Altered immune environment in peritoneal endometriotic lesions: relationship to lesion appearance.

Objective: To study the localization of and quantify different immune cell populations in red, black, and white peritoneal endometriotic lesions and compare immune cell densities between lesions and the surrounding tissue.

Design: Cross-sectional study.

Setting: Teaching hospital, university research laboratory.

The Lymphatic System in Endometriosis: a Pilot Study of Endometrial-Like Cells and Immune Cell Populations in Lymph Nodes Associated with Deep Infiltrating Bowel Lesions.

In endometriosis, the lymphatic and immune systems are implicated in disease establishment and progression. The objective of this pilot study was to examine endometrial-like, and for the first time, immune cell populations in lymph nodes associated with deep infiltrating endometriosis (DIE) bowel lesions. Premenopausal women undergoing excision of endometriosis and/or hysterectomy were included.

Endometrial polyps: Pathogenesis, sequelae and treatment.

Endometrial polyps are overgrowths of endometrial glands that typically protrude into the uterine cavity. Endometrial polyps are benign in nature and affect both reproductive age and postmenopausal women. Although endometrial polyps are relatively common and may be accompanied by abnormally heavy bleeding at menstruation.

The Expression and Cellular Localisation of Neurotrophin and Neural Guidance Molecules in Peritoneal Ectopic Lesions.

Endometriosis is a gynaecological disorder characterised by the presence of endometrial-like tissue outside the uterus. It affects 10-15% of women during their reproductive age. The existence of close and complex relationship between chronic pelvic pain and endometriosis are widely recognised.

Blood microvasculature and lymphatic densities in endometrial polyps and adjacent and distant endometrium.

Objective: Endometrial polyps are localised growths of endometrial tissue containing glands, stroma and blood vessels, covered with epithelium. The reported prevalence of endometrial polyps is dependent upon the population being studied and the uterine imaging technique utilised. The light microscopy literature provides very little information regarding their microvasculature and lymphatic systems; however, a plethora of ultrasound data demonstrating single central arteries in most medium- or large-sized endometrial polyps are well documented.

Peripheral and endometrial dendritic cell populations during the normal cycle and in the presence of endometriosis.

Background: Dysfunctional immune response may be implicated in endometriosis pathogenesis, and dendritic cells (DC) may play greater roles in this response than previously recognized. This study set out to evaluate peripheral blood and endometrial DC population changes in the presence and absence of endometriosis pathology.

Methods: Endometrial (n = 83) and peripheral blood samples (n = 30) were subjected to immunohistochemical techniques and flow cytometry, respectively, to assess DC populations in women with and without endometriosis.

Angiogenesis, lymphangiogenesis and neurogenesis in endometriosis.

Endometriosis is a common, benign gynecological disease affecting 10 - 15% of reproductively aged women. It is characterized by the presence of endometrial-like tissue at sites outside the uterus. The most widely accepted theory of endometriosis pathogenesis proposes that shed menstrual endometrium can reach the peritoneum, implant and grow as endometriotic lesions.

A novel pilot study of endometrial stromal cells and immune cell populations in sentinel uterine-draining lymph nodes during the menstrual cycle and in endometriosis.

Recent studies suggest that changes in certain uterine immune cell populations in endometrium of women with endometriosis are likely to precede changes at ectopic sites. This preliminary study is a first look into the function of uterine-draining lymph nodes (LNs) during the menstrual cycle and in the presence of endometriosis. Paraffin-embedded obturator LNs were obtained from women with (n = 7, mean age 44.

Discovery of a novel biomarker in the urine in women with endometriosis.

Objective: To investigate whether proteins secreted in urine differ between women with and without endometriosis.

Design: Laboratory study using human urine.

Setting: University-based laboratory.

Nerve fibers in ovarian endometriomas.

Ovarian endometriomas (n = 29) were innervated by mainly sympathetic and sensory fibers. These fibers may be involved in the generation of pain symptoms.

The role of Foxp3+ regulatory T-cells in endometriosis: a potential controlling mechanism for a complex, chronic immunological condition.

Background: Endometriosis is an inflammatory condition, associated with highly dysregulated immune response at both uterine and peritoneal levels. Surprisingly, Foxp3+ regulatory T-cells, which control and suppress a range of immune responses, have not previously been investigated in endometriosis.

Methods And Results: Immunohistochemical analysis of Foxp3+ cells in 127 eutopic endometrial samples and 59 ectopic peritoneal lesions revealed that these immune cell populations are highly disturbed in women suffering from endometriosis.

Abdominal bloating: an under-recognized endometriosis symptom.

Objective: To explore the association between the symptom of abdominal bloating and the diagnosis of endometriosis.

Methods: Twenty-six patients with endometriosis diagnosed by laparoscopy and 25 women without endometriosis were recruited to a case-control study. Subjects completed detailed questionnaires regarding perception of abdominal bloating, bloating-related symptoms, and effect on lifestyle.

Neuroendocrine cells in eutopic endometrium of women with endometriosis.

Background: Endometriosis is a common gynaecological disease, but the pathogenesis of endometriosis and pathophysiological basis for endometriosis-associated painful symptoms are still uncertain. Little is known about neuroendocrine (NE) cells in the uterus.

Methods: For this study, 38 premenopausal women with histologically diagnosed ovarian endometrioma or peritoneal endometriosis and 24 women without endometriosis were selected.

Hyperinnervation in intestinal deep infiltrating endometriosis.

Study Objective: To investigate the extent and types of innervation of endometriotic lesions in various regions of the bowel.

Design: Retrospective nonrandomized immunohistochemical study (Canadian Task Force classification II-3.

Setting: University-based laboratory.

Novel finding of high density of activated mast cells in endometrial polyps.

Endometrial polyps are benign lesions frequently identified in women with infertility or abnormal uterine bleeding in the reproductive and postmenopausal phases We report the striking observation that the numbers of activated mast cells expressing tryptase are increased more than sevenfold throughout the cycle in endometrial polyps (n = 20) compared with normal endometrium. This novel finding has important implications for growth, development, and symptoms associated with polyps in many different tissues.

Dendritic cell populations in the eutopic and ectopic endometrium of women with endometriosis.

Background: Immune alterations may be involved in the pathogenesis and progression of endometriosis. Dendritic cells (DCs) are potent antigen presenting cells that are highly involved in the initiation of the immune response. The aim of this study was to investigate DC populations in the eutopic and ectopic endometrium of women with endometriosis compared with controls.

Rich innervation of deep infiltrating endometriosis.

Background: Deep infiltrating endometriosis (DIE) is a specific type of endometriosis, which can be associated with more severe pelvic pain than other forms of endometriotic lesions. However, the mechanisms by which pain is generated are not well understood.

Methods: DIE (n = 31) and peritoneal endometriotic (n = 40) lesions were sectioned and stained immunohistochemically with antibodies against protein gene product 9.

Macrophages and nerve fibres in peritoneal endometriosis.

Background: Endometriosis is considered to be an inflammatory disease, and macrophages are the most numerous immune cells in endometriotic lesions. However, the mechanisms underlying the elevation of macrophages and their role in the pathogenesis and manifestations of endometriosis still remain unclear.

Methods: The number of macrophages stained for CD68 in endometriotic lesions (n = 24) and in peritoneum distant from the lesions (n = 14) from women with endometriosis was compared with the number of macrophages in normal peritoneum from women without endometriosis (n = 18).

Macrophage expression in endometrium of women with and without endometriosis.

Background: Endometriosis is an inflammatory condition, characterized by the presence of endometrial-like tissue outside the uterus. The immune system provides a defence mechanism in response to foreign pathogens, and macrophages play important roles in this response. Activation of macrophages has been reported in peritoneal fluid and ectopic endometriotic lesions; however, controversy exists regarding the composition and function of macrophage populations in eutopic endometrium of women with and without endometriosis.

Effect of progestogens and combined oral contraceptives on nerve fibers in peritoneal endometriosis.

Objective: To investigate how progestogens and combined oral contraceptives change nerve fiber density in peritoneal endometriotic lesions and to identify the types of nerve fibers still present during hormone treatment.

Design: Laboratory study using human tissue.

Setting: University-based laboratory.

Effects of hormonal treatment on nerve fibers in endometrium and myometrium in women with endometriosis.

Objective: To investigate how hormonal treatment can change nerve fiber density and to identify types of nerve fibers in endometrium and myometrium in women with endometriosis.

Design: Laboratory study using human tissue.

Setting: University-based laboratory.

A pilot study to evaluate the relative efficacy of endometrial biopsy and full curettage in making a diagnosis of endometriosis by the detection of endometrial nerve fibers.

Objective: The purpose of this study was to evaluate endometrial biopsy and curettage in detecting small nerve fibers in eutopic endometrium for diagnosis of endometriosis.

Study Design: Endometrial biopsies with precise, consistent technique and curettings were taken from 37 women (20 with endometriosis and 17 without endometriosis). Sensitivity, specificity, and positive and negative predictive value were formally calculated.

Proteomic analysis of protein expression in the eutopic endometrium of women with endometriosis.

Endometriosis affects 10-15% of the female population during their reproductive years. Although the pathogenesis of this disease is undefined, the presence of endometrium-like tissue plaques outside of the uterus could implicate the eutopic endometrium in the origin of the disease. Utilising a proteomic approach the protein expression profile of the eutopic endometrium of women without endometriosis (n = 12) was compared to that in eutopic endometrium of women with a confirmed diagnosis of endometriosis (n = 6) (both in the secretory phase of the cycle).

The use of proteomics to study wound healing: a preliminary study for forensic estimation of wound age.

Proteomics is the analysis of the protein complement of the genome. The technique involves extracting proteins from the tissue being examined; separating the proteins using methods such as two-dimensional gel electrophoresis and then identifying the proteins by mass spectrometry. This paper describes the application of proteomics to incised wounds of the rat to determine if this technology could be applied to the important forensic issue of determining the age of wounds.