Hormonal therapy potentiates the effect of surgery on gene expression profile of peripheral blood mononuclear cells in patients affected by endometriosis

Michele Vignali, M. Vignali, Serena Pisoni, S. Pisoni, Pisoni S, Davide Gentilini, Gentilini D, Spada E, Elena Spada, Solima E, Eugenio Solima, Paola Viganò, Viganò P, Massimo Candiani, Candiani M, Mauro Busacca, Busacca M, Anna Maria Di Blasio, Di Blasio AM, Anna M DI Blasio
Minerva endocrinology · 2021 · vol. 46(1) , pp. 90–98 · doi:10.23736/s2724-6507.20.03298-8 · PMID:33269572 · W3109928923
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Surgery downregulated nine endometriosis-associated genes in peripheral blood mononuclear cells, with combined oral contraceptive treatment further downregulating these and three additional genes.

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Abstract

BACKGROUND: Combined oral contraceptives (COCs) represent a common pharmacological approach for endometriosis. They have been demonstrated to mitigate painful symptoms in patients and are considered the first line therapy for symptomatic disease. The goal of this study was to evaluate whether the presence of pelvic endometriotic lesions can exert a systemic effect on PBMC gene expression and to investigate whether hormonal treatment may restore a normal gene expression profile. METHODS: Forty women, with endometriosis at stage III-IV, were enrolled in the study. After surgery, 20, randomly chosen, were treated with COC for six months and 20 did not receive hormonal therapy. Blood samples were obtained few days before surgery and six months after surgery. Gene expression profile of PBMC was studied by microarray. Gene expression levels before surgery and post-surgery, in presence and absence of COC, were compared. RESULTS: Nine genes previously reported to be overexpressed by endometriosis, were confirmed to be significantly downregulated after surgery. COC treatment lead to a greater down-regulation of these genes and to a significant down-regulation of 3 additional genes. 145 genes resulted downregulated and 28 upregulated by comparing gene expression before surgery with that 6 months after surgery in the presence of COC therapy. CONCLUSIONS: Results support the concept that a systemic chronic inflammatory status is among the mechanisms underlying endometriosis. Moreover, they shed light into the mechanisms of action of COCs and strength the rationale for their use to improve quality of life of women affected by the disease.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Leukocytes, Mononuclear Contraceptives, Oral, Combined Female Humans Quality of Life Transcriptome

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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