Pathogenetic features of progesterone signaling pathway and PR-B expression in deep infiltrating endometriosis

Н. А. Буралкина, N.A. Chekeneva, A. S. Safronova, A.V. Asaturova
In: Voprosy ginekologii, akušerstva i perinatologii · 2023 · vol. 22(5) , pp. 22–26 · doi:10.20953/1726-1678-2023-5-22-26 · W4391563797
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This study compared PR-B expression in deep infiltrating endometriosis patients, finding higher levels in ectopic lesions and lower stromal expression in those with infertility, which may impact pregnancy onset and hormonal therapy response.

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This study analyzed progesterone receptor isoform B (PR-B) expression in tissue samples from patients with deep infiltrating endometriosis and a control group with infertility. Immunohistochemical analysis revealed that PR-B levels were significantly higher in ectopic lesions of the peritoneum and colon compared to ovarian cyst capsules, while eutopic endometrium showed no significant differences between groups. However, stromal cell PR-B expression was notably lower in infertile patients with endometriosis compared to their fertile counterparts, suggesting a link to pregnancy disruption. This paper is centrally about endometriosis — specifically investigating the pathogenetic role of PR-B expression in deep infiltrating lesions and its implications for hormonal therapy response and fertility outcomes.

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Abstract

Objective. To study the expression of progesterone receptor isoform B (PR-B) in patients with deep infiltrating endometriosis (DIE). Patients and methods. This article presents a comparative analysis of PR-B expression in eutopic and ectopic endometrial tissue samples obtained from patients with DIE (study group, n = 50) and tubo-peritoneal factor infertility (comparison group, n = 9). PR-B expression was analyzed by immunohistochemistry. Results. In the group of patients with DIE, PR-B expression in ectopic endometrial glandular and stromal cells of endometriosis lesions in the peritoneum and colon was significantly higher compared to the capsule of ovarian endometriotic cyst (p 0.05). Stromal cell PR-B expression in patients with infertility in the study group was significantly lower compared to fertile patients with DIE (p = 0.04). Conclusion. No decrease in PR-B expression in the endometrium of patients with DIE was found, which may indicate a favorable response to postoperative hormonal therapy in this group of patients. At the same time, we observed a decrease in PR-B expression in eutopic endometrial stromal cells in patients with DIE and infertility compared to fertile patients, which confirms the role of PR in disrupting pregnancy onset in endometriosis. Search for prognostic markers is currently implemented to develop a personalized approach to the treatment of endometriosis and individual selection of hormone therapy for preventing primary and subsequent surgical interventions and reducing severe pain syndrome in endometriosis. Key words: progesterone, PR-B expression, deep endometriosis, pain syndrome, dienogest
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Pathogenetic features of progesterone signaling pathway and PR-B expression in deep infiltrating endometriosis Natalya А. Buralkina / Natalya A. Chekeneva / Anastasiia S. Safronova / Aleksandra V. Asaturova / Objective. To study the expression of progesterone receptor isoform B (PR-B) in patients with deep infiltrating endometriosis (DIE). Patients and methods. This article presents a comparative analysis of PR-B expression in eutopic and ectopic endometrial tissue samples obtained from patients with DIE (study group, n = 50) and tubo-peritoneal factor infertility (comparison group, n = 9). PR-B expression was analyzed by immunohistochemistry. Results. In the group of patients with DIE, PR-B expression in ectopic endometrial glandular and stromal cells of endometriosis lesions in the peritoneum and colon was significantly higher compared to the capsule of ovarian endometriotic cyst (p 0.05). Stromal cell PR-B expression in patients with infertility in the study group was significantly lower compared to fertile patients with DIE (p = 0.04). Conclusion. No decrease in PR-B expression in the endometrium of patients with DIE was found, which may indicate a favorable response to postoperative hormonal therapy in this group of patients. At the same time, we observed a decrease in PR-B expression in eutopic endometrial stromal cells in patients with DIE and infertility compared to fertile patients, which confirms the role of PR in disrupting pregnancy onset in endometriosis. Search for prognostic markers is currently implemented to develop a personalized approach to the treatment of endometriosis and individual selection of hormone therapy for preventing primary and subsequent surgical interventions and reducing severe pain syndrome in endometriosis. Key words: progesterone, PR-B expression, deep endometriosis, pain syndrome, dienogest For citation: Buralkina N.A., Chekeneva N.A., Safronova A.S., Asaturova A.V. Pathogenetic features of progesterone signaling pathway and PR-B expression in deep infiltrating endometriosis. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2023; 22(5): 22–26. (In Russian). DOI: 10.20953/1726-1678-2023-5-22-26 Open access

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