Endometriose und Aktivität

In: Der Gynäkologe · 2002 · vol. 35(3) , pp. 232–237 · doi:10.1007/s00129-002-1161-0 · W49568186
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Non-pigmented endometriotic lesions exhibit higher levels of growth factors and cytokines, indicating greater biological activity compared to pigmented lesions.

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The paper examines heterogeneity in endometriotic lesions by proposing that different morphologic types correspond to different levels of disease “activity,” focusing on differences between non-pigmented and pigmented lesions. It reports that non-pigmented lesions show higher expression of growth factors and cytokines, including VEGF, angiopoietins, and MMP, and argues that higher levels of these mediators reflect higher biologic activity. It states that prior clinical studies largely did not account for disease activity and that accurately documenting activity during laparoscopy is presented as a prerequisite for appropriate therapy, with the caveat that the current evidence base does not yet integrate activity in clinical outcome research. This paper is centrally about endometriosis — it specifically relates lesion pigmentation status to biochemical markers of “activity” and emphasizes incorporating activity documentation during laparoscopy.

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Zusammenfassung Hinter der Vielzahl der Erscheinungsbilder der Endometriose verbergen sich unterschiedlich “aktive” Areale der Erkrankung. Die nicht pigmentierten Läsionen der Endometriose gehen mit einer erhöhten Expression von unterschiedlichen Wachstumsfaktoren und Zytokinen einher. Dadurch unterscheiden sie sich von pigmentierten Läsionen der Endometriose. Setzt man die erhöhte Expression bestimmter Parameter mit “Aktivität” gleich, bedeutet dies, dass die nicht pigmentierten Läsionen aktive Formen der Erkrankung darstellen. Die bisherigen klinischen Resultate berücksichtigen die Aktivität der Erkrankung nicht oder nur marginal. Eine exakte Dokumentation der Aktivität während der diagnostischen/operativen Laparoskopie stellt die Grundvoraussetzung für eine adäquate Therapie dar. Darüber hinaus liefert die Kenntnis über biochemische Eigenschaften der Endometrioseläsionen wichtige Rückschlüsse auf die Pathogenese der Erkrankung und eröffnet so neue Therapieoptionen. Abstract The numerous morphologic aspects of different endometriotic lesions can be related to different stages of activity of the endometriotic disease. Non-pigmented endometriotic lesions are demonstrating higher levels of growth factors and cytokines than pigmented lesions. It seems that high levels of growth factors (VEGF, angiopoietins, MMP) are related with high biologic activity, therefore the pigmented lesions represent the active manifestation of the disease. Until now most clinical studies have not taken into account the activity of the disease. An exact documentation of the activity during laparoscopy represents a prerequisite for an adequate therapy. Furthermore, the improvement of our knowledge will lead to a better understanding of the pathogenesis of the endometriotic disease and to new options in the treatment of endometriosis. Similar content being viewed by others Author information Authors and Affiliations Rights and permissions About this article Cite this article Malik, E., Kressin, P., Buchweitz, O. et al. Endometriose und Aktivität. Gynäkologe 35, 232–237 (2002). https://doi.org/10.1007/s00129-002-1161-0 Published: Issue date: DOI: https://doi.org/10.1007/s00129-002-1161-0

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