The value of the expression of endometrial receptors for steroid hormones in patients with endometriosis

In: Journal of Education, Health and Sport · 2020 · vol. 10(5) , pp. 321–331 · doi:10.12775/jehs.2020.10.05.034 · W3105478531
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This study examined endometrial steroid receptor expression in women with endometriosis and found that Dienogest increased estrogen sensitivity and reduced progesterone receptor positivity, while Dipherelin decreased sensitivity to ovarian hormones.

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This study investigated progesterone and estrogen receptor expression in the endometrium of 119 women with small-sized endometrioma with adenomyosis, assessing how endometriosis therapies alter steroid receptor patterns. Endometrial aspirates were collected from multiple uterine sites before treatment and after 3 months, comparing Dienogest-treated participants (n=35) with those receiving the GnRH agonist Diferelin (n=34). Dienogest was associated with increased endometrial sensitivity to estrogens and a partial reduction in the number of progesterone-receptor–positive cells, whereas Diferelin corresponded to decreased sensitivity to ovarian hormones with adequate ER and PR expression. This paper is centrally about endometriosis — it directly measures endometrial steroid receptor expression before and after dienogest or GnRH-agonist therapy in women with endometriosis (including adenomyosis).

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Abstract

Aim: To elucidate the nature of the expression of progesterone receptors (PR) and estrogen receptors (ER) of the endometrium in patients with endometriosis in order to study the effect of endometriosis therapy on endometrial receptors while taking progestogens and agonists of gonadotropin-releasing hormones (a-GnRH).Materials and Methods. A total of 119 women were examined, including 69 patients with small-sized endometrioma with adenomyosis, who were divided into two subgroups during the study: 35 women received Dienogest therapy, other 34 patients received Diferelin. To study the expression of endometrial steroid receptors, the patients underwent endometrial aspiration biopsy from different points of the uterine cavity before the treatment and after 3 months against the background of the therapy for endometriosis.ResultsEndometriosis therapy affects the expression pattern of endometrial steroid receptors. While taking Dienogest, the sensitivity of the endometrium to estrogens increases, and the number of cells with a positive response to progesterone receptors is partially reduced. When using gonadotropin-releasing hormone agonists (Dipherelin), the sensitivity of the uterine mucosa to ovarian hormones decreases, which is confirmed by the adequate expression of ER and PR. There is a need for more research on estrogen beta receptors, as well as progesterone receptors A and B, and the related ratios.
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Materials

and Methods. A total of 119 women were examined, including 69 patients with small-sized endometrioma with adenomyosis, who were divided into two subgroups during the study: 35 women received Dienogest therapy, other 34 patients received Diferelin. To study the expression of endometrial steroid receptors, the patients underwent endometrial aspiration biopsy from different points of the uterine cavity before the treatment and after 3 months against the background of the therapy for endometriosis.

Results

Endometriosis therapy affects the expression pattern of endometrial steroid receptors. While taking Dienogest, the sensitivity of the endometrium to estrogens increases, and the number of cells with a positive response to progesterone receptors is partially reduced. When using gonadotropin-releasing hormone agonists (Dipherelin), the sensitivity of the uterine mucosa to ovarian hormones decreases, which is confirmed by the adequate expression of ER and PR. There is a need for more research on estrogen beta receptors, as well as progesterone receptors A and B, and the related ratios.

References

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endometriosisadenomyosisendometrioma

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