Smooth muscle metaplasia and innervation in interstitium of endometriotic lesions related to pain

Kohei Odagiri, Odagiri K, Konno R, Ryo Konno, Fujiwara H, Hiroyuki Fujiwara, Sachiho Netsu, Netsu S, Yang C, Chenghui Yang, Suzuki M, Mitsuaki Suzuki
Fertility and sterility · 2008 · vol. 92(5) , pp. 1525–1531 · doi:10.1016/j.fertnstert.2008.08.101 · PMID:18930216 · W2118472202
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This study investigated smooth muscle metaplasia and innervation within the interstitium of endometriotic lesions and their correlation with pain.

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Abstract

ObjectiveTo investigate the pathogenesis of endometriotic pain.DesignRetrospective nonrandomized immunohistochemical study.SettingA university hospital, Department of Gynecology.Patient(s)Twenty human endometriotic specimens were selected from different lesions including ovarian endometrioma, peritoneal lesion, and deep infiltrating lesion. Premenopausal women with histologically diagnosed endometriosis were selected (mean age 39 years; range, 25-53 years). The chief complaint was dysmenorrhea, dyschezia, and dyspareunia. A rat endometriosis model was induced in 10 SLC-Sprague-Dawley rats (8 weeks old) by surgical autotransplantation of the uterus.Intervention(s)Immunohistochemical staining of endometriotic specimens for alpha-smooth muscle actin (ASMA), neural cell adhesion molecule (NCAM), and nerve growth factor (NGF) expression.Main outcome measure(s)Comparison of the immunoreactive staining of ASMA, NCAM, and NGF expression in human endometriosis and a rat endometriosis model.Result(s)Morphological analysis revealed thick interstitium in both human and rat endometriotic lesions. The major components of fibrotic interstitium are smooth muscle cells, stained by anti-ASMA antibody, and nerve cells, stained by anti-NCAM antibody. Inflammatory cells are also present (e.g., macrophages and lymphocytes) as revealed by anti-NGF antibody staining.Conclusion(s)These results suggest that the contraction of smooth muscle cells and the hyperalgia derived from innervation in the interstitial area is related to pain in endometriosis.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Muscle, Smooth Muscle, Smooth Ovarian Diseases Pelvic Pain Peritoneal Diseases Actins Actins Adult Animals Endometriosis Endometriosis Endometriosis Female Humans Metaplasia Metaplasia Middle Aged Muscle, Smooth Muscle, Smooth

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References (40)

Cited by (47)

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