EPHect – the Endometriosis Phenome (and Biobanking) Harmonisation Project – may be very helpful for clinicians and the women they are treating

Miller, Lee A.; Johnson, Neil

doi:10.12688/f1000research.9850.1

Cited by 16 publications

(10 citation statements)

References 12 publications

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“…This limitation is now well-acknowledged to frequently yield confusing results. In fact, the WERF EPHect guidelines recommend the adoption of standardized methods for clear annotation, sampling and data mining based on optimized and valid data segregation approaches to avoid the expected high noise in the results [23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…We hypothesized that marked inconsistencies among the observations of endometrial steroid physiology in previous studies might have resulted from the lack of a categorical consideration of the relative effects of fertility and menstrual histories on steroid hormone biosynthesis, metabolism and their receptors in the endometrium of patients with and without ovarian endometriosis (OE). The EPHect guidelines essentially highlight the necessity of developing a consensus on the standardization and harmonization of phenotypic surgical and clinical data and biological sample handling methods in endometriosis research [23, 24]. In the present study, endometrial samples obtained from thirty-two (32) control subjects and fifty-two (52) patients with moderate to severe (stages III-IV) OE who had a known fertility history and menstrual cycle phase registered in a tertiary hospital in New Delhi were examined to determine the intra-tissue concentrations of major sex steroid hormones (P4, T, E1 and E2) and the transcript and protein levels of steroid-synthesizing enzymes (CYP19A1/aromatase, HSD17B1/17β-HSD1, and HSD17B2/17β-HSD2), steroidogenic co-factors (NR5A1/SF-1 and STAR/StAR), and the receptors for estrogen (ESR1/ERα and ESR2/ERβ) and progesterone (PGR/PRA and PRB) to test this concept.…”

Section: Introductionmentioning

confidence: 99%

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An assessment of the multifactorial profile of steroid-metabolizing enzymes and steroid receptors in the eutopic endometrium during moderate to severe ovarian endometriosis

Anupa

Sharma

Roy

et al. 2019

Reprod Biol Endocrinol

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BackgroundPrevious studies of expression profiles of major endometrial effectors of steroid physiology in endometriosis have yielded markedly conflicting conclusions, presumably because the relative effects of type of endometriosis, fertility history and menstrual cycle phases on the measured variables were not considered. In the present study, endometrial mRNA and protein levels of several effectors of steroid biosynthesis and action in patients with stage III-IV ovarian endometriosis (OE) with known fertility and menstrual cycle histories were compared with the levels in control endometrium to test this concept.MethodsEndometrial samples were collected from patients without endometriosis (n = 32) or OE stages III-IV (n = 52) with known fertility and cycle histories. qRT-PCR and immunoblotting experiments were performed to measure levels of NR5A1, STAR, CYP19A1, HSD17Bs, ESRs and PGR transcripts and proteins, respectively. Tissue concentrations of steroids (P4, T, E1 and E2) were measured using ELISAs.ResultsThe levels of expression of aromatase and ERβ were lower (P < 0.0001) and 17β-HSD1 (P < 0.0001) and PRA (P < 0.01) were higher in OE endometrium. Lower aromatase levels and higher 17β-HSD1 levels were detected in fertile (aromatase: P < 0.05; 17β-HSD1: P < 0.0001) and infertile (aromatase: P < 0.0001; 17β-HSD1: P < 0.0001) OE endometrium than in the matched control tissues. Both proliferative (PP) and secretory (SP) phase OE samples expressed aromatase (P < 0.0001) and ERβ (PP: P < 0.001; SP: P < 0.01) at lower levels and 17β-HSD1 (P < 0.0001) and PRA (PP: P < 0.01; SP: P < 0.0001) at higher levels than matched controls. Higher 17β-HSD1 (P < 0.01) and E2 (P < 0.05) levels and a lower (P < 0.01) PRB/PRA ratio was observed in infertile secretory phase OE endometrium than in control.ConclusionsWe report that dysregulated expression of 17β-HSD1 and PGR resulting in hyperestrogenism and progesterone resistance during the secretory phase of the menstrual cycle, rather than an anomaly in aromatase expression, was the hallmark of eutopic endometrium from infertile OE patients. Furthermore, the results provide proof of concept that the fertility and menstrual cycle histories exerted relatively different effects on steroid physiology in the endometrium from OE patients compared with the control subjects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An assessment of the multifactorial profile of steroid-metabolizing enzymes and steroid receptors in the eutopic endometrium during moderate to severe ovarian endometriosis

Anupa

Sharma

Roy

et al. 2019

Reprod Biol Endocrinol

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“…Although the project was not specifically intended solely for clinical research, combining the patient clinical information along with surgical findings and treatment in a harmonised form should facilitate large-scale multicentre research to provide insight into this heterogeneous disease. 13 Hopefully, this will translate into a better understanding of this disease and optimised care for women affected by endometriosis.…”

Section: Discussionmentioning

confidence: 99%

How feasible and practical is it to introduce the Endometriosis Phenome and Biobanking Harmonisation Project (EPHect) standard surgical form into clinical practice?

Lam

Shyamsunder

et al. 2018

Journal of Endometriosis and Pelvic Pain Disorders

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Background: The Endometriosis Phenome and Biobanking Harmonisation Project has been set up to facilitate and advance global endometriosis research. Aim: To test the feasibility and practicality of using the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form in routine clinical practice. Materials and methods: Standard surgical form was filled out using a web-based application for 225 consecutive women who underwent surgery for suspected or known endometriosis. Results: Median age was 37 years. Half (49.8%) of the women had a previous surgical diagnosis of endometriosis. Endometriosis was found in 91.5% of patients in this cohort. Median operative time was 101 min. Operative photographs substantially assisted completion of the standard surgical form post-operatively. The median time required to fill out the questionnaire was 8 min (range, 2-17 min). This was mostly dependent on the severity and distribution of endometriosis lesions. The standard surgical form is very comprehensive and has the advantage of including both the American Society of Reproductive Medicine classification and the Endometriosis Fertility Index; however, characterisation of deep endometriosis is insufficient for some women. In addition, some sections such as the descriptive endometriosis table (section IX) remain subjective. Conclusion: Using the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form to collect research data is feasible, especially when using an electronic database entry tool. It is also practically manageable, although the time taken is more than originally estimated by the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form authors. Even though some sections of the standard surgical form may be subjective, it is comprehensive and we would recommend its adoption into routine clinical practice for endometriosis research.

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“…All specimen collected are part of the Auria biobank sample collection ( https://www.auria.fi/biopankki/en/index.php?lang = en ). The sample collection protocol closely resembles those recommended by World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project and the Endometriosis Phenome and Biobanking Harmonization Project WERF/EpHECT 20 – 24 , despite carrying out the collection before those recommendations were published.…”

Section: Methodsmentioning

confidence: 99%

A relational database to identify differentially expressed genes in the endometrium and endometriosis lesions

et al. 2020

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Endometriosis is a common inflammatory estrogen-dependent gynecological disorder, associated with pelvic pain and reduced fertility in women. Several aspects of this disorder and its cellular and molecular etiology remain unresolved. We have analyzed the global gene expression patterns in the endometrium, peritoneum and in endometriosis lesions of endometriosis patients and in the endometrium and peritoneum of healthy women. In this report, we present the EndometDB, an interactive web-based user interface for browsing the gene expression database of collected samples without the need for computational skills. The EndometDB incorporates the expression data from 115 patients and 53 controls, with over 24000 genes and clinical features, such as their age, disease stages, hormonal medication, menstrual cycle phase, and the different endometriosis lesion types. Using the web-tool, the end-user can easily generate various plot outputs and projections, including boxplots, and heatmaps and the generated outputs can be downloaded in pdf-format. Availability and implementation: The web-based user interface is implemented using HTML5, JavaScript, CSS, Plotly and R. It is freely available from https://endometdb.utu.fi/.

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EPHect – the Endometriosis Phenome (and Biobanking) Harmonisation Project – may be very helpful for clinicians and the women they are treating

Cited by 16 publications

References 12 publications

An assessment of the multifactorial profile of steroid-metabolizing enzymes and steroid receptors in the eutopic endometrium during moderate to severe ovarian endometriosis

An assessment of the multifactorial profile of steroid-metabolizing enzymes and steroid receptors in the eutopic endometrium during moderate to severe ovarian endometriosis

How feasible and practical is it to introduce the Endometriosis Phenome and Biobanking Harmonisation Project (EPHect) standard surgical form into clinical practice?

A relational database to identify differentially expressed genes in the endometrium and endometriosis lesions

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