Chronic sterile inflammation in the pathogenesis of benign myometrial diseases

E.D. Dubinskaya, С.Н. Колесникова, E.V. Aleshkina, A.S. Gasparov
In: Voprosy ginekologii, akušerstva i perinatologii · 2024 · vol. 23(1) , pp. 84–93 · doi:10.20953/1726-1678-2024-1-84-93 · W4393394965
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Chronic sterile inflammation, marked by DAMPs, underlies the pathogenesis of adenomyosis and uterine fibroids through shared mechanisms involving abnormal cell division, neoangiogenesis, neoneurogenesis, and fibrosis.

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This review analyzes existing literature to establish chronic sterile inflammation as a central mechanism in the pathogenesis of benign myometrial diseases, specifically adenomyosis and uterine fibroids. The authors identify damage-associated molecular patterns (DAMPs) as key markers of inflammation severity that drive neoangiogenesis, neoneurogenesis, and fibrosis through abnormal cell division responses. Genetic and epigenetic factors determine whether these inflammatory processes manifest as fibroids or adenomyosis, leading to clinical symptoms such as pain, bleeding, and infertility. The paper concludes by recommending further investigation into the systemic immune profile and cellular composition of these tissues to clarify the role of inflammation. This paper is centrally about adenomyosis — it examines its pathogenesis alongside uterine fibroids through the lens of chronic sterile inflammation.

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Abstract

This article presents an analysis of current literary sources on the role of chronic sterile inflammation in the development of proliferative diseases of the myometrium (adenomyosis, uterine fibroids). DAMPs (damage-associated molecular patterns) are considered as a significant marker of inflammation severity in these diseases. The pathogenesis of both uterine fibroids and adenomyosis is based on similar mechanisms related to chronic sterile inflammation in response to abnormal cell division. Neoangiogenesis, neoneurogenesis and fibrosis are likely to be the result of inflammation and contribute to the progression of pathological process, as well as determine its clinical manifestations (pain, heavy menstrual bleeding, infertility, miscarriage, etc.). The development of a particular pattern of pathological processes (uterine fibroids or adenomyosis) is determined by genetic and epigenetic mechanisms. Further studies of proliferative diseases of the myometrium should examine in more detail the systemic immune profile and cellular composition of the myometrium, uterine fibroids and adenomyosis to better understand the role of chronic inflammatory processes in the pathogenesis of myometrial proliferative diseases. Key words: chronic sterile inflammation, DAMPs, adenomyosis, uterine fibroids, fibrosis
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Chronic sterile inflammation in the pathogenesis of benign myometrial diseases Ekaterina D. Dubinskaya / Svetlana N. Kolesnikova / Elizaveta V. Aleshkina / Aleksandr S. Gasparov / This article presents an analysis of current literary sources on the role of chronic sterile inflammation in the development of proliferative diseases of the myometrium (adenomyosis, uterine fibroids). DAMPs (damage-associated molecular patterns) are considered as a significant marker of inflammation severity in these diseases. The pathogenesis of both uterine fibroids and adenomyosis is based on similar mechanisms related to chronic sterile inflammation in response to abnormal cell division. Neoangiogenesis, neoneurogenesis and fibrosis are likely to be the result of inflammation and contribute to the progression of pathological process, as well as determine its clinical manifestations (pain, heavy menstrual bleeding, infertility, miscarriage, etc.). The development of a particular pattern of pathological processes (uterine fibroids or adenomyosis) is determined by genetic and epigenetic mechanisms. Further studies of proliferative diseases of the myometrium should examine in more detail the systemic immune profile and cellular composition of the myometrium, uterine fibroids and adenomyosis to better understand the role of chronic inflammatory processes in the pathogenesis of myometrial proliferative diseases. Key words: chronic sterile inflammation, DAMPs, adenomyosis, uterine fibroids, fibrosis For citation: Dubinskaya E.D., Kolesnikova S.N., Aleshkina E.V., Gasparov A.S. Chronic sterile inflammation in the pathogenesis of benign myometrial diseases. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2024; 23(1): 84–93. (In Russian). DOI: 10.20953/1726-1678-2024-1-84-93

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