The Endometrium in Adenomyosis

Giuseppe Benagiano; Ivo Brosens

doi:10.2217/whe.12.8

The Endometrium in Adenomyosis

Giuseppe Benagiano, Ivo Brosens

Women's health (London, England) · 2012 · vol. 8(3) , pp. 301–312 · doi:10.2217/whe.12.8 · PMID:22554177 · W2162477178

review OA: gold CC0 ⤵ 52 in-corpus citations

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Adenomyosis is characterized by endometrial metabolic and molecular abnormalities that promote angiogenesis, proliferation, and local estrogen production, while impairing apoptosis and progesterone resistance, facilitating myometrial infiltration and disease progression.

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Abstract

Eutopic and ectopic endometria of women with adenomyosis show a series of metabolic and molecular abnormalities that increase angiogenesis and proliferation, decrease apoptosis, allow local production of estrogens, create progesterone resistance, and impair cytokine expression. These changes enhance the ability of the endometrium to infiltrate the junctional zone myometrium and the growth of ectopic tissue. In addition, in these subjects several immunological abnormalities have been observed, together with an increased production of 'free radicals' leading to excessive growth of endometrial stromal cells that may facilitate the establishment of adenomyosis. A limiting factor is that these studies have been performed on hysterectomy specimens representing final stages of the disease. This increased knowledge has created new therapeutic options, including the block of local aromatase production through the use of selective estrogen receptor modulators, estrogen-progestin combinations and gonadotropin-releasing hormone super agonists. Also promising are investigations into the mechanism of dysmenorrhea and abnormal uterine bleeding.

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Condition tags

endometriosisadenomyosisdysmenorrhea

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Humans

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References (100)

Cited by (50)

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[1] Aberrant expression of deoxyribonucleic acid methyltransferases DNMT1, DNMT3A, and DNMT3B in women with endometriosis via openalex

[2] Aberrant expression of glutathione peroxidase in eutopic and ectopic endometrium in endometriosis and adenomyosis via openalex

[3] Aberrant Immunoreactivity of Deoxyribonucleic Acid Methyltransferases in Adenomyosis via openalex

[4] Aberrant methylation at HOXA10 may be responsible for its aberrant expression in the endometrium of patients with endometriosis via openalex

[5] Absence of aromatase protein and mRNA expression in endometriosis via openalex

[6] Adenomyosis and junctional zone changes in patients with endometriosis via openalex

[7] Adenomyosis—A Result of Disordered Stromal Differentiation via openalex

[8] Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex

[9] Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex

[10] Adenomyosis: New Knowledge is Generating New Treatment Strategies via openalex

[11] Adenomyosis: the pathophysiology of an oestrogen-dependent disease via openalex

[12] Alterations in expression of endometrial endothelial nitric oxide synthase and αvβ3 integrin in women with endometriosis via openalex

[13] Altered apoptosis and proliferation in endometrial stromal cells of women with adenomyosis via openalex

[14] Apoptosis and bcl-2 expression in normal human endometrium, endometriosis and adenomyosis via openalex

[15] Apoptosis and expression of Bcl-2 and Bax in eutopic endometrium from women with endometriosis via openalex

[16] Apoptosis and Ki-67 expression in adenomyotic lesions and in the corresponding eutopic endometrium via openalex

[17] Association of the CYP17 gene and CYP19 gene polymorphisms with risk of endometriosis in Japanese women via openalex

[18] Cell proliferation effect of GnRH agonist on pathological lesions of women with endometriosis, adenomyosis and uterine myoma via openalex

[19] Changes in the T-helper cytokine profile and in lymphocyte activation at the systemic and local levels in women with endometriosis via openalex

[20] Changes in tissue inflammation, angiogenesis and apoptosis in endometriosis, adenomyosis and uterine myoma after GnRH agonist therapy via openalex

[21] Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis. via openalex

[22] Comparison of the effect of oestradiol, tamoxifen and raloxifene on nerve growth factor-alpha expression in specific neonatal mouse uterine cell types using laser capture microdissection via openalex

[23] Constitutive and tumor necrosis factor-α-induced activation of nuclear factor-κB in adenomyosis and its inhibition by andrographolide via openalex

[24] Cyclooxygenase-2 expression in deep endometriosis and matched eutopic endometrium via openalex

[25] Cytokine Network of Eutopic and Ectopic Endometrium in Women with Adenomyosis via openalex

[26] Decreased levels of the potent regulator of monocyte/macrophage activation, interleukin-13, in the peritoneal fluid of patients with endometriosis via openalex

[27] Decreased suppression of interleukin-6 after treatment with medroxyprogesterone acetate and danazol in endometrial stromal cells of women with adenomyosis via openalex

[28] Detection of aromatase cytochrome P-450 in endometrial biopsy specimens as a diagnostic test for endometriosis via openalex

[29] Differences in uterine innervation at hysterectomy via openalex

[30] Different types of small nerve fibers in eutopic endometrium and myometrium in women with endometriosis via openalex

[31] Distribution of cyclooxygenase-2 in eutopic and ectopic endometrium in endometriosis and adenomyosis via openalex

[32] Distribution of heat shock proteins in eutopic and ectopic endometrium in endometriosis and adenomyosis via openalex

[33] Effect of GnRHa on apoptosis and release of VEGF in endometrial cell cultures from patients with adenomyosis. via openalex

[34] Effect of the menstrual cycle and oral contraceptives on aromatase and cyclooxygenase-2 expression in adenomyosis via openalex

[35] Effects of LNG-IUS on nerve growth factor and its receptors expression in patients with adenomyosis via openalex

[36] Elevated Immunoreactivity against Class I Histone Deacetylases in Adenomyosis via openalex

[37] Elevated immunoreactivity to tissue factor and its association with dysmenorrhea severity and the amount of menses in adenomyosis via openalex

[38] Endometrial Anomalies in Women with Endometriosis via openalex

[39] Endometrial aromatase mRNA as a possible screening tool for advanced endometriosis and adenomyosis via openalex

[40] Endometrial nerve fibers in women with endometriosis, adenomyosis, and uterine fibroids via openalex

[41] Endometriosis: the pathophysiology as an estrogen-dependent disease via openalex

[42] Endothelial nitric oxide synthase in the endometrium during the menstrual cycle in patients with endometriosis and adenomyosis via openalex

[43] Enhanced invasion of stromal cells from adenomyosis in a three-dimensional coculture model is augmented by the presence of myocytes from affected uteri via openalex

[44] Estrogen and progesterone receptor isoform distribution through the menstrual cycle in uteri with and without adenomyosis via openalex

[45] Eutopic endometrial interleukin-18 system mRNA and protein expression at the level of endometrial-myometrial interface in adenomyosis patients via openalex

[46] Evidence for estrogen synthesis in adenomyotic tissues via openalex

[47] Experimental Murine Endometriosis Induces DNA Methylation and Altered Gene Expression in Eutopic Endometrium1 via openalex

[48] Expression and possible role of interleukin-10 receptors in patients with adenomyosis via openalex

[49] Expression of Apoptosis-Related Proteins in Adenomyotic Uteri Treated with Danazol and GnRH Agonists via openalex

[50] Expression of Aromatase Cytochrome P450 in Eutopic Endometrium and Its Application as a Diagnostic Test for Endometriosis via openalex

[51] Expression of Cyclooxygenase-2 and Matrix Metalloproteinase-2 in Adenomyosis and Endometrial Polyps and its Correlation With Angiogenesis via openalex

[52] Expression of heme oxygenase in the eutopic and ectopic endometrium in patients with adenomyosis via openalex

[53] Expression of interleukin-8 receptors in endometriosis via openalex

[54] Expression of interleukin-8 receptors in patients with adenomyosis via openalex

[55] [Expression of matrix metalloproteinase and tissue inhibitor of metalloproteinase in adenomyosis]. via openalex

[56] Expression of tyrosine kinase receptor B in eutopic endometrium of women with adenomyosis via openalex

[57] Expression of Vascular Endothelial Growth Factor (VEGF), Hypoxia Inducible Factor-1α (HIF-1α), and Microvessel Density in Endometrial Tissue in Women With Adenomyosis via openalex

[58] Expression of γδT Cells and Adhesion Molecules in Endometriotic Tissue in Patients With Endometriosis and Adenomyosis via openalex

[59] GnRH agonist-suppressed expression of nitric oxide synthases and generation of peroxynitrite in adenomyosis via openalex

[60] Gonadotropin-releasing hormone agonist and danazol normalize aromatase cytochrome P450 expression in eutopic endometrium from women with endometriosis, adenomyosis, or leiomyomas via openalex

[61] Granulocyte macrophage colony-stimulating factor in adenomyosis and autologous endometrium via openalex

[62] Granulocyte Macrophage Colony-Stimulating Factor in Adenomyosis and Autologous Endometrium via openalex

[63] High density of small nerve fibres in the functional layer of the endometrium in women with endometriosis via openalex

[64] High endometrial aromatase P450 mRNA expression is associated with poor IVF outcome via openalex

[65] Histocompatibility leukocyte antigen-G is not expressed by endometriosis or endometrial tissue via openalex

[66] HLA-G is expressed by the glandular epithelium of peritoneal endometriosis but not in eutopic endometrium via openalex

[67] HOXA-10 expression in the mid-secretory endometrium of infertile patients with either endometriosis, uterine fibromas or unexplained infertility via openalex

[68] HOXA10 expression is decreased in endometrium of women with adenomyosis via openalex

[69] HOX gene expression is altered in the endometrium of women with endometriosis via openalex

[70] Hysterosalpingography: current applications. via openalex

[71] Hysteroscopic images of an isolated lesion of unknown origin in a young infertile patient via openalex

[72] Hysteroscopic myometrial biopsy to diagnose adenomyosis and its clinical application. via openalex

[73] Imaging features of adenomyosis via openalex

[74] Immunohistochemical assessment of superoxide dismutase expression in the endometrium in endometriosis and adenomyosis via openalex

[75] Immunohistochemical study of HLA-DR antigen in endometrial tissue of patients with endometriosis via openalex

[76] Immunological factors in endometriosis-associated reproductive failure: studies in fertile and infertile women with and without endometriosis via openalex

[77] Immunoreactivity of oxytocin receptor and transient receptor potential vanilloid type 1 and its correlation with dysmenorrhea in adenomyosis via openalex

[78] Increased expression of human chorionic gonadotropin/human luteinizing hormone receptors in adenomyosis. via openalex

[79] Increased immunoreactivity to SLIT/ROBO1 and its correlation with severity of dysmenorrhea in adenomyosis via openalex

[80] Increased Immunoreactivity to SLIT/ROBO1 in Ovarian Endometriomas via openalex

[81] Increased matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 secretion but unaffected invasiveness of endometrial stromal cells in adenomyosis via openalex

[82] Increased microvessel density in adenomyosis uteri via openalex

[83] Infertility and Adenomyosis via openalex

[84] Integrin Adhesion Molecules in the Endometrial Glandular Epithelium in Patients with Endometriosis or Adenomyosis via openalex

[85] Interleukin-8 Induces Proliferation of Endometrial Stromal Cells: a Potential Autocrine Growth Factor1 via openalex

[86] Interleukin-8 in the Human Endometrium<sup>1</sup> via openalex

[87] Intraepithelial leukocytes in endometriosis and adenomyosis: comparison of eutopic and ectopic endometrium with normal endometrium via openalex

[88] Iron overload in the peritoneal cavity of women with pelvic endometriosis via openalex

[89] IS-47 Increased matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 secretion but unaffected invasiveness of endometrial stromal cells in adenomyosis(Group6 Oncology3,International Session) via openalex

[90] Is adenomyosis the neglected phenotype of an endomyometrial dysfunction syndrome? via openalex

[91] Is endometriosis an endometrial disease? via openalex

[92] Leukemia inhibitory factor is dysregulated in the endometrium and uterine flushing fluid of patients with adenomyosis during implantation window via openalex

[93] Localization of T Cells, Interferon-Gamma and HLA-DR in Eutopic and Ectopic Human Endometrium via openalex

[94] Magnetic resonance imaging to assess familial risk in relatives of women with endometriosis via openalex

[95] Matrix Metalloproteinase-2 and -9 Expression Correlated with Angiogenesis in Human Adenomyosis via openalex

[96] Molecular characterization of human adenomyosis via openalex

[97] Neonatal administration of tamoxifen causes disruption of myometrial development but not adenomyosis in the C57/BL6J mouse via openalex

[98] Neonatal tamoxifen treatment of mice leads to adenomyosis but not uterine cancer via openalex

[99] Neurotrophin Expression Is Not Affected in Uteri of Women with Adenomyosis via openalex

[100] Oxidative stress and peritoneal endometriosis via openalex