Endometriosis, adenomyosis and uterine fibroids represent benign gynecologic diseases, affecting women of reproductive age associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. The present knowledge indicates that hormonal function (estrogen and progesterone receptors), immunological and neuroinflammatory factors are critically altered in every of uterine disorders. The aggressive behaviour of deep infiltrating endometriosis may be explained by the highly decreased apoptosis, by the increased proliferation activity related to oxidative stress and by invasive neurogenic mechanisms and inflammatory patterns that explain its correlation with chronic pelvic pain. Adenomyotic nodules are novel site of protein expression of inflammatory and neurogenic factors, probably involved in the pathogenesis of adenomyosis: endometrial cells invade and proliferate within myometrium, and inflammatory mediators participate to the intense painful symptoms. The increased expression of neurogenic factors in uterine fibroids and endometrium may contribute to explain the painful stimuli; in addition, NGF hyperexpression, in both fibroids and endometrium, may be associated with infertility. Accordingly, in the future, these neurogenic factors may represent potential therapeutic avenues to treat the fibroid-related symptoms. 
 In conclusion, our results give new insights into the neurogenic characteristics of uterine disorders showing that endometriosis, adenomyosis and fibroids has distinct molecular patterns. With further advances in our understanding of uterine disorders, preventive strategies, novel non-surgical diagnostic modalities, and targeted therapeutics hold great promise of becoming realities and help to treat our patients. The future research may contribute to a better phenotyping of these benign gynaecological diseases in order to give a specific efficient management to each disorder. Basic science approach is necessary to increase pathogenesis knowledge of endometriosis, adenomyosis and uterine fibroids, and new medical treatment, and the clinical and diagnostic approach is necessary for planning an accurate surgical or medical treatment.

Tosti, C. (2019). NEUROGENESIS IN UTERINE DISORDERS.

NEUROGENESIS IN UTERINE DISORDERS

Claudia Tosti
2019-01-01

Abstract

Endometriosis, adenomyosis and uterine fibroids represent benign gynecologic diseases, affecting women of reproductive age associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. The present knowledge indicates that hormonal function (estrogen and progesterone receptors), immunological and neuroinflammatory factors are critically altered in every of uterine disorders. The aggressive behaviour of deep infiltrating endometriosis may be explained by the highly decreased apoptosis, by the increased proliferation activity related to oxidative stress and by invasive neurogenic mechanisms and inflammatory patterns that explain its correlation with chronic pelvic pain. Adenomyotic nodules are novel site of protein expression of inflammatory and neurogenic factors, probably involved in the pathogenesis of adenomyosis: endometrial cells invade and proliferate within myometrium, and inflammatory mediators participate to the intense painful symptoms. The increased expression of neurogenic factors in uterine fibroids and endometrium may contribute to explain the painful stimuli; in addition, NGF hyperexpression, in both fibroids and endometrium, may be associated with infertility. Accordingly, in the future, these neurogenic factors may represent potential therapeutic avenues to treat the fibroid-related symptoms. 
 In conclusion, our results give new insights into the neurogenic characteristics of uterine disorders showing that endometriosis, adenomyosis and fibroids has distinct molecular patterns. With further advances in our understanding of uterine disorders, preventive strategies, novel non-surgical diagnostic modalities, and targeted therapeutics hold great promise of becoming realities and help to treat our patients. The future research may contribute to a better phenotyping of these benign gynaecological diseases in order to give a specific efficient management to each disorder. Basic science approach is necessary to increase pathogenesis knowledge of endometriosis, adenomyosis and uterine fibroids, and new medical treatment, and the clinical and diagnostic approach is necessary for planning an accurate surgical or medical treatment.
2019
Tosti, C. (2019). NEUROGENESIS IN UTERINE DISORDERS.
Tosti, Claudia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/1095599
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