The role of tissue factor and protease‐activated receptor 2 in endometriosis

Lin, Min; Weng, Huinan; Wang, Xuefeng; Zhou, Bing; Yü, Ping; Wang, Yifeng

doi:10.1111/j.1600-0897.2012.01152.x

Cited by 18 publications

(13 citation statements)

References 29 publications

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“…Moreover, the protease-activated receptor 2 (PAR-2), which is activated by TF/FVIIa, was as well demonstrated to be highly upregulated in the glandular epithelium of eutopic endometrium. Hence, both TF and the PAR-2 receptor are strategically poised for angiogenic and inflammatory signaling in endometriotic lesions [ 36 , 37 ]. Once TF is exposed to blood, it starts a reaction cascade that culminates in the increased production of thrombin.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

et al. 2020

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The presence of endometriosis determines an inflammatory response locally. The objective of this validation study and systematic review was to assess systemic levels of coagulation and inflammatory parameters in women with or without the disease. We conducted a retrospective analysis of a database prospectively collected from January 2017 to February 2020 including n = 572 women who underwent laparoscopic surgery for endometriosis (cases, n = 324) or other benign gynecologic diseases (controls, n = 248). Inflammatory markers and coagulation parameters were determined. An advanced systematic search of the literature on the same parameters was conducted up to April 2020. A significantly higher neutrophil count was found in endometriosis patients. Patients with endometriomas and stage III–IV disease had a significantly lower absolute lymphocyte count and shortened activated partial thromboplastin time (aPTT) values. In the final regression model, aPTT retained significant predictive value for stage III–IV endometriosis (odds ratio (OR) = 0.002, 95% confidence interval (CI) = 0.00–0.445; p = 0.024). Results from the n = 14 included studies in the systematic review are characterized by a high variability, but some consistency has been found for alterations in thrombin time, platelet-to-lymphocyte ratio, and neutrophil count associated with endometriosis. Modest systemic changes of some inflammatory and coagulation parameters are associated with endometriosis. Indeed, all the modifications detected are still within the normal reference intervals, explaining the high heterogeneity among studies.

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Section: Discussionmentioning

confidence: 99%

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

et al. 2020

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“…In women with endometriosis, platelet counts (PLT) and plasma fibrinogen levels increase [15, 16], thrombin time (TT) [15] and activated partial thromboplastin time (APTT) decrease [15, 17], while prothrombin time (PT) remains at normal level. Moreover, tissue factor (TF, coagulation factor III) is also increased in the endometriotic lesions and PF in women with endometriosis [14, 18]. TF binds to coagulation factor VIIa, activates coagulation factors IX and X, and induces thrombin formation.…”

Section: Introductionmentioning

confidence: 99%

Is there a correlation between inflammatory markers and coagulation parameters in women with advanced ovarian endometriosis?

et al. 2019

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BackgroundEndometriosis is defined as a chronic inflammatory disease. Recent studies have shown that increased coagulation parameters including fibrinogen and platelets are associated with endometriosis. The objective of this study was to determine the levels of inflammatory markers and coagulation parameters and their correlations in women with endometriomas compared to those with benign ovarian cysts or normal pelvic anatomy.MethodsBetween June 2015 and June 2017, a total of 548 women who underwent laparoscopic/laparotomic surgery for ovarian endometriomas (OMA group, n = 226), non-endometriosis benign ovarian cysts (Cyst group, n = 210) and tubal reanastomosis (Control group, n = 112) were recruited in this study. Inflammatory markers including c-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and coagulation parameters including platelet count, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time, and plasma fibrinogen as well as CA-125 were determined.ResultsCompared with Cyst group and Control group, TT and PT in OMA group were significantly shorter and plasma fibrinogen levels were significantly higher (P < 0.05). Moreover, the levels of plasma fibrinogen were positively correlated with CRP, NLR and PLR (P < 0.05). In addition, the confidence intervals for the area under the curve (AUC) for CA-125 × fibrinogen were significantly higher than those for CA-125 (0.904–0.952 vs. 0.899–0.949) in the diagnosis of endometrioma.ConclusionsThese results indicate that women with endometriomas demonstrate a hypercoagulable status due to the inflammatory nature of endometriosis. The combined determination for CA-125 and fibrinogen demonstrate a higher area under the curve than the single detection of CA-125 in those with endometriomas compared to these with benign ovarian cysts.Trial registrationThis study was approved by the Human Ethics Committee of the Women’s Hospital, School of Medicine, Zhejiang University (No.20170174) and all women provided written informed consent.

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“…[6][7][8] Finally, other factors involved in the coagulation cascade such as tissue factor (TF) and proteinase-activated receptors have also been reported to be altered in endometriosis, although their involvement has not been portrayed in the context of coagulation per se but, rather, in the context of angiogenesis or inflammation. 9,10 Indeed, some general inflammatory markers including the neutrophil-to-lymphocyte ratio (NLR) have been suggested to be increased in women with endometriosis compared to controls. [6][7][8]11,12 Normal hemostasis is characterized by a dynamic equilibrium between procoagulant and anticoagulant components of the hemostatic system.…”

Section: Introductionmentioning

confidence: 99%

Coagulation Status in Women With Endometriosis

et al. 2018

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Subtle alterations in coagulation and fibrinolysis have been recently reported in patients with endometriosis supporting a potential hypercoagulable status associated with the disease. This cross-sectional study aimed at evaluating some variables of coagulation status and inflammatory markers in women with endometriosis. A total of 314 women who underwent surgery were considered. The case group (n = 169) included patients with a surgical diagnosis of endometriosis, at any stage of disease. The control group (n = 145) included women with a surgical diagnosis of benign gynecologic pathology. No difference was found for thrombin time, International Normalized Ratio (INR), platelet count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR) between women with endometriosis and controls. Conversely, patients with endometriosis had significantly shortened activated partial thromboplastin time (APTT) when compared to controls (1.08 ± 0.06 and 1.12 ± 0.19, respectively; P < .01). In the subgroup analysis, women with ovarian endometriosis had significantly shortened APTT values in comparison to women without this form and women with stage I to II endometriosis had significantly shorter APTT values and higher PLR than those with stage III to IV disease. In multivariate logistic regression analysis, after controlling for potential confounders, a shortened APTT remained associated with the disease. Activated partial thromboplastin time is shorter in women with endometriosis but still in the normal range. The evidence is insufficient to foresee a possible use of APTT as a diagnostic marker and to claim a crucial role of a systemic hypercoagulable state in the origin of the disease. A role of the local coagulation system in the pathogenesis of the disease cannot be excluded.

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The role of tissue factor and protease‐activated receptor 2 in endometriosis

Abstract: The abnormal co-upregulated expression of TF and PAR-2 in eutopic and ectopic endometrium may affect the development and growth of endometriotic lesions and highlighted the pathologic role of TF and PAR-2 in eutopic endometrium in endometriosis.

Cited by 18 publications

References 29 publications

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

Is there a correlation between inflammatory markers and coagulation parameters in women with advanced ovarian endometriosis?

Coagulation Status in Women With Endometriosis

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