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.

Complementary treatments for endometriosis symptoms: acupuncture, exercise, electrotherapy, or yoga?

Endometriosis is associated with debilitating symptoms in some women including dysmenorrhea, chronic pelvic pain, deep dyspareunia, dyschezia, and dysuria. There are a few therapeutic options to treat these symptoms; however, only a few studies have considered treating the pain symptoms using conventional complementary treatments. This article by Mira et al. from Department of Obstetrics and Gynecology, the University of Campinas in Brazil, was published in International Journal of Gynecology & Obstetrics with the main aim to identify randomized clinical trials…

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Therapeutic potential of ginseng based compound in preclinical models of endometriosis

Currently, the drug option for women with endometriosis mainly focus on reducing estrogens levels (e.g., progestins, androgens, gonadotropin-releasing hormone (GnRH) agonists, and aromatase inhibitors). However, these therapies can have low effectiveness with frequent recurrence and considerable side effects. Therefore, there is a need to develop more effective treatments that may be based on other mechanisms of action. Autophagy is a regulated cellular mechanism in which the cell that mediates natural sequestration of cellular organelles and macromolecules, allowing for orderly degradation…

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N-acetyl cysteine, alpha lipoic acid and bromelain improved endometriosis-associated pelvic pain

Oxidative stress has been implicated in many processes that lead to the development and progression of endometriosis. Typically, women with endometriosis have to endure pelvic pain which negatively impacts their quality of life. Pelvic pain can be chronic and related to dysmenorrhea and dyspareunia. Endometriosis treatment includes gonadotropin-releasing hormone analogs and hormonal contraceptives. These treatments are not suitable for women who wish to become pregnant. Other treatments options that can preserve fertility include analgesics and/or anti-inflammatory agents. One of the…

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Detecting endometriosis using peripheral blood

Laparoscopic visualization of endometriotic lesions with histological confirmation is the gold standard for the diagnosis of endometriosis. However, this diagnostic procedure, due to the need for laparoscopy and variability of disease/symptoms, can have a major delay up to 8-10 years from symptoms onset time. Another method such as transvaginal ultrasound is useful for deep nodules and ovarian endometriotic cysts identification, but it is dependent on the operator and has limited accuracy for the detection of superficial peritoneal lesions. Therefore, a…

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Expert discussion on mechanisms of endometriosis development and progression

Several mechanisms have been proposed to explain the occurrence and worsening of endometriosis. Classically, it is believed that retrograde menstruation causes endometriosis. However, the presence of endometriosis in newly menarcheal or pre-menarcheal girls cannot fully explain this early onset endometriosis. With the increasing number of studies, other mechanisms have also been introduced. Particularly, three prominent aspects of the pathogenesis of endometriosis are: (i) numerous genes are differentially expressed in the ectopic endometrium compared with those in the eutopic and normal…

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Inflammatory molecules promote the migration and invasion of endometriosis cells

Increasing scientific evidence has shown that the immune and inflammatory mechanisms play a central role in the progression of endometriosis by allowing a permissive environment that allows migration, adhesion, proliferation, and invasion of endometrial cells in ectopic regions of the body. This article by Peng et al. from Department of Gynecology and Obstetrics, Women’s Hospital, Zhejiang University Medical College, China published in Reproductive Sciences journal aimed to investigate the expression level of chemokine CXCL16/CXCR6 in endometriosis and explore its potential…

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Altered Immunity in Endometriosis

In recent years, there has been increased attention on the role of immune system in endometriosis development. Normally, immune reactions are supposed to destroy endometrial cells seeding in the peritoneal cavity. Nonetheless, in endometriosis, these cells are able to evade, penetrate, proliferate and ultimately are forming lesions. Persistent inflammatory response within peritoneal cavity causing vasodilation and increased permeability of blood vessels contributing to initial endometrial growth. Thus, changes in cell-mediated and humoral immunity may contribute to pathogenesis endometriosis. This review…

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Animal models of endometriosis

For advancing understanding and treatment of endometriosis, The World Endometriosis Society has previously brought together researchers and clinicians to discuss the many important research priorities. One of these was the recommendation to development and building on the use of animal models for future endometriosis research activities. Endometriosis is a complex disease to mimic. It can broadly be classified into peritoneal, ovarian and deep infiltrating depending upon the location, extent, and appearance of the lesions. Furthermore, American Society for Reproductive Medicine…

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Managing of endometriosis and associated ovarian cancer risk

According to a number of studies, endometriosis is associated with moderate increase in ovarian cancer risk. This risk is elevated in subjects with a long-standing history of untreated ovarian endometriosis. Endometriosis is particularly associated with risk for certain histological subtypes of ovarian cancer including the clear cell and endometrioid ovarian cancer. Clear cell ovarian cancer prevalence is dependent on geographic area. It has a higher prevalence in Asian regions, particularly Japan (15-25%), as compared to 1-13% reported in Europe and…

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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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