which circulating stem cells originating from bone marrow or the basal layer of the endometrium can differentiate into endometrial tissue in different anatomical locations; or the theory of genetic/epigenetic changes in which, regardless of the origin of the initial cell, genic variants or epigenetic changes associated with changes in the peritoneal environment, such as inflammatory, immunological and oxidative stress, could initiate diseases in their different forms (ovarian, peritoneal, deep, and lesions outside the pelvis) and thus explain its complexity [ 11 , 53 ], which may lead also to significant anatomical alterations and make the surgical approach difficult [ 54 ]. Recently, a systematic review that summarized the findings from 21 studies and 1263 women with endometriosis reported that survivin (gene and/or protein) expression is increased in endometriosis, regardless of the methodology used (real-time reverse transcription polymerase chain reaction (RT-PCR), quantitative PCR (RT-qPCR), immunohistochemistry, Western blot, or enzyme-linked immunosorbent assay (ELISA)), sample studied (endometrium or blood), the phenotype of the endometriosis (superficial, ovarian, and deep) or morphology of the endometriotic lesions (pigmented or non-pigmented) [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

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BIRC5/Survivin Expression as a Non-Invasive Biomarker of Endometriosis

et al. 2020

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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.

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Research Progress of Caspase in Endometriosis

Yang,

Li,

et al. 2024

Reprod. Sci.

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The role of survivin in the pathogenesis of endometriosis

Cited by 7 publications

References 81 publications

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review

BIRC5/Survivin Expression as a Non-Invasive Biomarker of Endometriosis

Research Progress of Caspase in Endometriosis

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