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.

Reducing side effect of estrogen based therapy by using Tissue-Selective Estrogen Complex

The aberrant regulation of the ERα level in endometriosis and other estrogen-related diseases makes it a promising target for therapy. However, the standard beneficial roles of estrogen in specific target tissues, e.g., the bone, can be primarily affected by such treatment. To reduce these side effects, there has been continuous effort to develop tissue-specific modulators of ERα effectively to treat the estrogen-related disease progression while minimizing the side effects in certain tissues. This has led to the generation of selective…

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Adhesion molecules and endometriosis

Decoy receptor 3 (DcR3) is an immunomodulator regulated by estrogen and can regulate cell adhesion, which is a critical step in the initiation of endometriosis. In particular, the cell adhesion molecules, including ICAM-1 (intercellular adhesion molecule 1) and HCAM (homing cell adhesion molecule, CD44) are associated with aberrant adhesion in endometriosis. The DcR3 expression is upregulated by sex hormones and its level in the serum become detectable during the menstrual cycle, while undetectable in normal tissues. This study by Tsai et…

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Estrogen Receptor-β in Women’s Health

Since the discovery of estrogen receptor (ER), there has been a vast number of studies regarding its functions in cellular and physiological processes. The identification of estrogen receptor-β (ERβ), a second receptor, resulted in a much more complex understanding of the ER biology. Because of the diverse ERs expression patterns, detailed understanding of their tissue-specific roles can be difficult to decipher. This article highlights the role of ERβ that is relevant to various physiological and pathological processes in women. Breast cancer…

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An update of estrogen receptors on human disease

Estrogens and its receptors influence numerous human physiological processes. Two estrogen receptors exist, including estrogen receptor α (ERα) and ERβ. Hence, it is essential to elucidate the functions of these receptors in healthy and diseased states. This is particularly important for developing relevant therapeutics. This review highlights the more recent (5-year update) regarding the influence of estrogens on some human cancers (breast, ovarian, colon, prostate, endometrial), endometriosis, fibroids, and cardiovascular disease. Breast cancer: ERα has been long determined as a…

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Roles of Progesterone in Endometrial Cancer, Endometriosis, Uterine Fibroids, and Breast Cancer

Progesterone is an important hormone, which together with estrogen prepares the women endometrium and breast tissue for pregnancy. The roles of progesterone in human tissues and diseases can be difficult to decipher. While there is a strong evidence for the positive associations of estrogen and endometrial cancer, endometriosis, uterine fibroids, or breast cancer, the actions of progesterone remain unclear. This review article highlight findings and provide perspectives regarding the actions of progesterone in these conditions.    In normal endometrium, progesterone…

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Association between blood inflammatory markers and the risk of endometriosis

Previous studies have suggested that aberrant immunologic and inflammatory responses may play a role in the pathogenesis of endometriosis. Peritoneal fluid collected from endometriosis contains elevated immune cells that may enhance the survival of endometriosis by secreting growth factors and cytokines. In particular, many studies have identified inflammatory factors, including interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) to be elevated in the peritoneal fluid and the peripheral blood of women with endometriosis.…

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Is there any association between menstrual pain and ovarian cancer?

Inflammation may be important in ovarian carcinogenesis. Epidemiological studies show that inflammatory conditions such as endometriosis and pelvic inflammatory disease have been associated with an increased risk of ovarian cancer, while regular use of non-steroidal anti-inflammatory drugs has reduced associated risk. Menstrual pain, also known as "dysmenorrhea" is commonly associated with increased inflammation and has been evaluated for ovarian cancer previously. However, there remains significant uncertainty between the association of menstrual pain and certain histological subtype of ovarian cancer. This…

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Mitogen-Activated Protein Kinase p38 modulates Inflammation in Endometriosis

The p38 mitogen-activated protein kinase (MAPK) is a serine/threonine kinase, which transduces signals within the cell in response to various environmental stimuli. In doing so, it mediates intracellular signaling of cytokine production, cell proliferation, and apoptosis amongst many other cellular functions. Increased local estradiol (E2) production is an essential characteristic factor for the pathogenesis of endometriosis. The authors previously showed that E2 could induce p38 MAPK activation in endometrial stromal cells, suggesting that local E2 production in endometriosis may cause…

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Exposure to organic pollutants and endometriosis

There is increasing evidence suggesting the associations between exposure to endocrine disrupting chemicals and gynecological diseases over the last decade. In rodent and primate experimental models, consistent associations have been previously found between exposure to dioxins and the onset of endometriosis. Despite previous investigative efforts, existing studies existing studies remains relatively inconclusive due to methodological and population heterogeneity. Ploteau et al. conducted a case-control study published in the journal named Environment International,  to assess the associations between the exposure to POPs…

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Cohort study on outcomes of laparoscopic endometriosis surgery

Laparoscopic surgery followed by histological confirmation is considered a standard for diagnosis, staging, and treatment of endometriosis. Radical and conservative surgical approaches are often required for the removal of endometriotic lesions in the case of vaginal or rectal wall deep infiltrative endometriosis, as well as for removal of bowel or bladder endometriosis. The high recurrence of pain and ovarian endometriomas are of most concern post-surgical treatment. This study aimed to investigate the effect of total resection of endometriosis lesions by…

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A Systematic Review of Guidelines for Diagnosis and Management of Endometriosis

Guidelines are systematically developed statements derived from best research evidence to improve patient care through informed clinical practice. Appropriate guidelines can reduce unwarranted variations health practice and the implementation of better interventions. Endometriosis commonly has three different manifestations, including peritoneal endometriosis, ovarian endometriosis, and deep infiltrating endometriosis. Treatment decision often varies significantly between severity and associated symptoms such as pain and infertility. Therefore, it can be difficult to produce accurate diagnostic tests and effective therapeutic interventions to inform unified patient…

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Human Endometrium-Derived Mesenchymal Stem Cells for Cell-based Therapies

Mesenchymal stem cells are a promising candidate for cell-based targeted therapies because they have characteristics such as self-renewal, multipotency, low immunogenicity, and non-oncogenicity. It has the capacity to migrate to sites of inflammation including in endometrial lesions and tumor. Most of these studies have examined MSCs and little studies have focused on endometrial mesenchymal stem cells, which have all these characteristics of MSCs. Hence, EMSCs can be explored for regenerative medicine and used to reduce inflammation such as in endometriosis.…

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The dose of the GnRHa after laparoscopic surgery

Laparoscopic surgery is considered a routine way to diagnose and remove endometriosis. The primary concern with laparoscopic surgery is the recurrence of endometriosis because of incomplete lesion excision. Hence, the challenge is to decrease endometriosis recurrence rate. Gonadotrophin-releasing hormone agonist (GnRHa) is a clinically available for treating endometriosis, however, the use after a certain period of time can suppress sex steroids, leading to reduction of bone mineral density, and an increase in symptoms of estrogen deficiency including hot flashes, and…

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Endometriosis and Ovarian Cancer Risk

Ovarian cancer prevalence in women with endometriosis is higher than the general population. It is often hypothesized that endometriosis-associated malignancies can occur from ovarian endometrioma. This systematic review by Taniguchi highlighted new insights on the relationship between endometriosis and ovarian cancer. On top of describing potential etiology of endometriosis-associated ovarian cancer according to histological findings, this article presented information from other relevant studies. These include: (i) Shizuoka Cohort Study on Endometriosis and Ovarian Cancer Programme in Japan where approximately 0.72%…

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DNA methylation changes in endometrium during the transition from pre-receptive to receptive phase

The endometrium is unique in that it undergoes remarkable changes during menstrual cycle under the control of hormones, estrogen, and progesterone. The function of the endometrium is crucial for embryo implantation, during which the endometrium is receptive around a week after ovulation. Previous gene transcription studies have demonstrated changes in endometrial gene expression during this transition from pre-receptive to receptive phase. This study by Kukushkina et al. published in Scientific Report is aimed at understanding how the endometrial DNA methylation…

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Ovarian Endometriomas vs Deep Infiltrating Endometriosis

Ovarian endometrioma (OMA) and deep infiltrating endometriosis (DIE) have been described as two disease entities, although they are both characterized by endometrial tissue located outside the uterus. As OMA and DIE look different histologically, it is puzzling what cause their differences. Importantly, among subtypes of endometriosis, OMA is most prevalently diagnosed, while DIE is thought to be less prevalent than OMA. Women with DIE, however, experienced more severe pain and challenging clinical management. Diagnosis for DIE includes endometriotic lesions infiltrating…

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Glycodelin and altered endometrial function in endometriosis

A laparoscopic examination is the only diagnostic tool for endometriosis to date. Since the procedure is invasive, there has been much effort by researchers to develop a biomarker for non-invasive diagnosis of endometriosis. To this end, there has been growing interest in studies on GdA, which was formerly known as "placental protein 14" as a candidate biomarker. However, little is known about its expression in the endometrium during the menstrual cycle and in endometriosis. GdA is a glycoprotein with several…

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Reduced vascularization in ovarian endometriomas associated with less pain

Angiogenesis, i.e., the development of new blood vessels is believed to play an important role in endometriosis pathogenesis and symptoms. Endometriosis is associated and requires neovascularization to proliferate, invade surrounding normal structure in order to establish an endometriotic lesion. Ovarian endometriomas occur when small endometrial tissue is transplanted, and grow/enlarges inside the ovaries. Its presence is often associated with pelvic pain in women. To better understand the impact of angiogenesis in painful symptoms associated with endometriomas, Rizzello et al. evaluated…

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Sexual Pain in Endometriosis

Pelvic pain during sexual intercourse (deep dyspareunia) is a major concern for women with endometriosis. As many as half of women with endometriosis experience deep dyspareunia and has been shown to have a detrimental impact on quality of life. The mechanism of endometriosis-associated deep dyspareunia is not well understood. However, cul-de-sac/uterosacral (i.e., the cul-de-sac peritoneal fold between the uterus and the rectum) endometriosis is more likely to be associated with deep dyspareunia. To understand deep dyspareunia, Peng et al. studied…

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Is it Estrogen that Regulates Endometriosis Pain?

Endometriosis-associated pain is a debilitating condition; however, it is surprising that the perceived pain has no correlation to the endometriosis extent. The mechanism that causes the pain is also poorly understood. Nerve growth factor is enhanced in endometriosis and may increase sensory hypersensitivity by modulating inflammatory processes. Inflammatory components such as interleukins, tumor necrosis factor alpha and interferon are elevated in endometriosis and tend to associate with severity of pain experienced by patients. A disturbed hormonal homeostasis can alter pain perception…

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