Hyperinnervation in Intestinal Deep Infiltrating Endometriosis

Wang G, Guoyun Wang, Natsuko Tokushige, Tokushige N, Peter Russell, Russell P, Dubinovsky S, Sylvia Dubinovsky, Robert Markham, Markham R, Fraser Is, Ian S. Fraser
Journal of Minimally Invasive Gynecology · 2009 · vol. 16(6) , pp. 713–719 · doi:10.1016/j.jmig.2009.07.012 · PMID:19896597 · W2015421305
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This paper investigated the extent of nerve presence in deep infiltrating endometriosis lesions within the intestine.

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Abstract

Study objectiveTo investigate the extent and types of innervation of endometriotic lesions in various regions of the bowel.DesignRetrospective nonrandomized immunohistochemical study (Canadian Task Force classification II-3.SettingUniversity-based laboratory.PatientsThirty-six women undergoing laparoscopy or laparotomy because of deep infiltrating endometriosis in various regions of the bowel, including the sigmoid colon, appendix, and rectum.InterventionsImmunohistochemical staining of endometriotic specimens with antibodies against protein gene product 9.5, neurofilament, nerve growth factor, nerve growth factor receptors tyrosine kinase receptor A and p75, growth-associated protein 43, substance P, neuropeptide Y, and vasoactive intestinal peptide to demonstrate myelinated, unmyelinated, sensory, and autonomic nerve fibers.Measurements and main resultsThere were significantly more nerve fibers in intestinal deep infiltrating endometriosis (mean [SD] 172.6 [94.2]/mm(2)) than in other deep infiltrating endometriotic lesions (e.g., cul-de-sac and uterosacral ligament) (67.6 [65.1]/mm(2); p<.01). Intestinal deep infiltrating endometriosis was innervated abundantly by sensory Adelta,sensory C, cholinergic, and adrenergic nerve fibers. Nerve growth factor, tyrosine kinase receptor A, and p75 were strongly expressed in endometriotic lesions, and growth-associated protein-43 was also strongly expressed in the endometriosis-associated nerve fibers.ConclusionThe hyperinnervation in intestinal deep infiltrating endometriosis may help to explain why patients with this type of lesion have more severe pain.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Intestine, Large Intestine, Large Adult Endometriosis Female GAP-43 Protein GAP-43 Protein Humans Immunohistochemistry Intestine, Large Intestine, Large Middle Aged Nerve Growth Factor Nerve Growth Factor Receptor, Nerve Growth Factor Receptor, Nerve Growth Factor Receptor, trkA Receptor, trkA Retrospective Studies

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