Differential Proteomic Analysis of Endometriosis

Differential proteins expressing in ectopic and eutopic endometria were investigated by means of proteomic analysis. Five patients in secretary phase were diagnosed as endometriosis by laparoscopy. The five ectopic endometria(two at stage Ⅱ, two at stage Ⅲ and one at stage IV) and five eutopic endometria were surgically excised. One-dimensional electrophoresis coupled with liquid chromatography and mass spectrometry was used to screen and identify differential proteins. Three differential bands in one-dimensional electrophoresis were resolved by liquid chromatography and mass spectrometry and 14 up-regulated proteins were identified, including collagen α-1, α-2, α-3(VI), α-1(XIV) chain, actin, annexin A2, EMILIN-1, ferritin light polypeptide variant, fucosyltransferase 10, myosin-9, protein S100-A9, KIAA1783 protein, and two hypothetical proteins. Our data provides a list of potential biomarkers for endometriosis. The identifications may be used to develop new diagnoses for endometriosis.     

Voice changes in women treated for endometriosis and related conditions: The need for comprehensive vocal assessment

Hormonal treatments which have an androgenic effect have the potential to cause vocal changes. The changes in vocal fold structure and voice quality are considered to be irreversible. To date, studies have documented subjective vocal changes or documented single cases without detailed, baseline voice assessments. The impact on laryngeal function of women taking these androgenic treatments requires further detailed, objective assessment. The need for increased awareness of the actions of androgenic hormones on womns' voices, and the benefits of a thorough voice assessment are discussed.     

GnRH-a治疗中重度盆腔子宫内膜异位症后妊娠情况分析

目的探讨中重度子宫内膜异位症患者使用促性腺激素释放激素激动剂(GnRH-a)治疗后妊娠情况.方法选取中重度子宫内膜异位症患者61例,其中期待组(48例)予期待妊娠,必要时监测排卵或常规促排卵,辅助生殖组(13例)予体外受精-胚胎移植,观察比较两组患者术后使用GnRH-a治疗后的妊娠情况.结果61例患者总妊娠率67.2%(41/61).期待组月经恢复的0~3个月妊娠率(56.3%,27/48)明显高于月经恢复第4~12个月的妊娠率(12.5%,6/48),差异有统计学意义(P<0.05).辅助生殖组月经恢复的0~3个月妊娠率(30.8%,4/13)与月经恢复第4~12个月的妊娠率(30.8%,4/13)差异无统计学意义(P>0.05).月经恢复后的1年内,两组患者妊娠率的差异无统计学意义(P>0.05).GnRH-a使用3次与使用4~6次比较,妊娠率的差异无统计学意义(P>0.05).结论中重度子宫内膜异位症性患者,使用3次GnRH-a治疗,在月经恢复前及恢复最初3个月积极指导患者期待妊娠,在月经恢复3个月后及合并子宫内膜异位症外其他不孕因素的患者尽早给予辅助生殖治疗,有利于提高妊娠率.     

子宫内膜异位症中miR-143、miR-145和miR-126的差异表达

目的探索子宫内膜异位症（EMs）中miR-143、miR-145和miR-126的差异表达,以及不同月经周期的影响。方法利用realtimeRT-PCR技术,比较miR-143、miR-145和miR-126在EMs患者在位内膜（EU,2例）、异位内膜（EC,14例）、配对EU+EC（14例）,与非EMs患者内膜（EN,28例）中的表达差异;并分析EN和EC组不同月经周期对miR-143、miR-145和miR-126表达的影响。结果不同月经周期的影响分析,发现仅EN标本中miR-143增生期表达量高于分泌期,差异有统计学意义（P＜0.05）。与EN相比,miR-143和miR-145在EU中均表达上调（P＜0.05）,miR-143、miR-145和miR-126在EC中均表达上调（P＜0.01）。配对EU-EC中,miR-143、miR-145和miR-126在EC中均表达上调（P＜0.01）。结论miR-143、miR-145和miR-126在EMs中表达高于非EMs,在EC中表达高于EU。     

Beyond laparoscopy: 3-T magnetic resonance imaging in the evaluation of posterior cul-de-sac obliteration

Objectives

Endometriosis is the ectopic localization of endometrial glands. Symptoms include a wide variety of chronic pelvic pain. Ovarian endometriosis represents the most frequent site of implantation followed by the Douglas pouch which is undepicted unless peritoneal fluid is present. Pelvic exams may be reported as normal in 40% of evaluations, although multiple nodularities are located in this region. Nowadays, laparoscopy represents the standard technique for endometriosis evaluation. However, magnetic resonance imaging (MRI) remains the best noninvasive technique for the evaluation of pelvic lesions. According to the importance of a precise preoperative diagnosis of deep infiltrative endometriosis involving the Douglas pouch, we evaluated feasibility of a 3-T system in the evaluation of this particular region.

Methods

We enrolled 19 women coming with either ultrasound or anamnestic suspicion of endometriosis. Pelvic MRI examination was performed on the 3-T system. We applied a standard exam protocol including pulse sequences [single-shot fast spin echo (FSE)] and high-resolution T2W and T1W FSE sequences with and without FS.

Results

MRI diagnosed posterior cul-de-sac obliteration in 15/19 patients. MRI findings were compared with laparoscopy, thus obtaining the following statistical values: mean sensitivity, specificity, positive predictive value and negative predictive value, respectively, of 93%, 75%, 93% and 75%. Moreover, we calculated an interobserver agreement k value of 0.72 with a substantial degree of agreement between two radiologists of a sensitivity value of 93% and specificity value of 75%.

Conclusions

Precise preoperative mapping of posterior cul-de-sac region is essential for a preoperative planning. In our work, the 3-T MRI was shown to be excellent in the evaluation of posterior cul-de-sac obliteration associated to an optimal evaluation of the uterosacral ligaments due to the higher contrast spatial resolution.     

Systematic identification of the druggable interactions between human protein kinases and naturally occurring compounds in endometriosis

Diverse kinase signaling pathways have been involved in the pathogenesis of endometriosis (EM), which can be modulated either by directly targeting the hub kinases or by indirectly regulating marginal members in the pathways. Here, a systematic kinase–inhibitor interaction profile was created for 8 naturally occurring compounds against 20 human protein kinases. The compounds are all non-sterid that have been reported as pharmacologically active molecular entities potential for EM therapeutics, while the kinases were curated via gene ontology terms enriched from the gene co-citation network with EM. The resulting profile was analyzed at structural, energetic and dynamic levels to identify druggable kinase–compound interactions. The compounds Gossypol, Curcumin and EGCG showed a similar interaction profile across these kinases; they can bind tightly to the top-listed kinases in gene ontology, while the compounds Marrubiin, Apigenin and DIM were predicted to exhibit generally weak affinity for the 20 curated kinases. The JNK kinase, a MAPK family member, was identified as a putative candidate of druggable target for EM therapeutics; the inhibitory activity of eight naturally occurring compounds as well as a sophisticated kinase inhibitor SP600125 against the JNK was tested using enzymatic activity analysis. As might be expected, the Gossypol and EGCG were determined to have high inhibitory activity at namomolar level (IC₅₀ = 55 and 94 nM, respectively), which are comparable with or better than the positive control SP600125 (IC₅₀ = 76 nM), while other tested compounds exhibited weak inhibition (IC₅₀ > 100 nM) or bad potency (IC₅₀ = n.d.) against the kinase.     

改良超长降调节方案启动日LH、E2水平与EMs患者IVF- ET结局的关系

目的探讨改良超长降调节方案启动日LH、E2水平与子宫内膜异位症（EMs）患者体外受精-胚胎移植技术（IVF- ET）结局的关系。方法50例EMs患者（腹腔镜确诊）接受改良超长降调节方案治疗,患者接受GnRH- a治疗3～6个月,每次1.88 mg（1/2支）达菲林肌内注射,间隔28d,第2次注射达菲林后2周开始检测血清CA125,CA125降至18U/L以下后注射末次达菲林1/2支,于末次达菲林注射后2～6周开始用人绝经期促性腺激素（HMG）肌肉注射促进卵泡发育,按启动日血清LH水平分为两组,A1组25例,LH＜0.5U/L,B1组25例,LH≥0.5U/L,比较两组IVF- ET结局。另按启动日E2水平分为两组,A2组E2＜20pg/ml,B2组E2≥20pg/ml,比较两组IVF- ET结局。结果 A1组平均用药天数[（14.71±4.13）d]多于B1组[（8.86±0.49）d],A1组种植率（24.5%）低于B1组（33.3%）,差异均有统计学意义（均P＜0.05）。A2组与B2组间各项指标未见明显差异。结论改良超长降调节方案治疗EMs患者启动日LH过低将增加HMG用药天数,降低种植率,LH应作为超排启动的主要指标。     

Ultrasmall superparamagnetic iron oxides enhanced MR imaging in rats with experimentally induced endometriosis

Purpose

The purpose of our study was to evaluate the feasibility of magnetic resonance imaging (MRI) using ultrasmall superparamagnetic iron oxides (USPIO) in the detection of experimentally induced endometriosis.

Materials and methods

Endometriosis was surgically induced in rats by transplanting an autologous fragment of uterine tissue onto the inner surface of the abdominal wall, the posterior surface of the uterine body and the arterial cascades of the small intestines adjacent to mesenteric blood vessels. Six weeks later, MRI using Gd-DTPA and USPIO was performed for the evaluation of the ectopic uterine tissue (EUT). A scoring system was developed for image interpretation (0=absence, 1=probably absence, 2=probably presence and 3=presence). We defined MR index (MRIx) as the sum of T1-weighted and enhanced T1-weighted and T2-weighted image scores, and USPIO MRIx (MRIx^+USPIO) as the MRIx score plus the score of USPIO-enhanced T2-weighted image.

Results

The MRIx^+USPIO was also higher in the successfully autotransplanted group than in the failed group (6.19±1.72 versus 3.94±1.20, P<.001). There was also a significant linear relationship between MRIx^+USPIO and pathologic status (R²=0.494, P<.001). Thirty-one (64.6%) of the 48 implanted uterine tissues were histologically confirmed on pathologic review. The area of MRIx and MRIx^+USPIO in the detection of EUT more than 3 mm in size was 0.739 and 0.913, respectively.

Conclusion

Our results suggest that USPIO-enhanced MRI could be a novel diagnostic tool for diagnosis in experimentally induced peritoneal endometriosis.