Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer

Signorile, Pietro G.; Baldi, Feliciano; Bussani, Rossana; D'Armiento, M.; Falco, Maria De; Baldi, Alfonso

doi:10.1186/1756-9966-28-49

Cited by 103 publications

(97 citation statements)

References 19 publications

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“…It is also known that endometriosis does not emerge exclusively after the third decade of life. In fact, recent studies have demonstrated that 11% of female fetuses submitted to necropsy were found to have endometriosis, with lesions located in similar regions to those found in adult women [5]. Contemporary observations indicate that the most common sites of endometriosis are the uterosacral ligaments and torus uterinus (i.e., the uterine transversal fold corresponding to insertion of both uterosacral ligaments) [6].…”

Section: Introductionmentioning

confidence: 99%

“…Considering the possibility that the HOXA10 gene is related to the development of endometriosis, it remains to be elucidated how and when its action would take place. Signorile et al [5] have beautifully demonstrated the presence of endometriosis in 11% of human female fetuses, at a gestational Fig. 3 Embryogenesis of the female internal genital system and proposed role of the HOXA10 in the etiology of endometriosis.…”

Section: Hoxa10 May Influence the Formation Of Misplaced Endometrialmentioning

confidence: 99%

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The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

Zanatta

Rocha

Carvalho³

et al. 2010

J Assist Reprod Genet

173

118

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Purpose Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease.Methods This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility. Result The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/ HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Müllerian tract. Conclusions Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis.

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Section: Introductionmentioning

confidence: 99%

Section: Hoxa10 May Influence the Formation Of Misplaced Endometrialmentioning

confidence: 99%

The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

Zanatta

Rocha

Carvalho³

et al. 2010

J Assist Reprod Genet

173

118

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show abstract

“…it is a structure of embryonic origin, and it is sometimes associated with other malformations or congenital abnormalities. The fact that it has been found in female fetuses, infants, children, adolescents and adults supports the theory that it is a congenital developmental disease (11). The etiology of this lesion still remains unknown.…”

Section: Case Reportmentioning

confidence: 69%

Müllerianosis with intestinal metaplasia: a case report

Carmen

Rodríguez²,

Gomez³

et al. 2015

TJPATH

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müllerianosis or müllerian choristomas are developmental alterations that consist of an organoid structure with normal müllerian tissue. We present a 62-year-old patient diagnosed on ultrasound scanning and on CT scan of bilateral ovarian cysts. During surgery, a left ovarian cyst and retroperitoneal tumor (adhered to sigmoid serous surface) were found. On histological examination, the tumor corresponded with a müllerian choristoma showing endometrial, endosalpingeal and endocervical epithelium, with foci of intestinal metaplasia, a phenomenon not described in the literature.

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“…5,6 The authors suggested that endometriosis developed during organogenesis by dislocation (ectopia) of primitive endometrial tissue outside of the uterine cavity. 7 Jean Bouquet de Jolini ere et al researched the reproductive organs from 7 female fetuses at autopsy between 18 and 36 weeks of gestation. Serial sections revealed numerous ectopic endometrial glands and embryonic duct remnants inside the myometrium, uterine broad and ovarian ligaments and under the fallopian tube serosa in 2 fetuses with low levels of expression of estrogen receptor-a (ER-a) and progesterone receptors (PR).…”

Section: Introductionmentioning

confidence: 99%

Endometriosis origin from primordial germ cells

Makiyan

2017

Organogenesis

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ABSTRACT. Endometriosis is defined by the presence of endometrial ectopia. Multiple hypotheses have been postulated to explain the etiology of endometriosis to understand various clinical evidences. The etiology of endometriosis is still unclear.The primary question to understanding the etiology of endometrial ectopia (endometriosis) is determining the origin of eutopic (normally cited) endometrium.According to the new theory, primordial germ cells migrate from hypoblast (yolk sac close to the allantois) to the gonadal ridges. The gonadal ridges which composed of primordial germ cells derive to the: eutopic endometrium, ovary, ovarian ligament and ligamentum teres uteri.There are 2 principal processes in uterine organogenesis: the intersection of gonadal ridges with mesonephral ducts to form the uterine folds with an endometrial cavity and the fusion of the both uterine folds together to form the unicavital (normal) uterus. In the uterine folds there are closer cell-to-cell communications, polypotential germ cells differentiate and grow into myometrium and endometrial layers.Some of the polypotential germ cells fail to reach the ridges and stay in the peritoneal cavity, where they may be transforming into external endometrial heterotopies.The main insight in the etiology of endometriosis is polypotential germ cells origin, which may explain its potency, pathogenesis and expansion.

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Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer

Cited by 103 publications

References 19 publications

The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review

Müllerianosis with intestinal metaplasia: a case report

Endometriosis origin from primordial germ cells

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