Ultramicro-trauma in the endometrial-myometrial junctional zone and pale cell migration in adenomyosis

Ibrahim, M. G.; Chiàntera, Vito; Frangini, Sergio; Younes, Shadi; Köhler, Christian; Taube, Eliane Tabea; Plendl, Johanna; Mechsner, Sylvia

doi:10.1016/j.fertnstert.2015.09.002

Cited by 51 publications

(45 citation statements)

References 29 publications

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“…In addition, they may trigger additional genetic and epigenetic incidents through inflammation and oxidative stress. Interestingly, microtraumas are also observed in the endometrial-myometrial JZ (239), which is consistent with the Archimetra theory (265,266).…”

Section: Growth and Maturation Of Typical Cystic And Deep Endometrisupporting

confidence: 87%

“…The mesothelial cell metaplasia theory, proposed in 1942 (31), has been expanded to metaplasia of peritoneal stem cells (215,(221)(222)(223)(224)(225)(226)(227)(228)(229)(230)(231), endometrial stem cells (232,233), and more recently bone marrow cells (221,225,(234)(235)(236)(237)(238), pale cells (239,240) and embryonic remnants (241)(242)(243). These concepts find support in the frequent mesothelialmesenchymal transitions with a role of platelets (244) and in the role of bone marrow cells in peritoneal repair (245).…”

Section: The Pathogenesis Of Endometriosis: the Genetic/epigenetic Thmentioning

confidence: 99%

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Pathogenesis of endometriosis: the genetic/epigenetic theory

Koninckx

Ussia

Adamyan

et al. 2019

Fertility and Sterility

301

187

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Objective: To study the pathophysiology of endometriosis. Design: Overview of observations on endometriosis. Setting: Not applicable. Patient(s): None. Interventions(s): None. Main Outcome Measure(s): The hypothesis is compatible with all observations. Result(s): Endometriosis, endometrium-like tissue outside the uterus, has a variable macroscopic appearance and a poorly understood natural history. It is a hereditary and heterogeneous disease with many biochemical changes in the lesions, which are clonal in origin. It is associated with pain, infertility, adenomyosis, and changes in the junctional zone, placentation, immunology, plasma, peritoneal fluid, and chronic inflammation of the peritoneal cavity. The Sampson hypothesis of implanted endometrial cells following retrograde menstruation, angiogenic spread, lymphogenic spread, or the metaplasia theory cannot explain all observations if metaplasia is defined as cells with reversible changes and an abnormal behavior/morphology due to the abnormal environment. We propose a polygenetic/polyepigenetic mechanism. The set of genetic and epigenetic incidents transmitted at birth could explain the hereditary aspects, the predisposition, and the endometriosis-associated changes in the endometrium, immunology, and placentation. To develop typical, cystic ovarian or deep endometriosis lesions, a variable series of additional transmissible genetic and epigenetic incidents are required to occur in a cell which may vary from endometrial to stem cells. Subtle lesions are viewed as endometrium in a different environment until additional incidents occur. Typical cystic ovarian or deep endometriosis lesions are heterogeneous and represent three different diseases. Conclusion(s): The genetic epigenetic theory is compatible with all observations on endometriosis. Implications for treatment and prevention are discussed. (Fertil Steril Ò 2019;111:327-40. Ó2018 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Section: Growth and Maturation Of Typical Cystic And Deep Endometrisupporting

confidence: 87%

Section: The Pathogenesis Of Endometriosis: the Genetic/epigenetic Thmentioning

confidence: 99%

Pathogenesis of endometriosis: the genetic/epigenetic theory

Koninckx

Ussia

Adamyan

et al. 2019

Fertility and Sterility

301

187

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“…Endometriosis could develop from stem cells in the endometrium (132,133) or in the peritoneal cavity (29,(134)(135)(136)(137)(138)(139)(140)(141)(142)(143)(144), possibly induced by genetic changes (60). Recently a specific cell in the endometrium called pale cell (145,146), because of their appearance, was speculated to be involved in endometriosis and adenomyosis development.…”

Section: Development Of (Deep) Endometriosis: What Is the Original Cell?mentioning

confidence: 99%

Pathogenesis of deep endometriosis

Gordts

Koninckx²,

Brosens

2017

Fertility and Sterility

187

115

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“…Basierend auf dieser Hypothese geht man davon aus, dass basale endometriale Zellen ins Myometrium infiltrieren oder disloziert über die Tuben retrograd in den Bauchraum gelangen und sich dort ansiedeln. Passend zu dieser Hypothese konnten in Patientinnen mit Adenomyosis uteri aktivierte endometriale stammzellartige Zellen, die ihre natürliche Nische verlassen hatten, nachgewiesen werden [7]. Basierend auf dem Stammzellkonzept ist gut nachvollziehbar, dass sich neben Epithel-und Stromazellen immer auch Muskelzellen in den Läsionen entwickeln, sodass der Eindruck eines Miniaturuterus entsteht.…”

Section: Ursachen Der Endometrioseunclassified

Hormonelle Zusammenhänge der Endometriose

Mechsner¹

2016

Zeitschrift für Komplementärmedizin

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Summary Die Endometriose als klassische ?strogenabh?ngige Erkrankung hat eine Reihe von ?berlebensstrategien entwickelt, die es den ektopen L?sionen erm?glichen, sich zu entwickeln. Als wichtigste Pathogenesefaktoren gelten die von ovariellen Steroidhormonen unabh?ngige Aromataseexpression, die zu einer lokalen Estrogensynthese f?hrt, und die Progesteronresistenz. Damit verbunden ist eine Akkumulation von lokal freigesetztem ?strogen. Durch unterschiedliche Herdlokalisationen zeigt sich ein sehr heterogenes Beschwerdebild mit viszeralen und somatischen Schmerzen. Neben typischen Beschwerden treten eine ganze Reihe eher unspezifischer Beschwerden auf, die zyklisch, azyklisch sowie chronifiziert sein k?nnen. Schmerzen sind die gr??te Herausforderung im Therapiemanagement. Viszerale und somatische Schmerzen sind vom Charakter her sehr unterschiedlich und k?nnen die stark variierenden Beschwerden erkl?ren. Eine m?gliche Interaktion von viszeralen sensorischen Nervenfasern mit autonomen Nervenfasern kann vegetative Reaktionen wie ?belkeit und Erbrechen bedingen. Allgemein liegt der Schmerzgenese eine ?u?erst komplexe Aktivierung von peripheren und zentralen Sensitivierungsmechanismen zugrunde.

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Ultramicro-trauma in the endometrial-myometrial junctional zone and pale cell migration in adenomyosis

Abstract: The myofiber disarray in the inner myometrium, and the nuclear membrane irregularities in adenomyosis, are evidence for ultramicro-trauma in adenomyosis. The migrating nonleukocytic pale cells may be involved in pathogenesis of adenomyosis.

Cited by 51 publications

References 29 publications

Pathogenesis of endometriosis: the genetic/epigenetic theory

Pathogenesis of endometriosis: the genetic/epigenetic theory

Pathogenesis of deep endometriosis

Hormonelle Zusammenhänge der Endometriose

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