Increased systemic and peritoneal oxidative stress biomarkers in endometriosis are not related to retrograde menstruation

Abstract

Objetives: The goal of this study was to determine if systemic and peritoneal oxidative stress biomarkers are related to each other and to retrograde menstruation in endometriosis. Methods: Plasma and peritoneal fluid oxidative stress biomarkers and hemoglobin and erythrocytes in peritoneal fluid as retrograde menstruation indicators, were measured in 28 patients with endometriosis and 23 without endometriosis. Results: In the peritoneal fluid, carbonyls and lipohydroperoxides, indicative of protein and lipid oxidative damage, were higher in endometriosis group (21%, p = 0.016 and 46%, p = 0.009, respectively). However, these biomarkers were not different in the blood plasma of both groups, and only protein dityrosine, was increased in the plasma of endometriosis group (31%, p = 0.04). The peritoneal fluid hemoglobin content was not higher in the endometriosis group, nor related to carbonyls and lipohydroperoxides. Additionally, the peritoneal fluid oxidative biomarkers were not correlated with the blood plasma ones, and only malondialdehyde, and ischemia-modified albumin were almost two times higher in peritoneal fluid. Discussion: Our results show a peritoneal and systemic oxidative stress biomarkers increase in endometriosis, but not related to each other, and do not support the hypothesis of an increase in hemoglobin-iron supply towards the peritoneal cavity that causes oxidative damage.

Molecular and Clinical Insights on the Complex Interaction between Oxidative Stress, Apoptosis, and Endobiota in the Pathogenesis of Endometriosis

“…However, a correlation between systemic and peritoneal oxidative biomarkers could not be established following Montoya-Estrada et al's [28] study in which increased levels of carbonyls and LPO were found in EMS patients peritoneal fluid, while other protein oxidation product (protein dityrosine) levels were increased in the blood, as compared to the control group. Despite the fact that no correlation was found between the hemoglobin content of the peritoneal fluid and carbonyls and LPO and between the OS markers from blood and peritoneal fluid, the study reported a significant increase of MDA levels in the latter, suggesting that, together with the ischemia-modified albumin levels increase, oxidative balance impairment could play a determinant role in EMS-related tissular damage and a possible correlation in the co-occurring pro-inflammatory processes.…”

Interplay Between MicroRNAs and Oxidative Stress in Ovarian Conditions with a Focus on Ovarian Cancer and Endometriosis

“…However, the small number of patients included in the majority of studies and the high variability in the assessed analytes preclude any molecule being proposed as a reliable biomarker at this point. A common finding in studies evaluating OS as biomarkers for endometriosis is an increase in either plasma or serum oxidative stress biomarkers [151,152] and reduced levels of thiols [153,154] in patients in comparison to control women. In addition, other authors evaluated urine as a source of biomarkers, observing higher concentration of metabolites related to inflammation and oxidative stress (namely N (1)-methyl-4-pyridone-5-carboxamide, guanidinosuccinate, creatinine, taurine, valine, and 2-hydroxyisovalerate) in patients with endometriosis [155].…”

The Risk of Endometrial Cancer and Uterine Sarcoma Following Endometriosis or Pelvic Inflammatory Disease

“…Inflammation has a central role in endometriosis pathogenesis, whereby it upregulates the production of chemokines, which are responsible for elevated macrophage accumulation and activation in ectopic endometrial deposits and peritoneal fluid [5]. Peritoneal fluid can further augment inflammation around abnormal endometrial stains by promoting reactive oxygen species production and lipid peroxidation [6]. This inflammation can induce endothelial dysfunction and even cause carcinogenesis [7].…”