Treatment optimization of patients with genital endometriosis
The aim of the research: to optimize the treatment of patients with combined genital pathology, including internal endometriosis (adenomyosis) and inflammatory diseases.
Materials and methods: prospective study has been conducted on 160 women with adenomyosis. There were 24 (15 %) patients with the I degree of adenomyosis spreading, 72 (45.0 %) women with the II degree, 33 (20.6 %) patients with the III degree, and 31 (19.4 %) woman with the IV degree of adenomyosis spreading. Microbial flora analysis included bacterioscopic, bacteriological research methods with determination of sensitivity to antibiotics, and PCR method.
The concentration of cytokines in the culture medium (supernatant) was determined by the enzyme immunoassay.
Results: the obtained data from the study indicate a high percentage of the combination of adenomyosis with chronic inflammatory diseases of the pelvic organs. An immuno-inflammatory reaction preceding adenomyosis is accompanied by the violation of the local cytokine balance. In turn, the increased activity of cytokines and the presence of infectious agents can participate in the relapse of endometriosis.
Conclusion: considering the immuno-inflammatory reaction, accompanied by the violation of the local cytokine balance in the development of adenomyosis. The study substantiates the necessity of using antimicrobial therapy in patients with combined genital pathology, including adenomyosis and inflammatory diseases
Lin, W.-C., Chang, C. Y.-Y., Hsu, Y.-A., Chiang, J.-H., Wan, L. (2016). Increased Risk of Endometriosis in Patients With Lower Genital Tract Infection. Medicine, 95 (10), e2773. doi: http://doi.org/10.1097/md.0000000000002773
Bukulmez, O., Hardy, D. B., Carr, B. R., Word, R. A., Mendelson, C. R. (2007). Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis. Endocrinology, 149 (3), 1190–1204. doi: http://doi.org/10.1210/en.2007-0665
Clement, P. B. (2007). The pathology of endometriosis – A survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Advances in Anatomic Pathology, 14 (4), 241–260. doi: http://doi.org/10.1097/pap.0b013e3180ca7d7b
Prokhorova, M. V., Manukhin, I. B., Gevorkyan, M. A., Smirnova, S. O. (2013). Suppressive therapy for chronic pelvic pain in patients with external genital endometriosis. Obstetrics and gynecology, 9, 101–104.
Bourdon, M., Santulli, P., Chouzenoux, S., Maignien, C., Bailly, K., Andrieu, M. et. al. (2018). The Disease Phenotype of Adenomyosis-Affected Women Correlates With Specific Serum Cytokine Profiles. Reproductive Sciences, 26 (2), 198–206. doi: http://doi.org/10.1177/1933719118816852
Ozcelik, K., Capar, M., Ucar, M. G., Cakur, T., Ozcelik, F., Ilhan, T. T. (2016). Are cytokine levels in serum, endometrial tissue, and peritoneal fluid a promising predictor to diagnosis of endometriosis-adenomyosis? Clinical and Experimental Obstetrics & Gynecology, 43 (4), 569–572.
Wang, X.-Q., Zhou, W.-J., Luo, X.-Z., Tao, Y., Li, D.-J. (2017). Synergistic effect of regulatory T cells and proinflammatory cytokines in angiogenesis in the endometriotic milieu. Human Reproduction, 32 (6), 1304–1317. doi: http://doi.org/10.1093/humrep/dex067
Zaynetdinova, L. F., Telesheva, L. F., Koryaushkina, A. V. (2020). Features of local immunity in women with endometriosis and genital infection. Russian Journal of Infection and Immunity, 10 (1), 145–158. doi: http://doi.org/10.15789/2220-7619-fol-1192
Nowak, N. M., Fischer, O. M., Gust, T. C., Fuhrmann, U., Habenicht, U.-F., Schmidt, A. (2008). Intraperitoneal inflammation decreases endometriosis in a mouse model. Human Reproduction, 23 (11), 2466–2474. doi: http://doi.org/10.1093/humrep/den189
Koninckx, P. R., Ussia, A., Tahlak, M., Adamyan, L., Wattiez, A., Martin, D. C. et. al. (2019). Infection as a potential cofactor in the genetic-epigenetic pathophysiology of endometriosis: a systematic review. Facts Views and Vision in Obgyn, 11 (3), 209–216.
Glukhov, E. Yu., Oboskalova, T. A., Urakov, A. V. (2014). Possibilities of argon plasma coagulation in the combination therapy of severe endometriosis. Obstetrics and gynecology, 2, 53–56.
Sugimoto, K., Nagata, C., Hayashi, H., Yanagida, S., Okamoto, A. (2015). Use of dienogest over 53 weeks for the treatment of endometriosis. Journal of Obstetrics and Gynaecology Research, 41 (12), 1921–1926. doi: http://doi.org/10.1111/jog.12811
Frackiewicz, E. J., Zarotsky, V. (2003). Diagnosis and treatment of endometriosis. Expert Opinion on Pharmacotherapy, 4 (1), 67–82. doi: http://doi.org/10.1517/14656522.214.171.124
Adamyan, L. V., Aznaurova, Y. B. (2015). Molecular aspects of endometriosis. Problemy Reproduktsii, 21 (2), 66–77. doi: http://doi.org/10.17116/repro201521266-77
Adamian, L. V., Kulakov, V. I., Andreeva, E. N. (2006). Endometriosis. Moscow: Medicine, 411.
Alkatout, I., Wedel, T., Maass, N. (2018). Combined treatment of endometriosis: radical yet gentle. Aktuelle Urologie, 49 (1), 60–72. doi: http://doi.org/10.1055/s-0043-122175
Soares, S. R., Martínez-Varea, A., Hidalgo-Mora, J. J., Pellicer, A. (2012). Pharmacologic therapies in endometriosis: a systematic review. Fertility and Sterility, 98 (3), 529–555. doi: http://doi.org/10.1016/j.fertnstert.2012.07.1120
Lykov, A. P., Sakhno, L. V., Kozlov, V. A. (1998). Production of cytokines (interleukins 1 and 2, tumor necrosis factor by blood mononuclear cells in the Chernobyl accident liquidators. Immunology, 4, 56–57.
Glants, S. M. (1999). Biomedical statistics. Moscow: Praktika, 459.
Xie, Q., He, H., Wu, Y., Zou, L., She, X., Xia, X., Wu, X. (2019). Eutopic endometrium from patients with endometriosis modulates the expression of CD36 and SIRP‐α in peritoneal macrophages. Journal of Obstetrics and Gynaecology Research, 45 (5), 1045–1057. doi: http://doi.org/10.1111/jog.13938
Sukhikh, G. T., Sotnikova, N. Y., Antsiferova, Y. S., Posiseeva, L. V., Veryasov, V. N., Vanko, L. V. (2004). Cytokine Production by Immunocompetent Cells of Peritoneal Fluid in Women with External Genital Endometriosis. Bulletin of Experimental Biology and Medicine, 137 (6), 568–571. doi: http://doi.org/10.1023/b:bebm.0000042714.32571.6b
Kodati, V. L., Govindan, S., Movva, S., Ponnala, S., Hasan, Q. (2008). Role of shigella infection in endometriosis: A novel hypothesis. Medical Hypotheses, 70 (2), 239–243. doi: http://doi.org/10.1016/j.mehy.2007.06.012
Khan, K. N., Fujishita, A., Hiraki, K., Kitajima, M., Nakashima, M., Fushiki, S., Kitawaki, J. (2018). Bacterial contamination hypothesis: a new concept in endometriosis. Reproductive Medicine and Biology, 17 (2), 125–133. doi: http://doi.org/10.1002/rmb2.12083
Tai, F.-W., Chang, C., Chiang, J.-H., Lin, W.-C., Wan, L. (2018). Association of Pelvic Inflammatory Disease with Risk of Endometriosis: A Nationwide Cohort Study Involving 141,460 Individuals. Journal of Clinical Medicine, 7 (11), 379. doi: http://doi.org/10.3390/jcm7110379
Chadchan, S. B., Cheng, M., Parnell, L. A., Yin, Y., Schriefer, A., Mysorekar, I. U., Kommagani, R. (2019). Antibiotic therapy with metronidazole reduces endometriosis disease progression in mice: A potential role for gut microbiota. Human Reproduction, 34, 1106–1116. doi: http://doi.org/10.1093/humrep/dez041
Copyright (c) 2021 Nikolay Shcherbina, Anastasiia Chekhunova
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.