MOLECULAR MECHANISMS OF FORMATION OF CHRONIC PELVIC PAIN SYNDROME IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS: MARKERS AND TARGETS FOR DIAGNOSIS AND THERAPY (REVIEW)

Daria E. Nikiforova, Tatyana A. Makarenko, A. B. Salmina
In: Annals of the Russian academy of medical sciences · 2018 · vol. 73(4) , pp. 221–228 · doi:10.15690/vramn937 · W2890593570
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This review systematizes studies on the pathogenesis of chronic pelvic pain in external genital endometriosis, highlighting mixed pain components and the need for early biomarker-based diagnosis.

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This review systematizes molecular and pathogenetic evidence for how chronic pelvic pain syndrome (CPPS) forms in patients with external genital endometriosis (EGE), emphasizing that pain arises from both neuropathic and nociceptive mechanisms reflected in ectopic foci by specific biomarkers. It argues that prolonged diagnostic delays (reported as 5–8 years on average) may contribute to a persistent autonomous pain syndrome with pain relapses even after comprehensive surgical and/or long-term hormonal treatment, and it discusses the rationale for developing a non-invasive diagnostic biomarker panel for early disease. A stated limitation is that the article synthesizes published studies rather than presenting new primary patient data, so the proposed biomarker/target framework depends on the quality and heterogeneity of underlying research. This paper is centrally about endometriosis — it focuses on molecular mechanisms of chronic pelvic pain formation in external genital endometriosis and on markers/targets for diagnosis and therapy.

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Abstract

This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease.
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MOLECULAR MECHANISMS OF FORMATION OF CHRONIC PELVIC PAIN SYNDROME IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS: MARKERS AND TARGETS FOR DIAGNOSIS AND THERAPY (REVIEW) - Authors: Nikiforova D.E.1, Makarenko T.A.1, Salmina A.B.1 - Affiliations: - Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky - Issue: Vol 73, No 4 (2018) - Pages: 221-228 - Section: OBSTETRICS AND GYNECOLOGY: CURRENT ISSUES - Published: 25.07.2018 - URL: https://vestnikramn.spr-journal.ru/jour/article/view/937 - DOI: https://doi.org/10.15690/vramn937 - ID: 937 Cite item Full Text Abstract This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease. About the authors Daria E. Nikiforova Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky Author for correspondence. Email: [email protected] ORCID iD: 0000-0001-7516-5203 MD. 1, Partizana Zheleznyaka street, 660022 Krasnoyarsk, Phone: +7 (495) 627-24-00. SPIN-код: 1219-6470 Russian FederationTatyana A. Makarenko Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky Email: [email protected] ORCID iD: 0000-0001-7823-6222 MD, PhD. 1, Partizana Zheleznyaka street, 660022 Krasnoyarsk, Phone: +7 (495) 627-24-00. SPIN-код: 3133-7406 Russian FederationAlla B. Salmina Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky Email: [email protected] MD, PhD, Professor. 1, Partizana Zheleznyaka street, 660022 Krasnoyarsk, Phone: +7 (495) 627-24-00. SPIN-код: 6504-7657 Russian FederationReferences - Эндометриоз: диагностика, лечение и реабилитация. Клинические рекомендации по ведению больных / Под ред. Л.В. Адамян. ― М.; 2013. ― 86 с. - May KE, Conduit-Hulbert SA, Villar J, et al. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update. 2010;16(6):651−674. doi: 10.1093/humupd/dmq009. - May KE, Villar J, Kirtley S, et al. Endometrial alterations in endometriosis: a systematic review of putative biomarkers. 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