Unus pro omnibus, omnes pro uno: A novel, evidence-based, unifying theory for the pathogenesis of endometriosis

Laganà, Antonio Simone; Vitale, Salvatore Giovanni; Salmeri, Francesca Maria; Triolo, Onofrio; Frangež, Helena Ban; Vrtačnik-Bokal, Eda; Stojanovska, Lily; Apostolopoulos, Vasso; Granese, Roberta; Sofo, Vincenza

doi:10.1016/j.mehy.2017.03.032

Cited by 196 publications

(166 citation statements)

References 191 publications

(104 reference statements)

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“…Laganà et al . proposed that deregulation of many genes involved in the differentiation and development of the urogenital tract and the Wnt signaling pathway (Wnt/β‐catenin) leads to aberrations and deregulation within the mesoderm, and may cause aberrant placement of stem cells, leading to ectopic endometrial cells, in endometriosis …”

Section: Discussionmentioning

confidence: 99%

Accuracy of anogenital distance and anti‐Müllerian hormone in the diagnosis of endometriosis without surgery

Sánchez-Ferrer

Jiménez-Velázquez

Mendiola

et al. 2018

Intl J Gynecology & Obste

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Objective To assess the predictive ability of a combination of anogenital distance (AGD) and anti‐Müllerian hormone (AMH) to diagnosis the presence of endometriosis without surgery. Methods The present study included women diagnosed with endometriosis and a control group who attended the “Virgen de la Arrixaca” University Hospital, Murcia, Spain, between September 1, 2014, and May 31, 2015. Serum concentrations of AMH were measured, and two AGD measurements were obtained: from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF). Data were assessed by receiver operator characteristic (ROC) curves. Results Women in the endometriosis group (n=57) had significantly shorter AGDAF (22.8 ± 4.6 vs 27.2 ± 5.7 mm; P<0.001) and lower AMH (2.2 ± 2.5 vs 3.3 ± 1.9 ng/mL; P<0.003) compared with the control group (n=93). Women with serum AMH below the clinical cut‐off (1 ng/mL) were 17.40‐times more likely to have endometriosis (95% confidence interval [CI] 5.64–53.82). The area under the ROC curve of combined AMH and AGDAF was 0.77 (95% CI 0.70–0.85). Conclusion The model for predicting endometriosis on the basis of AMH and AGD could be useful for clinicians and epidemiologists to improve diagnosis and prognosis of this condition.

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Section: Discussionmentioning

confidence: 99%

Accuracy of anogenital distance and anti‐Müllerian hormone in the diagnosis of endometriosis without surgery

Sánchez-Ferrer

Jiménez-Velázquez

Mendiola

et al. 2018

Intl J Gynecology & Obste

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“…Several theories have been proposed for its etiopathogenesis with the retrograde menstruation hypothesis being the most accepted [15]. However, this hypothesis has many limitations, which numerous other theories have attempted to circumvent [16,17], including altered Genetic/Epigenetic-based mechanisms [18]. …”

Section: Introduction: Vitamin D Metabolism and Reproductionmentioning

confidence: 99%

Vitamin D and Endometrium: A Systematic Review of a Neglected Area of Research

Cermisoni

Alteri

Corti

et al. 2018

IJMS

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Growing evidence supports a role of vitamin D (VD) in reproductive health. Vitamin D receptor (VDR) is expressed in the ovary, endometrium, and myometrium. The biological actions of VD in fertility and reproductive tissues have been investigated but mainly using animal models. Conversely, the molecular data addressing the mechanisms underlying VD action in the physiologic endometrium and in endometrial pathologies are still scant. Levels of VDR expression according to the menstrual cycle are yet to be definitively clarified, possibly being lower in the proliferative compared to the secretory phase and in mid-secretory compared to early secretory phase. Endometrial tissue also expresses the enzymes involved in the metabolism of VD. The potential anti-proliferative and anti-inflammatory effects of VD for the treatment of endometriosis have been investigated in recent years. Treatment of ectopic endometrial cells with 1,25(OH)2D3 could significantly reduce cytokine-mediated inflammatory responses. An alteration of VD metabolism in terms of increased 24-hydroxylase mRNA and protein expression has been demonstrated in endometrial cancer, albeit not consistently. The effect of the active form of the vitamin as an anti-proliferative, pro-apoptotic, anti-inflammatory, and differentiation-inducing agent has been demonstrated in various endometrial cancer cell lines.

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“…In addition, studies have demonstrated a possible role of oxidative stress and reactive oxygen species which appear to trigger an inflammatory process that may contribute to the pathogenesis of endometriosis. 1,17 DE is an estrogen-dependent disease; therefore, two phenomena can lead to spontaneous regression or symptom improvement, pregnancy, and menopause. Nevertheless, post-menopausal deep endometriosis does exist and pregnancy can be complicated by the presence of endometriosis.…”

Section: Introductionmentioning

confidence: 99%

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

Habib¹,

Centini²,

Lazzeri³

et al. 2020

IJWH

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Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits (constipation/diarrhoea) dyschezia, dysmenorrhoea and dyspareunia in addition to infertility. To date, there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis. Several techniques have been proposed including transvaginal and/or transrectal ultrasonography, magnetic resonance imaging, and double-contrast barium enema. These different imaging modalities provide greater information regarding presence, location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning. In cases where surgical management is indicated, surgery should be performed by experienced surgeons, in centres with access to multidisciplinary care. Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible, whilst at the same time preserving organ function. In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.

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Unus pro omnibus, omnes pro uno: A novel, evidence-based, unifying theory for the pathogenesis of endometriosis

Cited by 196 publications

References 191 publications

Accuracy of anogenital distance and anti‐Müllerian hormone in the diagnosis of endometriosis without surgery

Accuracy of anogenital distance and anti‐Müllerian hormone in the diagnosis of endometriosis without surgery

Vitamin D and Endometrium: A Systematic Review of a Neglected Area of Research

<p>Bowel Endometriosis: Current Perspectives on Diagnosis and Treatment</p>

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