Endometriosis is a pelvic inflammatory process with altered function of immune-related cells and increased number of activated macrophages in the peritoneal environment that secrete various local products, such as growth factors and cytokines. The elevation of cytokines and other factors in the peritoneal fluid is accompanied by the elevation of similar factors, such as CRP, SAA, TNF-α, MCP-1, IL-6, IL-8 and CCR1, in the peripheral blood of patients with endometriosis. CD44+ and CD14+ monocytes are significantly increased, while CD3+ T lymphocytes and CD20+ B lymphocytes show modest, but significant decrease in peripheral blood of women with endometriosis. This indicates that endometriosis could be viewed as a local disease with systemic subclinical manifestations. This review provides an overview of data on the changes of various factors in peripheral blood and their potential use as diagnostic tools in patients with endometriosis.

The authors demonstrate expression of the vitamin D receptor (VDR) and its hydroxylases in the endometrium and ovaries of women with and without endometriosis and endometrial or ovarian cancer. Immunohistochemistry showed strong staining of the VDR in endometriosis and endometrial cancer, with the most intense staining in epithelial cells. The VDR mRNA was significantly increased in patients with endometrial and ovarian cancer compared to the control group. There was a significantly higher 1 alpha-hydroxylase expression in the endometrium of patients with endometriosis compared to healthy controls. The observed differences in VDR and 1 alpha -hydroxylase mRNA levels were maintained at the protein level. The authors found no differences in 25-OH vitamin D levels between the serum of patients with endometriosis (25.7 +/- 2.1 ng/mL, n = 46) and healthy controls (22.6 +/- 2.0 ng/mL, n = 33, P = .31). They hypothesize that vitamin D might influence the local activity of immune cells and cytokines thought to play important pathogenic roles in the development and maintenance of endometriosis.

BackgroundCesarean scar endometriosis (CSE) is the most common type of abdominal wall endometriosis (AWE). The aim of this study was to systematically identify the clinical features of CSE and recommend precautionary measures.MethodsA large, retrospective study was undertaken with CSE patients treated surgically at our hospital between January 2005 and December 2017.ResultsA total of 198 CSE patients were enrolled, with a mean age of 32.0 ± 4.0 years. The main complaint of the patients was abdominal mass (98.5%), followed by cyclic pain (86.9%). The latency period of CSE was 31.6 ± 23.9 months, and the duration between the onset of symptoms and this surgery was 28.3 ± 25.0 months. A majority (80.8%, n = 160) of the patients had undergone a Pfannenstiel incision, and a minority (19.2%, n = 38) a vertical midline incision. The latency period of CSE in the case of a Pfannenstiel incision was significantly shorter than that in the case of a vertical midline incision (24.0 vs 33.0 months, P = 0.006). A total of 187 (94.4%) patients had a single endometrioma, 11 (5.6%) patients had multiple endometriomas, and the 11 multiple-endometrioma patients had all undergone a Pfannenstiel incision. Lesions of endometrioma were common in corner sites, after either incision: 142/171 (83.0%) in Pfannenstiel incision scars and 32/38 (84.2%) in vertical incision scars.ConclusionsThe findings of this study indicate that the Pfannenstiel incision carries a higher risk of CSE than the vertical midline incision. Thorough cleaning at the conclusion of CS, particularly of both corner sites of the adipose layer and the fascia layer, is strongly recommended for CSE prevention. Further studies might provide additional recommendations.

In oxygenic photosynthesis, chlorophyll plays a crucial rule in light harvesting as well as in transformation of absorbed light energy to chemical energy. However, the combination of chlorophyll and light is both a blessing and a curse for photosynthetic organisms. Whereas both are required for photosynthesis, chlorophyll excited by light can be converted to the triplet state, which in the presence of oxygen may lead to the formation of potentially damaging singlet oxygen ( 1 O 2 ) (1). The photodestructive potential of chlorophyll is greatly reduced if the chlorophyll is adjacent to carotenoids, which are efficient quenchers of both triplet chlorophyll and 1 O 2 (2). In vivo this is accomplished through pigment-binding proteins, which provide adjacency between chlorophylls and carotenoids and which allow efficient transfer of excitations eventually to the reaction center chlorophyll. In higher plants, the major chlorophyllbinding proteins are those that are part of the core complex of photosystem (PS) 1 I and PS II as well as the light-harvesting antenna complexes, which are encoded by a multigene family of cab genes (3). Most of the cab gene family members code for chlorophyll a/b-binding proteins with three transmembrane helices, of which the sequences of the first and third membrane-spanning regions are similar and where chlorophyllbinding sites are highly conserved. Other members of the cab gene family in plants are psbS, the product of which is predicted to have four membrane-spanning regions (4) and affects nonphotochemical quenching (5), as well as genes for singlehelix (6) and two-helix (7) members.In contrast to plants, cyanobacteria use phycobilisomes as the major light-harvesting apparatus, and they do not contain multihelix Cab proteins (light-harvesting antenna complexes or related chlorophyll a/b-binding peripheral antenna proteins). However, numerous genes potentially coding for small proteins with a single membrane-spanning region similar to the first and third transmembrane regions of Cab proteins and with conserved residues involved in chlorophyll binding were found in genomes of many cyanobacteria including prochlorophytes (see Refs. 8 and 9). For example, the Prochlorococcus marinus MED4 genome contains as many as 23 such genes (9). The genome of the cyanobacterium Synechocystis sp. PCC 6803 contains genes for four small Cab-like proteins (SCPs) that have been named ScpB-ScpE (10). In addition, ferrochelatase in cyanobacteria and the chloroplast-targeted isozyme in plants has a ϳ60-residue C-terminal extension (absent in other ferrochelatases) that is similar to the SCPs. For this reason, the C-terminal extension has been named ScpA and this SCP extension does not seem to be necessary for the activity of ferrochelatase in Synechocystis (10). Since one of the conditions under which the small scp genes are expressed is high light intensity, these genes also have been named hli (high lightinducible) by other authors (8,11 Downloaded fromThe function of SCPs is still largely unclear, although...