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Biomedicines
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Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment
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Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 8881

Special Issue Editors

Prof. Dr. Masao Ichikawa

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Guest Editor
Department of Obstetrics and Gynecology Nippon Medical School, 1-1-5 Sendagi Bunkyo Tokyo, 113-8602, Japan
Interests: preoperative diagnostic method for endometriosis; systematic resection of deep endometriosis; diagnosis of intestinal endometriosis
Dr. Osamu Hiraike

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, 113-8655 Japan.
Interests: pathophysiology of the human reproduction and ovary; reproductive endocrinology; benign gynecological tumors; minimally invasive gynecological surgery and endoscopy; repair of pelvic floor; breast cancer; endometrial cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Koichi Shinohara

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Aichi Medical University, Aichi 480-1195 Japan
Interests: endometriosis; laparoscopic surgery; menopause and women’s health
Dr. Kuniaki Ota

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Tokyo Rosai Hospital, and Fukushima Medical Center for Children and Women, Fukushima Medical University, Tokyo 143-8540, Japan
Interests: reproductive endocrinology; reproductive immunology; reproductive surgery; reproductive health

Special Issue Information

Dear Colleagues,

Endometriosis affects approximately 10% of reproductive-age women, highlighting the urgent need to establish appropriate treatment strategies. The establishment of effective treatments would not only enhance the quality of life for the affected women but also contribute significantly to society. However, the causative factors, non-invasive diagnostic methods enabling early detection, and optimization of treatment for this disease remain largely elusive or unestablished. Consequently, addressing these issues is imperative.

This Special Issue explores the latest advancements in endometriosis, focusing on three key aspects: pathogenesis, diagnosis, and treatment. It seeks to gather cutting-edge research and insights on the molecular mechanisms underlying endometriosis, innovative diagnostic approaches, new knowledge of anatomy required for surgery, and advancements in therapeutic interventions. By bringing together expert perspectives and recent scientific findings, this Special Issue aims to enhance our understanding of endometriosis and provide valuable knowledge for clinicians, researchers, and healthcare professionals. This Special Issue also emphasizes the importance of patient-centered care and improving the quality of life for individuals affected by this condition. Through this collection of articles, we hope to foster dialogue and facilitate further progress in endometriosis.

Prof. Dr. Masao Ichikawa
Dr. Osamu Hiraike
Dr. Koichi Shinohara
Dr. Kuniaki Ota
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pathogenesis of endometriosis
  • epigenetics
  • inflammation and immune response
  • non-invasive diagnosis
  • non-invasive imaging modality
  • endometriosis-related biomarker
  • pharmacotherapy
  • optimization of surgical approaches
  • hormone therapy

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Published Papers (4 papers)

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Research

17 pages, 1372 KiB  
Article
Feasibility of Predicting Surgical Duration in Endometriosis Using Numerical Multi-Scoring System of Endometriosis (NMS-E)
by Masao Ichikawa, Tatsunori Shiraishi, Naofumi Okuda, Shigeru Matsuda, Kimihiko Nakao, Hanako Kaseki, Go Ichikawa, Shigeo Akira, Masafumi Toyoshima, Yoshimitu Kuwabara and Shunji Suzuki
Biomedicines 2024, 12(6), 1267; https://doi.org/10.3390/biomedicines12061267 - 6 Jun 2024
Viewed by 1282
Abstract
Background: Endometriosis is a multifaceted gynecological condition that poses diagnostic challenges and affects a significant number of women worldwide, leading to pain, infertility, and a reduction in patient quality of life (QoL). Traditional diagnostic methods, such as the revised American Society for Reproductive [...] Read more.
Background: Endometriosis is a multifaceted gynecological condition that poses diagnostic challenges and affects a significant number of women worldwide, leading to pain, infertility, and a reduction in patient quality of life (QoL). Traditional diagnostic methods, such as the revised American Society for Reproductive Medicine (r-ASRM) classification, have limitations, particularly in preoperative settings. The Numerical Multi-Scoring System of Endometriosis (NMS-E) has been proposed to address these shortcomings by providing a comprehensive preoperative diagnostic tool that integrates findings from pelvic examinations and transvaginal ultrasonography. Methods: This retrospective study aims to validate the effectiveness of the NMS-E in predicting surgical outcomes and correlating with the severity of endometriosis. Data from 111 patients at Nippon Medical School Hospital were analyzed to determine the correlation between NMS-E scores, including E-score—a severity indicator—traditional scoring systems, surgical duration, blood loss, and clinical symptoms. This study also examined the need to refine parameters for deep endometriosis within the NMS-E to enhance its predictive accuracy for disease severity. Results: The mean age of the patient cohort was 35.1 years, with the majority experiencing symptoms such as dysmenorrhea, dyspareunia, and chronic pelvic pain. A statistically significant positive correlation was observed between the NMS-E’s E-score and the severity of endometriosis, particularly in predicting surgical duration (Spearman correlation coefficient: 0.724, p < 0.01) and blood loss (coefficient: 0.400, p < 0.01). The NMS-E E-score also correlated strongly with the r-ASRM scores (coefficient: 0.758, p < 0.01), exhibiting a slightly more excellent predictive value for surgical duration than the r-ASRM scores alone. Refinements in the methodology for scoring endometriotic nodules in uterine conditions improved the predictive accuracy for surgical duration (coefficient: 0.752, p < 0.01). Conclusions: Our findings suggest that the NMS-E represents a valuable preoperative diagnostic tool for endometriosis, effectively correlating with the disease’s severity and surgical outcomes. Incorporating the NMS-E into clinical practice could significantly enhance the management of endometriosis by addressing current diagnostic limitations and guiding surgical planning. Full article
(This article belongs to the Special Issue Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment)
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18 pages, 4963 KiB  
Article
The Expression of Kisspeptins and Matrix Metalloproteinases in Extragenital Endometriosis
by Tatiana Kleimenova, Victoria Polyakova, Natalia Linkova, Anna Drobintseva, Dmitriy Medvedev and Alexander Krasichkov
Biomedicines 2024, 12(1), 94; https://doi.org/10.3390/biomedicines12010094 - 1 Jan 2024
Cited by 2 | Viewed by 1741
Abstract
Endometriosis is characterized by a condition where endometrial tissue grows outside the uterine cavity. The mechanisms of endometrium growth during endometriosis might be similar to the development of a tumor. The kisspeptin (KISS1) gene was initially discovered as a suppressor of metastasis. Matrix [...] Read more.
Endometriosis is characterized by a condition where endometrial tissue grows outside the uterine cavity. The mechanisms of endometrium growth during endometriosis might be similar to the development of a tumor. The kisspeptin (KISS1) gene was initially discovered as a suppressor of metastasis. Matrix metalloproteinases (MMPs) and their inhibitors are described as factors in the early stages of endometriosis and tumor growth progression. We applied the quantitative polymerase chain reaction and the immunofluorescence method to investigate KISS1, its receptor (KISS1R), MMP-2, and MMP-9 in the eutopic and ectopic endometrium in women with and without endometriosis. We presume that the dysregulation of KISS1 and MMPs might contribute to endometriosis pathogenesis. Samples for the immunofluorescence study were collected from patients with a confirmed diagnosis of endometriosis in stages I–IV, aged 23 to 38 years old (n = 40). The cell line was derived from the endometrium of patients with extragenital endometriosis (n = 7). KISS1 and KISS1R expression are present in the ectopic endometrium of patients with extragenital endometriosis, as opposed to the control group where these proteins were not expressed. There is a decrease in KISS1 and KISS1R values at all stages of endometriosis. MMP-2 and MMP-9 genes express statistically significant increases in stages II, III, and IV of extragenital endometriosis. MMP synthesis increased in the last stages of endometriosis. We suppose that the KISS1/KISS1R system can be used in the future as a suppressive complex to reduce MMP-2 and MMP-9 expression and prevent endometrial cells from invading. Full article
(This article belongs to the Special Issue Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment)
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16 pages, 2357 KiB  
Article
Shorter Anogenital Distance in Women with Ovarian Endometriomas and Adenomyosis, but Not Uterine Leiomyomas
by Xishi Liu, Ding Ding, Minhong Shen, Dingmin Yan and Sun-Wei Guo
Biomedicines 2023, 11(10), 2618; https://doi.org/10.3390/biomedicines11102618 - 23 Sep 2023
Cited by 5 | Viewed by 1703
Abstract
We investigated whether anogenital distance (AGD) is associated with adenomyosis, endometriosis and uterine leiomyomas (UL, also called uterine fibroids). We recruited 81 women with UL, 105 with ovarian endometrioma (OE), 116 with adenomyosis, 28 with both adenomyosis and UL, and 100 control subjects [...] Read more.
We investigated whether anogenital distance (AGD) is associated with adenomyosis, endometriosis and uterine leiomyomas (UL, also called uterine fibroids). We recruited 81 women with UL, 105 with ovarian endometrioma (OE), 116 with adenomyosis, 28 with both adenomyosis and UL, and 100 control subjects with other acquired gynecological conditions but not endometriosis, adenomyosis, UL, or polycystic ovarian syndrome. Measurements from the anterior clitoral surface to the center of the anus (AGDAC), from the tip of the clitoris to the center of the anus (AGDACt), and from the posterior fourchette to the center of the anus (AGDAF) were made in all subjects. Multiple regression was performed to estimate the association between AGDs and presence of OE, adenomyosis, and UL while controlling for possible confounding factors. We found that, compared with controls, women with OE and adenomyosis, but not UL, had significantly shorter AGDAF, but not AGDAC. However, the amount of variance that could be explained by the disease status is rather moderate, suggesting that factors other than disease status, bodyweight and height were also responsible for AGD. Thus, prenatal exposure to reduced levels of androgen may increase the risk of developing endometriosis and adenomyosis. However, other factors may also contribute to the pathogenesis of endometriosis and adenomyosis. Full article
(This article belongs to the Special Issue Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment)
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15 pages, 2561 KiB  
Article
Transvaginal Ultrasound vs. Magnetic Resonance Imaging: What Is the Optimal Imaging Modality for the Diagnosis of Endometriosis?
by Alexandra Irma Gabriela Baușic, Daniela Roxana Matasariu, Andrei Manu and Elvira Brătilă
Biomedicines 2023, 11(10), 2609; https://doi.org/10.3390/biomedicines11102609 - 23 Sep 2023
Cited by 1 | Viewed by 3061
Abstract
Endometriosis, an intriguing gynecological illness, poses a substantial health concern for women of reproductive age, despite its widespread occurrence and limited comprehension. The objective of this study is to assess the diagnostic precision of transvaginal sonography (TVS) and pelvic magnetic resonance imaging (MRI) [...] Read more.
Endometriosis, an intriguing gynecological illness, poses a substantial health concern for women of reproductive age, despite its widespread occurrence and limited comprehension. The objective of this study is to assess the diagnostic precision of transvaginal sonography (TVS) and pelvic magnetic resonance imaging (MRI) for the identification of deep infiltrated endometriosis (DIE). This study encompassed a cohort of 256 patients exhibiting signs and symptoms of endometriosis, with the aim of assessing the diagnostic accuracy over a span of four years. Both TVS and pelvic MRI were employed in the same centers to analyze each subject. The histopathologic analysis and laparoscopy were the most reliable and widely accepted methods for evaluation. TVS is a reliable diagnostic tool for ovarian endometriomas, obviating the necessity for MRI confirmation. The specificity of TVS in diagnosing ovarian endometriomas is 57.14%, while its sensitivity is 93.78%, resulting in an overall accuracy of 84.47%. In relation to parametrial lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS: 9%, 97%, 32%, MRI: 27.14%, 89.19%, and 40.11%. Concerning the uterosacral lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS:14.63%, 94.74%, and 55%, while MRI: 65.88%, 66.30%, and 66.1%. Regarding rectal endometriosis, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: 69.72%, 76.87%, and 73.82% for TVS, and 66.28%, 94.51%, and 80.79% for MRI. The results of the present study indicate that whereas MRI generally exhibits superior capability in assessing the severity of endometriosis, TVS demonstrates sufficient diagnostic accuracy in DIE comparable to MRI. Full article
(This article belongs to the Special Issue Advances in Endometriosis: Exploring Molecular Mechanisms, Diagnosis, and Treatment)
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