Decreased nerve fibers in the oviduct isthmus of women with endometriosis

Zhu, Libo; Huang, Qiongshi; Huang, Xiufeng; Zhang, Jing; Xu, Hong; Zhang, Xinmei

doi:10.1016/j.acthis.2014.02.005

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Furthermore, when compared with women without EP, S100-and PGP9.5-immunoreactivity were both significantly reduced in each layer of the ampulla tissue in cases with EP. Moreover, Zhu et al [18] reported the presence of PGP9.5-positive nerve fibers in smooth muscle strands, beneath the surface epithelium of the ampulla tissue, and in the vascular smooth muscle, thus suggesting that these may supply the surface epithelium, the smooth muscle, and the vasculature of the FTs. Abnormalities of the nerve plexus may be involved in the mechanisms that facilitate movement of the gametes; this could result in the pathogenesis of EP.…”

Section: Discussionmentioning

confidence: 99%

Reduced Numbers of Nerve Fibers in the Oviduct Ampulla of Women with Tubal Ectopic Pregnancy

Tang,

Ji,

Jin

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background:The oviduct plays a major role in fertility by facilitating the movement of gametes to promote fertilization and passage of the embryo for implantation. In the present study, we compared the distribution of nerve fibers in the ampulla of the oviduct tube in patients who presented with and without ectopic pregnancy (EP). Our aim was to acquire a better understanding of the pathologies underlying EP. Methods: We recruited 25 patients with EP (representing group A) and 25 patients who underwent hysterectomy for benign gynecological diseases (representing group B). None of the recruited women had a previous history of induced abortion. We acquired the oviduct ampulla from each patient in the two groups and used immunohistochemistry to detect S100 and protein gene product 9.5 (PGP9.5) and reveal abnormal distributions of nerve fibers within the fallopian tubes. Results: There was no statistical difference between the two groups in terms of the proportion of S100-and PGP9.5-immunoreactive nerve fibers in the mucosal, muscular and serosal layers of the oviduct ampulla. However, the proportions of S100-and PGP9.5-immunoreactive nerve fibers were reduced in the mucosal, muscular and serosal layers of the oviduct ampulla in women with EP when compared to women without EP. Conclusions: The reduced density of nerve fibers in the endometrial and muscular layer of the ampulla of the fallopian tube, as detected by PGP9.5 and S100, may play a significant role in the pathologies underlying ectopic pregnancy.

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Section: Discussionmentioning

confidence: 99%

Reduced Numbers of Nerve Fibers in the Oviduct Ampulla of Women with Tubal Ectopic Pregnancy

Tang,

Ji,

Jin

et al. 2023

Clin. Exp. Obstet. Gynecol.

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“…maternal voluntary efforts in the second stage of labor (among other obstetric injuries); both of which may lead to different, gynecologic syndromes [21,29]. Other groups have described denervationreinnervation in different pelvic organs and syndromes [31][32][33][34][35][36][37][38][39], including endometriosis [40][41][42][43][44][45][46][47][48][49][50], though without necessarily describing the source of these injuries.…”

Section: Obstetric and Gynecologic "Syndromes"mentioning

confidence: 99%

“…Different patterns of "endometriosis" are associated with injuries to uterovaginal nerves that cause retrograde menstruation with adhesion of ectopic endometrium to sites of tissue injury e.g. symmetric, hypertrophied, uterosacral ligaments following years of physical efforts during defecation, or, asymmetric, attenuated, uterosacral ligaments following difficult intrapartum episodes [40][41][42][43][44][45][46][47][48][49]. The laparoscopic appearances are both, dichotomous and confusing -but if the surgeon ignores the ectopic endometrium, notes the myofascial injuries, and, asks the question "What injuries has this woman sustained, and, when did they occur ?"…”

Section: Neurovascular Origins Of Some Gynecologic Syndromesmentioning

confidence: 99%

“…The laparoscopic appearances are both, dichotomous and confusing -but if the surgeon ignores the ectopic endometrium, notes the myofascial injuries, and, asks the question "What injuries has this woman sustained, and, when did they occur ?" then (s)he may be able to provide a better explanation of their origins with improved advice to the patient [76] Both uteri demonstrate aberrant reinnervation throughout the anatomic structures at the junction of uterus and vagina that may include the isthmus of the uterus, cervix, upper vagina, uterosacralcardinal ligaments, peritoneal surfaces and, even, the ectopic endometrium, itself [29,[40][41][42][43][44][45][46][47][48][49]. The prevailing opinion remains that deposits of ectopic endometrium are the primary source of pelvic pain; though some believe that increases in pelvic blood flow on regenerating nerves expressing "new and novel" pain receptors may be a better explanation of symptoms.…”

Section: Neurovascular Origins Of Some Gynecologic Syndromesmentioning

confidence: 99%

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Arteriolar injuries in clinical obstetric and gynecologic syndromes

Qing¹,

Xu²,

Yang³

et al. 2019

Clin Obstet Gynecol Reprod Med

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Narrowed, uterine arterioles in the placental bed are the histologic hallmark of many, clinical obstetric syndromes including preeclampsia, IUGR, preterm labor, midtrimester loss, and, placental abruption. Early reports illustrate, but do not explain, accompanying "halos" of hyalinised cells around these narrowed arterioles that are consistent features of these lesions (Figure 1a). Similar, narrowed arterioles are common in many gynecologic syndromes where there are "halos" of regenerating, injured nerves around narrowed uterine arterioles in presentations of chronic pelvic pain, dysmenorrhea, endometriosis , dyspareunia, vulvodynia, irritative bladder, and, bowel syndromes (Figure 1b). The neurovascular injury is one, and the same, in both obstetric and gynecologic, clinical syndromes. It results from injuries to pelvic vasomotor nerves (the "neural" injury) that release neural cytokines and growth factors causing transmural hyperplasia and narrowing of denervated arterioles, that become susceptible to successive, hyaline and fibrinoid changes (the "vascular" injury). Their common origins have been difficult to recognise because during pregnancy the injured arterioles extend to the placental bed, but, the injured nerves do not, leaving one, or more, layers of hyalinised cells around the injured arteriole in the placental bed biopsy (Figures 1a-b). Injuries to pelvic nerves result from "difficult" first labors, physical efforts during defecation, complications of gynecologic surgical procedures, as well as hypertension. Injuries to arteriolar vasomotor nerves induce "new" and "novel" receptors including purinergic, P2X3 and VEGF receptors in arteriolar smooth muscle that may respond to "pain" and "stretch" , or, activate other autonomic reflexes. Recent evidence suggests that the unexpectedly diverse, and varying, consequences of these neurovascular injuries may contribute to the pathophysiology of different, obstetric and gynaecologic syndromes.

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