An integrated multi-tissue approach for endometriosis candidate biomarkers: a systematic review

Axelle Brulport, Mathilde Bourdon, Daniel Vaiman, Christian Drouet, Khaled Pocate-Cheriet, Kheira Bouzid, K. Bouzid, Louis Marcellin, Pietro Santulli, Piétro Santulli, Carole Abo, Maxime Jeljeli, Sandrine Chouzenoux, Charles Chapron, Frédéric Batteux, Camille Berthelot, Ludivine Doridot
Reproductive biology and endocrinology : RB&E · 2024 · vol. 22(1) , pp. 21 · doi:10.1186/s12958-023-01181-8 · PMID:38341605 · W4391722388
review OA: gold CC0 ⤵ 23 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review identified 1107 endometriosis biomarkers across nine biological compartments, finding only four repeatedly detected in multiple tissues, highlighting a lack of integrative analysis for clinical relevance.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review studied the endometriosis biomarker literature across multiple biological compartments by searching PubMed and Embase for human studies (2005–September 2022) that included control groups without endometriosis and reported endometriosis phenotypes. Across 447 included articles, the authors found 1107 significantly deregulated biomarkers spanning nine compartments, most frequently peripheral blood and eutopic endometrium, and they reported that adjustments for menstrual cycle phase, symptoms, and treatments were uncommon (70%, 29%, 3%, and 6% of articles, respectively). To prioritize candidates with more consistent multi-tissue evidence, they highlighted 74 biomarkers detected in several compartments by at least two independent teams and noted that only four (TNF-a, MMP-9, TIMP-1, and miR-451) were detected in at least three tissues with cohorts of 30+ women. The review is limited by heterogeneous study designs and by the reliance on included studies that met specific eligibility criteria, which may affect the comprehensiveness and interpretability of biomarker rankings. This paper is centrally about endometriosis—specifically an integrative systematic review to synthesize candidate biomarker evidence across tissues and phenotypes.

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Abstract

Biomarker identification could help in deciphering endometriosis pathophysiology in addition to their use in the development of non invasive diagnostic and prognostic approaches, that are essential to greatly improve patient care. Despite extensive efforts, no single potential biomarker or combination has been clinically validated for endometriosis.Many studies have investigated endometriosis-associated biological markers in specific tissues, but an integrative approach across tissues is lacking. The aim of this review is to propose a comprehensive overview of identified biomarkers based on tissue or biological compartment, while taking into account endometriosis phenotypes (superficial, ovarian or deep, or rASRM stages), menstrual cycle phases, treatments and symptoms.We searched PubMed and Embase databases for articles matching the following criteria: 'endometriosis' present in the title and the associated term 'biomarkers' found as Medical Subject Headings (MeSH) terms or in all fields. We restricted to publications in English and on human populations. Relevant articles published between 01 January 2005 (when endometriosis phenotypes start to be described in papers) and 01 September 2022 were critically analysed and discussed.Four hundred forty seven articles on endometriosis biomarkers that included a control group without endometriosis and provided specific information on endometriosis phenotypes are included in this review. Presence of information or adjustment controlling for menstrual cycle phase, symptoms and treatments is highlighted, and the results are further summarized by biological compartment. The 9 biological compartments studied for endometriosis biomarker research are in order of frequency: peripheral blood, eutopic endometrium, peritoneal fluid, ovaries, urine, menstrual blood, saliva, feces and cervical mucus. Adjustments of results on disease phenotypes, cycle phases, treatments and symptoms are present in 70%, 29%, 3% and 6% of selected articles, respectively. A total of 1107 biomarkers were identified in these biological compartments. Of these, 74 were found in several biological compartments by at least two independent research teams and only 4 (TNF-a, MMP-9, TIMP-1 and miR-451) are detected in at least 3 tissues with cohorts of 30 women or more.Integrative analysis is a crucial step to highlight potential pitfalls behind the lack of success in the search for clinically relevant endometriosis biomarkers, and to illuminate the physiopathology of this disease.

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Outcome instruments

rASRM

Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (100)

Cited by (23)

Source provenance

europepmc
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