Comparison of BDNF and NGF Levels in Adenomyotic Tissue, Adjacent Myometrium, and Normal Myometrium and Their Correlation with Pain Severity

Agus Heriyanto,1 Dian Tjahyadi,1 Hartanto Bayuaji,1 Ruswana Anwar,1 Hanom Husni Syam,1 Mulyanusa Amarullah Ritonga,1 Binarwan Halim,2 Luky Adlino3 1Reproductive Endocrinology and Infertility Division, Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Reproductive Endocrinology and Infertility Division, Department of Obstetrics and Gynecology, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia; 3Siloam Hospitals Purwakarta, Purwakarta, West Java, IndonesiaCorrespondence: Agus Heriyanto, Email [email protected]: Adenomyosis is a major cause of chronic pelvic pain in women of reproductive age and significantly affects quality of life. Identifying biomarkers associated with pain mechanisms may improve understanding of disease pathophysiology and support the development of targeted therapeutic strategies. The mechanisms underlying adenomyosis-related pain are not fully understood but are thought to involve neurogenic factors such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), which promote nerve fiber proliferation and sensitization. However, evidence regarding the relationship between BDNF, NGF, and pain severity in adenomyosis remains limited.Objective: To compare BDNF and NGF levels in adenomyotic tissue, adjacent myometrium from patients with adenomyosis, and normal myometrium, and to evaluate their association with pain severity measured using the Visual Analog Scale (VAS).Methods: This cross-sectional study analyzed BDNF and NGF levels in adenomyotic tissue, adjacent myometrium, and normal myometrium from 120 tissue samples. Neurotrophin levels were compared among tissue groups and evaluated for their association with pain severity using Visual Analogue Scale (VAS) scores.Results: BDNF levels differed significantly among the three tissue groups (H = 99.364; p < 0.001), showing a decreasing trend from adenomyotic tissue to adjacent myometrium and then to normal myometrium. Post-hoc analysis confirmed significant differences across all pairwise comparisons (p < 0.001). NGF levels also differed significantly among groups (H = 96.056; p < 0.001), with significant differences in all pairwise comparisons (p < 0.001). No significant correlations were found between BDNF and VAS scores (ρ = − 0.038; p = 0.817) or NGF and VAS scores (ρ = 0.125; p = 0.441).Conclusion: Although BDNF and NGF levels differed significantly among tissue types, neither neurotrophin was significantly associated with pain severity, suggesting that additional mechanisms (eg, central sensitization or other inflammatory mediators) may underlie adenomyosis-related pain.Keywords: adenomyosis, BDNF, NGF, neuroinflammation, pelvic pain, VAS