Using the novel pelvic organ prolapse histologic quantification system to identify phenotypes in uterosacral ligaments in women with pelvic organ prolapse

Orlicky, David J.; Guess, Marsha K.; Bales, Elise S.; Rascoff, Lauren; Arruda, Jaime; Hutchinson-Colas, Juana; Johnson, Joshua; Connell, Kathleen A.

doi:10.1016/j.ajog.2020.10.040

Cited by 10 publications

(16 citation statements)

References 38 publications

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“…The number of neutrophils in the POP group increased signi cantly, consistent with the results of previous studies 19,20 . Further analysis of 1136 neutrophils in the POP group revealed four clusters with different gene expression pro les (Fig.…”

Section: Characterization Of Myeloid Cellssupporting

confidence: 91%

“…Moreover, it has been reported that the expression of the collagen-degrading enzyme, matrix metalloproteinase (MMP), is increased, and the expression of the tissue inhibitor of metalloproteinases (TIMP) is decreased, indicating dysregulation of MMP and TIMP 14,18 . In addition, studies have shown that the increased in ltration of neutrophils in the USL is related to the occurrence of POP 19,20 . Numerous studies have reported proteomic, transcriptomic, and genomic changes in POP 14,18−23 .…”

Section: Introductionmentioning

confidence: 99%

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Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse

Liu

Sue²,

Wei³

et al. 2023

Preprint

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Pelvic organ prolapse (POP) markedly affects the quality of life of women, including significant financial burden. Different cell types and corresponding marker genes were identified in the vaginal wall of women with POP; however, no study has explored gene expression and cellular heterogeneity in the uterosacral ligament. Using single-cell RNA sequencing, we constructed a transcriptional profile of the uterosacral ligament and control samples, and identified 10 major cell types. We performed subpopulation analysis of POP primary cells, explored differentially expressed genes, and performed pseudo-time and transcription factor analyses. We verified previous cell clusters of human fibroblasts, neutrophils, and found new clusters of uterosacral ligaments. Additionally, we dissected pattern changes of cell–cell interaction between stromal and immune cells and transcription factors related to the extracellular matrix, development, and immunity in POP. Here we provide insight into the molecular mechanisms of POP and valuable information for future research directions.

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Section: Characterization Of Myeloid Cellssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse

Liu

Sue²,

Wei³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The uterosacral ligaments (USLs) have long been recognized as important components of apical vaginal support. 9 In the current issue of the Journal, the cross-disciplinary study by Orlicky et al 10 used a systematic histologic evaluation and unbiased principal component analysis to determine whether variable alterations of the cervical portion of the USL exist in women with POP. The authors developed the Pelvic Organ Prolapse Histologic Quantification (POP-HQ) system.…”

mentioning

confidence: 99%

“…Emerging studies highlight the important role of inflammation in pathologic transformations of the pelvic floor structural components, including USL. 16 Interestingly, Orlicky et al 10 found that the POP-I phenotype had the least overlap with control USL and, therefore, was the strongest histologic predictor of POP after controlling for other known risk factors. The authors highlight that the chronic presence of the immune cells suggests a state of ongoing injury with up-regulation of a systems-level response.…”

mentioning

confidence: 99%

“…To achieve this, we need to get away from crude PFD phenotypes and develop reliable tools for quantitative phenotyping to accurately describe the dysfunction or function of the female pelvic floor soft structures. The recognition that women with symptomatic POP may present with more than one histologic phenotype, described by Orlicky et al, 10 is the first step in the continuum of research that will bridge the scientific disparity in female pelvic medicine. The major goal of quantitative phenotyping is to enable rigorous genotypephenotype correlations and the development of reliable biomarkers to predict POP progression and an individual patient's therapeutic response, neither of which is currently possible.…”

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confidence: 99%

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Deeper dive into tissue-level events that incite and promote pelvic organ prolapse

Alperin

2021

American Journal of Obstetrics and Gynecology

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Is It Possible to Diagnose Surgical Uterine Prolapse With Transperineal Ultrasound? Multicenter Validation of Diagnostic Software

García‐Mejido

Martín‐Martinez²,

González-Díaz³

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo validate an ultrasound software that uses transperineal ultrasound to diagnose uterine prolapse (UP).MethodsMulticenter, observational and prospective study with 155 patients that had indications for surgical intervention for dysfunctional pelvic floor pathology. Each patient underwent an examination with Pozzi tenaculum forceps was performed in the operating room with the patient anesthetized, followed by surgical correction of stages II–IV UP. Transperineal ultrasound was used to assess the difference in the pubis–uterine fundus measurement. With a multivariate logistic regression binary model (with the measurement ultrasound at rest, the Valsalva maneuver and age) using nonautomated methods to predict UP. With the purpose of evaluating the model, a table with coordinates of the receiver operating characteristic (ROC) curve, after which sensitivity and specificity were assessed.ResultsA total of 153 patients were included (73 with a diagnosis of surgical UP). It was obtained from the AUC (0.89) of the probabilities predicted by the model (95% confidence interval, 0.84–0.95; P < .0005). Based on the ROC curve for the model, obtaining a sensitivity of 91.8% and a specificity of 72.7%, values that were superior to those for the clinical exam for surgical UP (sensitivity: 80.8%; specificity: 71.3%).ConclusionsWe validated software that uses transperineal ultrasound of the pelvic floor and patient age to generate a more reliable diagnosis of surgical UP than that obtained from clinical examinations.

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Using the novel pelvic organ prolapse histologic quantification system to identify phenotypes in uterosacral ligaments in women with pelvic organ prolapse

Cited by 10 publications

References 38 publications

Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse

Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse

Deeper dive into tissue-level events that incite and promote pelvic organ prolapse

Is It Possible to Diagnose Surgical Uterine Prolapse With Transperineal Ultrasound? Multicenter Validation of Diagnostic Software

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