A novel non-invasive molecular biomarker in ovarian endometriosis: estrogen-related receptor α

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Estrogen-related receptor alpha (ERRα) mRNA expression is lower in ectopic compared to eutopic and normal endometria, and serum ERRα levels are decreased with endometriosis severity, suggesting it as a novel biomarker.

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The study examined whether estrogen-related receptor alpha (ERRα) could serve as a non-invasive biomarker for the occurrence and progression of ovarian endometriosis by measuring ERRα mRNA in ectopic, eutopic, and control endometrial tissues from 47 women with ovarian endometriosis and 32 controls. It also assessed serum ERRα protein levels by ELISA and analyzed associations with menstrual cycle, ovarian cyst size, demographic data, and tumor markers (including CA125, CA19-9, and HE-4). ERRα expression was significantly lower in ectopic endometria than in eutopic and normal tissues, and serum ERRα levels were also lower in endometriosis patients; serum ERRα decreased with increasing pathological stage and cyst size, alongside higher CA125 and CA19-9 (and related ratios) in the patient group. The paper does not describe external validation or a diagnostic accuracy analysis, which limits how broadly the biomarker performance can be generalized. This paper is centrally about endometriosis — it evaluates ERRα expression in tissue and serum as a proposed non-invasive biomarker for ovarian endometriosis progression.

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Abstract

PurposeThis study aimed to explore whether estrogen-related receptors α (ERRα) can prognosticate the occurrence and development of ovarian endometriosis (EMs) as a non-invasive biomarker.MethodsThe ectopic and its' correspond eutopic endometria from 47 patients with ovarian EMs and the control normal endometria from 32 cases were collected and detected the mRNA expression of ERRα by RT-qPCR. The serum protein of ERRα were tested by ELISA. The menstrual cycle, ovarian cyst sizes, relative clinical tumour markers, such as CA125, CA19-9 and HE-4, and other demographic data were also involved into analysis in these patients by SPSS 22.0 (IBM, Chicago, IL, USA).ResultsThe ERRα mRNA expression in ectopic endometria were significantly lower than it in eutopic endometria (P < 0.05) and the normal endometria (P < 0.05). Similarly, the serum ERRα levels in patients with EMs were significantly lower than it in control group (P < 0.01). Moreover, the serum ERRα levels were decreasing with the increasing of the pathological stages and ovarian cyst sizes. While, the serum CA125, CA19-9, CA125/ERRα ratio and CA19-9/ERRα ratio in the study group were significantly higher than those in the control group (all P < 0.01).ConclusionThe expression of ERRα is correlated with the development of ovarian EMs pathological stages and ovarian cyst sizes and can be used as a novel and non-invasive biomarker for evaluating the progression of ovarian EMs.
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Abstract

Purpose This study aimed to explore whether estrogen-related receptors α (ERRα) can prognosticate the occurrence and development of ovarian endometriosis (EMs) as a non-invasive biomarker.

Methods

The ectopic and its’ correspond eutopic endometria from 47 patients with ovarian EMs and the control normal endometria from 32 cases were collected and detected the mRNA expression of ERRα by RT-qPCR. The serum protein of ERRα were tested by ELISA. The menstrual cycle, ovarian cyst sizes, relative clinical tumour markers, such as CA125, CA19-9 and HE-4, and other demographic data were also involved into analysis in these patients by SPSS 22.0 (IBM, Chicago, IL, USA).

Results

The ERRα mRNA expression in ectopic endometria were significantly lower than it in eutopic endometria (P < 0.05) and the normal endometria (P < 0.05). Similarly, the serum ERRα levels in patients with EMs were significantly lower than it in control group (P < 0.01). Moreover, the serum ERRα levels were decreasing with the increasing of the pathological stages and ovarian cyst sizes. While, the serum CA125, CA19-9, CA125/ERRα ratio and CA19-9/ERRα ratio in the study group were significantly higher than those in the control group (all P < 0.01).

Conclusion

The expression of ERRα is correlated with the development of ovarian EMs pathological stages and ovarian cyst sizes and can be used as a novel and non-invasive biomarker for evaluating the progression of ovarian EMs. Similar content being viewed by others

References

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Endocr Rev 29:677–696 Yang C, Zhou DJ, Chen S (1998) Modulation of aromatase expression in the breast tissue by ERR alpha-1 orphan receptor. Cancer Res 58:5695–5700 Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author information Authors and Affiliations Contributions CL: study designation and manuscript writing; YJC: manuscript writing and statistical analysis; MC: data interpretation; XDM: laboratory analysis; BHD: statistical analysis; PMS: critically revised the article and supervised the study. Corresponding author Ethics declarations Conflict of interest The authors have no conflict of interest to declare. Ethical approval The study was approved by our institutional review board (2016-038). Informed consent Informed consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Liu, C., Chen, Y., Chen, M. et al. A novel non-invasive molecular biomarker in ovarian endometriosis: estrogen-related receptor α. Arch Gynecol Obstet 302, 405–414 (2020). https://doi.org/10.1007/s00404-020-05611-5 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-020-05611-5

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Ovary Receptors, Estrogen Adult Endometriosis Endometriosis ERRalpha Estrogen-Related Receptor Female Humans Ovary Prognosis Receptors, Estrogen

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