Yu Yu

Dr. Yu holds her Ph.D. in experimental pharmacology from University of Sydney, Australia and was a postdoctoral research fellow at Gynecologic Pathology Laboratory at the Johns Hopkins University School of Medicine. She was the previous recipient of Outside-the-Box Grant from the HERA Women’s Cancer Foundation and Ann Schreiber Mentored Investigator Award from Ovarian Cancer Research Foundation. Dr. Yu is currently a senior research fellow at the School of Pharmacy and Curtin Health Innovation Research Institute, Curtin University, Western Australia where her studies focus on therapeutics and biomarkers development for gynecological conditions.

Endometriosis signaling: the role of IL-34

An increasing number of studies have suggested that the pathogenesis of endometriosis is mediated by cytokines, such as interleukin (IL)−17, which promoted the formation and progression of endometriosis by up-regulating angiogenesis and pro-inflammatory cytokines secretion. IL-34 is a newly described cytokine. It regulates the differentiation and proliferation of monocytes. It can trigger multiple cellular processes such as cell proliferation, differentiation, apoptosis, angiogenesis, inflammation, and immunoregulation by triggering phosphorylation signaling cascades. The current article by Lin et al. from Zhejiang University…

Key Points Lay Summary

Natural killer cells receptor expression in endometriosis

Increasingly, studies have reported that endometriosis pathogenesis is related to defect in immune functions. The data also points to the impaired function of natural killer (NK) cells, leading to less cytotoxic NK cell activity in endometriosis. Similar to B and T lymphocytes, NK cells generally have a crucial function in human immunity, as they represent the third largest lymphocyte population in the peripheral blood. To identify NK cells, researchers have used the positive expression of surface markers. In a normal…

Key Points Lay Summary

Circulating Endometrial Cells

Endometriosis is difficult to diagnose because of non-specific symptoms. Currently, there is no biomarker that allows for non-invasive diagnosis of the condition.  Surgical laparoscopy remains the standard for diagnosis. Circulating endometrial cells (CECs) is the lymphovascular spread of endometrial cells. It was first reported by Halban J. in 1925, who discovered endometrial cells in the lymphatic system of the uterus in women with endometriosis. Since then, endometrial cells from peripheral blood and peritoneal washings from women with endometriosis have been…

Key Points Lay Summary

Immune environment of endometriosis

The results from the past decade of research have shown that an altered pro-inflammatory immune environment in endometriosis is believed to contribute to the pathophysiology of the disease. Because of changes in the immune microenvironment in the disease state, the reproductive function of the endometrium is also compromised. The menstrual cycle has several phases, which include the proliferative, secretory, menstrual and regenerative phases. Despite changes of immune cells in endometriosis, it is important to note that the immune environment of…

Key Points Lay Summary

M1 and M2 macrophages in ovarian endometriomas

Macrophages play an essential role in the immune response during inflammation and have been implicated in diseases such as inflammatory conditions and cancers. Broadly, macrophages are classified into M1 and M2. The M1 macrophages are pro-inflammatory, and in contrast, the M2 is anti-inflammatory and profibrotic. The M2 macrophages are also able to induce immunotolerance and angiogenesis. While the number and roles of these subpopulations of macrophages have been extensively studied in tumors, little is known about them in endometriosis. The…

Key Points Lay Summary

Optimal Management of Endometriosis and the associated pain

Around 5–10 million reproductive-aged women suffer from endometriosis in the United States. The condition is hard to diagnose due to large variation in symptoms, though most women experience pain that can either be cyclical pelvic pain with menses or noncyclic pelvic pain, such as dyspareunia, dyschezia, and dysuria. In addition, many women present with unexplained infertility. Because of these factors that markedly affect a woman’s quality of life, optimal management of endometriosis is crucial. The current article published in Obstetrics…

Key Points Lay Summary

Yogurt and ice cream consumption during adolescence may reduce endometriosis

Dietary factors may affect the development and severity of endometriosis because of estrogen, prostaglandin metabolism, inflammation, or smooth muscle contractility. Studies investigating the relationship between diet and endometriosis have focused on women’s dietary intake during adulthood. For example, the higher intake of dairy in adulthood has been shown to be associated with a lower risk of endometriosis. On the contrary, the current article studied diet during adolescence because the onset of endometriosis is probably during adolescence. Nodler et al. from…

Key Points Lay Summary

Endometriosis Knowledgebase

Several studies have pointed to possible genetic factors in endometriosis. Targeted gene-based and high-throughput methods such as Genome-Wide Association Studies (GWAS) have been previously employed to identify endometriosis-associated genes. However, the accuracy of these data are difficult to evaluate and can vary when studies in other larger cohorts. Therefore, endometriosis is genetically complex and require a more integrated method to provide meaningful study outcome. The current study by Joseph et al. from the National Institute for Research in Reproductive Health,…

Key Points Lay Summary

Clinical trial for the use of oral lactobacillus on endometriosis pain severity

The standard treatment of endometriosis consists of surgery and hormonal based treatment. There is evidence for the efficacy of these types of treatment, although their side effects remain a critical consideration for women. Based on molecular studies, changes in the function of immunologic cells like monocytes, macrophages, natural killer cells (NK), cytotoxic T cells and B cells have been detected in the peritoneal fluid of women with endometriosis. Lactobacillus bacteria consist of a number of species with Lactobacillus Aci­dophilus, Lactobacillus…

Key Points Lay Summary

A miniaturized version of endometrium: organoids for endometriosis research

Organoids are a miniaturized version of a tissue that is produced in culture through three dimensions techniques in order to better mimic the tissues of origin. These cultures are supposed to better replicate the complexity of a biological organ/disease. Endometrial disorders are a major problem in women’s health and one of the main causes of infertility. Some of the most common conditions include endometriosis and endometrial cancer. However, the pathogenesis of these conditions is not fully understood. In addition, there…

Key Points Lay Summary

Heme impairs macrophage phagocytosis

Heme is an iron-containing molecule that carries oxygen in the blood and also serves many essential biological proteins. It is released from ruptured erythrocytes during hemolysis. If not chelated, heme can cause harmful oxidative damage and inflammation. Thus, heme is usually bound to its scavenger hemopexin, to prevent the harmful effect. When taken up by a cell, heme is degraded by heme oxygenase-1 (HO). However, the capacity to scavenge heme may saturate in pathologic conditions, leading to tissue damage.  Women…

Key Points Lay Summary

Normal endometrium and cancer-associated mutations

Next-generation sequencing technology has enabled the detection of genetic mutation with high efficiency. It is believed that tumor progression is a result of accumulating mutations, so-called “driver mutations”, which confer growth advantages to the cell. Although such a process is well established in cancer, normal cells can also acquire somatic mutations over time. Intriguingly, recent studies showed that normal skin, blood, peritoneal washings, and esophageal epithelium contain somatic driver mutations that are usually associated with cancer.   In the current…

Key Points Lay Summary

The link between autoimmunity and endometriosis

A popular model to explain the etiology of endometriosis is Sampson’s theory of retrograde menstruation. In this model, the viable endometrial tissue is spread and attached to the peritoneal cavity through the fallopian tubes during menstruation, resulting in an inflammatory response. However, this theory does not fully explain the condition because not all women with reflux menstruation have endometriosis. Another theory to complement the retrograde menstruation is the autoimmunity theory, which suggests that endometriosis is associated with a chronic local…

Key Points Lay Summary

Could a defect in phagocytosis cause endometriosis?

The macrophages are important immune cells in the peritoneal cavity because they function to remove aberrant cells or tissues by the process of phagocytosis. In endometriosis, there is an increased number of peritoneal macrophages and heightened production of inflammation molecules such as cytokines and interleukin. The inadequate activation of macrophages in endometriosis can lead to their compromised function with reduced phagocytic capacity, thus contributing to poor clearance of endometrial lesions, resulting in endometriosis. Two molecules important for the regulation of…

Key Points Lay Summary

Behavioral Symptoms in an Animal Model of Endometriosis

Recent studies suggest that there is a relationship between endometriosis and some behavioral symptoms. Prolonged pelvic pain and the other endometriosis symptoms can often affect psychological and social functioning, resulting in issues with social relationships, sexuality, and even mental health. A previous systematic review showed that depression and anxiety are commonly associated with endometriosis. The biological mechanisms underlying the relationship between endometriosis and psychiatric symptoms; however, remains understudied. Filho et al. from Neuropsychopharmacology Laboratory, Department of Physiology and Pharmacology, Universidade…

Key Points Lay Summary

Antibiotic therapy for endometriosis

Current treatments for endometriosis are surgery and hormone therapy; however, these approaches may have significant side effects and do not prevent a recurrence. Therefore, alternative treatment modalities for endometriosis is needed. Recently, the idea that endometriosis may be influenced by the microbiome is developing. The women’s reproductive tracts are colonized by distinct microbial communities, which appear to correlate with conditions such as preterm birth and infertility. One study has also identified differences between the microbiome in the cervix and uterus…

Key Points Lay Summary

Correlation between Treg cells and peritoneal lesions in women with ovarian endometrioma

It is increasingly suggested that defective immune response is responsible for the survival and development of ectopic endometrial cells into endometriosis. In women with endometriosis, the immune system fails to create an inflammatory process that destroys endometrial cells at the ectopic site. One emerging research in this area is the role of a population of anti-inflammatory populations of T lymphocytes, called regulatory T (Treg) cells, which are potent immune response suppressor important to prevent immune destruction in all tissues. A…

Key Points Lay Summary

A newly found relationship between estrogen signalling and immune dysregulation in endometriosis

It is believed that endometriosis progression is "at least partly" due to dysregulation of immune cells resulting in the poor clearance of ectopic endometrial debris. In particular, aberrant macrophage function was found to be important in the establishment of endometriosis, since the primary role of macrophage is to engulf cellular debris. Macrophages differentiate into M1 (the classically activated macrophages) or M2 (the alternatively activated macrophages) depending on environmental stimuli. M1 macrophages kill microorganism and have a pro-inflammatory function, while M2 macrophages…

Key Points Lay Summary

Breast cancer incidence in women with endometriosis

The relationship between endometriosis and breast cancer remains unclear. Some studies have shown an increased risk of breast cancer among women with endometriosis, while others suggested no change in the risk of breast cancer. Previously, the authors have found that the overall risk of breast cancer in women with endometriosis was similar to the Finnish female population, irrespective of the type of endometriosis. However, the authors have re-examined the potential risk because breast cancer is one of the most common…

Key Points Lay Summary

Efficacy of an antibiotic, clarithromycin for endometriosis

Laparoscopic surgery is the standard treatment for advanced stages of endometriosis, followed by postoperative modalities including to progesterone, antiprogestogens, estrogen-progesterone combinations, danazol, and gonadotropin-releasing hormone agonists to reduce recurrence after surgery. However, these drugs interfere with ovulation and fertility. The role of immune system in endometriosis progression and clinical symptoms has resulted in treatment using anti-inflammatory agents. Clarithromycin is a macrolide with an anti-inflammatory effect. It is used for different inflammatory diseases, such as asthma, cystic fibrosis, bronchiectasis, and sepsis.…

Key Points Lay Summary