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.

Investigational drugs for the treatment of endometriosis

Endometriosis treatment involves surgery and medical therapies. Surgery can improve the associated pain, quality of life and sexual function, even though it is technically challenging with potential risks of complications. Medical therapy is often aimed to ameliorate pain symptoms and prevent post-surgical disease recurrence. The choice is based on several factors such as age, intensity, and characteristics of pain, other comorbidities (e.g., migraine) and desire to conceive. The challenges with endometriosis treatment include the need of a tolerable chronic regimen,…

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Reproductive delay and social egg freezing

The data collected from Office for National Statistics in England and Wales has suggested a major shift in the timing of motherhood. In the mid-1970s, the average age of motherhood was 26.4 years of age to, while in 2016, it has increased to 30.4 years. Concurrently occurring with this shift to later motherhood is the development of assisted reproductive technologies such as in vitro fertilization, and technologies of egg donation and freezing. This article by Baldwin from Centre for Reproduction…

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Inflammatory mediators in endometriosis pathogenesis

Proinflammatory cytokines play an important function in mediating inflammatory reactions in chronic inflammatory diseases and in endometriosis. IL-32 is a new proinflammatory cytokine, and can also induce other proinflammatory cytokines in the body such as Tumour Necrosis Factor-α (TNF-α) and IL-8.   This article by Lee et al. published in Human Reproduction journal from Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Seoul, Korea determined the role of IL-32 in the pathogenesis of endometriosis using endometrial cell…

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Exercise can improve pelvic pain and posture associated with endometriosis

Nearly half of women affected by endometriosis have mild to severe chronic pelvic pain (CPP). Clinically, postural changes are frequently seen in CPP sufferers. These postural changes can include uneven positions, shortenings, antalgic postures, and tensions. Moreover, endometriosis is also associated with pelvic floor dysfunction and secondary musculoskeletal impairments in the region of endometrial implantation e.g., on the psoas or lumbar musculature producing musculoskeletal symptoms. Physical therapy can reduce pain and improve quality of life in endometriosis through teaching patients…

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Endocrine and inflammatory factors in current understanding of endometriosis

There are three forms of endometriosis: peritoneal, ovarian, and deep infiltrating. All three forms consist of endometriotic lesions containing endometrial glands, stroma, nerves, blood vessels, and inflammatory cells. Endometriosis symptoms can be accounted by these elements and the involving organs. However, the exact factors contributing to endometriosis-associated pain or infertility are not clearly understood. This review article published in Best Pract Res Clin Obstet Gynaecol journal by Patel et al. from Department of Obstetrics and Gynecology at Wake Forest School…

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Recurrence of Deep Infiltrating Endometriosis

There are mainly three types of endometriotic lesions. These are ovarian endometriosis, superficial peritoneal endometriosis, and deep infiltrating endometriosis (DIE). The latter is often described as a lesion with greater than 5 mm invasion of the peritoneal surface. DIE lesions differ from other peritoneal surface lesions and are often associated with intense pelvic pain. They are most commonly located at the rectovaginal septum, uterosacral ligaments, pararectal space, and vesicouterine fold. To date, surgery is the treatment of choice for DIE.…

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Roles of melatonin in endometriosis

Melatonin is a neurohormone synthesized mainly by the pineal gland of mammals. It is controlled by the endogenous circadian clock located in brain hypothalamus. Melatonin is regulated by environmental light where the concentrations are low during the daytime and high at night. The physiological functions of melatonin include regulation of a variety of central and peripheral actions related to circadian rhythms and reproduction. It has a broad spectrum of effects including antioxidant, free radical scavenger, an anti-inflammatory agent, potential immunoregulator,…

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Using near-infrared imaging to discriminate malignant from benign endometriosis

Endometriosis usually begins as a benign disorder with an increased risk of developing ovarian and endometrial cancers. Endometrioid and clear cell carcinoma histologic subtype of ovarian cancer partially originate from endometriosis. Recent studies on the pathogenesis of endometriosis‑associated ovarian cancer suggest that hemoglobin (Hb), heme and iron‑induced oxidative stress in ovarian endometrioma cystic fluid may be responsible for the malignant transformation of endometriosis. The overproduction of iron‑induced oxidative stress could trigger carcinogenesis by damaging DNA. Hence, cystic fluid Hb species…

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Blood vessels formation in endometriosis

The endometrium undergoes dynamic changes during the menstrual cycle. Estrogen-driven angiogenesis is associated with the proliferative phase, and progesterone-driven vascular maturation occurs in the secretory phase. Hence, it is reasonable that the vascularization of endometriosis is also under complex regulation by the female sex hormones. In fact, endometriosis is associated with the upregulation of angiogenic factors in patients’ serum and peritoneal fluid, which can stimulate the formation of new blood vessels. Thus, vascularization is a critical feature in the pathogenesis of…

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Elevated Neutrophil Traps in Deep Infiltrating Endometriosis

Neutrophils are a part of the innate immune system and act as a first-line host defense system by phagocytosis, intracellular killing and more recently describes mechanism involving extracellular killing by means of neutrophil extracellular traps (NETs). These traps are defined as decondensed chromatin web-like structures that contain extracellular DNA, histones, and granular proteins. They are capable of microbial defense by trapping and degrading microorganisms. In addition, NETs have also been related to the pathogenesis of autoimmune and inflammatory conditions. Elevated…

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Analysis of suppressive regulatory T cells and latent transforming growth factor-β-expressing macrophages in endometriosis peritoneal fluid

One prominent theory of endometriosis origin is the implantation of steroid hormone-sensitive endometrial cells and tissues on the peritoneal surface during retrograde menstruation and caused an inflammatory response. While women exhibit retrograde menstruation, endometriosis may be affected by women suffering immune dysfunction that interferes with the clearing of such implanted lesions. However, the data supporting the theory is conflicting, and the association between endometriosis and Treg subpopulations has not been well studied. In this study by Hanada et al., the…

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The effect of anti-rheumatic drugs on endometriosis therapeutic outcomes

Endometriosis can be described as an autoimmune disease because the abnormalities associated with T and B cell function and various autoantibodies. Although endometriosis has not been found to associate with some severe autoimmune disorders such as systemic lupus erythematosus, it was reported to relate to inflammatory bowel disease. Regardless, the underlying immune dysfunction leading to endometriosis remains unclear, with the suggestion that the immune cells produce pro-inflammatory factors to enhance the growth of endometriotic implants. To study whether immunosuppression can…

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Atypical Sites of Deeply Infiltrative Endometriosis

Endometriosis is the presence of endometrial tissue outside the uterine cavity and is characterizes by fibrosis and inflammatory reaction. The pelvic cavity is the most common location for endometriotic lesions, which involves the retro-cervical space, ovaries, vagina, rectosigmoid colon, bladder dome, and round ligaments. However, the atypical location of endometriosis can occur, although it is rare and often difficult to diagnose. In this review article, Chamié et al. discuss atypical locations for endometriosis and the appropriate imaging methods to investigate…

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Deep endometriosis and pregnancy

Several previous studies have investigated whether endometriosis can affect the normal development of pregnancy, although the results have been controversial. The aim of this review article by Leone Roberti Maggiore et al. is to provide an updated overview of health evidence of the impact of deep endometriosis on obstetrical outcomes through evaluation of related articles from Pubmed database searches. The current literature showed several types of acute complications that may occur during pregnancy in women with deep endometriosis. The most…

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Ectoenzymes as endometriosis biomarkers

The diagnosis of endometriosis is often delayed by 7 to 11 years because of the lack of a non-invasive diagnostic test. The ovarian endometriomas occur in about 17%-44% of women with endometriosis and cysts which contain endometrial tissue and fluid of blood from the accumulation of menstrual debris. This ovarian endometriomas fluid can be seen as a waste fluid. However, its analysis may help to identify new biomarkers for endometriosis. The study by Trapero et al. analyzed the content of…

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Endometriosis pathogenesis through the lens of reactive oxygen species

Oxidative stress caused by reactive oxygen species is an essential factor in endometriosis pathogenesis. The harmful effects of reactive oxygen species have been implicated in many diseases, although the multiple biological changes caused is unclear especially in endometriosis. The article by Xie et al. reported the effect of reactive oxygen species in AT-rich interactive domain 1A (ARID1A) gene. This gene is frequently down-regulated and inactivated in endometriosis. It is also commonly mutated in some cancers, e.g., liver cancer, breast cancer,…

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Endometriosis early pointers

Endometriosis can take a long time to diagnose, thus associated with prolonged symptoms of pain, subfertility and patient frustration/demoralization. It can be difficult to diagnose clinically because the symptoms are common and non-specific so that GP can misconceive them as part of the regular menstruation experience or other conditions. Currently, there is limited benefit from biomarkers and imaging technology for diagnosis. Also, composite patterns of symptoms, such as repeated episodes of dysmenorrhoea can have diagnostic value. However, these composite pointers…

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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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