Engin Aydin, MD

Nasuhi Engin Aydin,  M.D. a graduate of Hacettepe University Faculty of Medicine, Turkey received Philadelphia based E.C.F.M.G. Certification. He started his academic career at Ankara University working on short-term carcinogenicity tests with his research cited in NCI, Bethesda Monograph 65. He has been working as a registered Anatomic Pathologist in Turkey since 1983. Main topics of interest are research on gynecologic pathology besides forensic and surgical pathology with manuscripts published internationally. 

A comprehensive review on the etiopathogenesis of endometriosis

Endometriosis, being a heterogeneous disease has a highly complex etiopathogenesis.  A multicenter comprehensive review on this important subject from Italy, Germany, and the USA by Lagana and associates, was recently published in the "International Journal of Molecular Sciences" an open-access journal. Computerized databases were used to retrieve publications using the Medical Subject Headings (MeSH)  “Endometriosis”  with “Etiology”, “Immunology”  “Genetics”  and “Epigenesis, Genetic”.  Available scientific evidence reveals that endometriosis is not just simply a transplanted normal endometrium. Numerous differences in hormone receptor levels,…

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A new ultrasound subgrouping reveals good clinical correlations in adenomyosis

Exacoustos and colleagues from two endometriosis tertiary referral centers in Rome, Italy published their observational, prospective study of the recently proposed transvaginal ultrasonographic scoring system in the "Journal of Minimally Invasive Gynecology". Adenomyosis or “endometriosis interna” is defined as the presence of endometrial glands and stroma within the myometrium along with the hypertrophy of the muscle tissue. This condition is also be associated with pelvic endometriosis and both conditions share similar pathogenesis and symptoms. The ultrasonographic scoring systems are designed to…

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Medical databases yield 32 published cases of surgically treated liver endometriosis

Prodromidou and colleagues from Greece have published a review of surgically diagnosed, histopathologically proven liver endometriosis cases published worldwide, in the journal "Annals of Hepatology". Searching at three electronic medical databases namely, PubMed (1966–2019), Scopus(2004–2019), and Google Scholar (2004–2019) for observational studies and case reports, there were  27 studies which yielded 32 patients with surgically treated liver endometriosis. Histopathological examination of surgical specimens revealed the presence of endometrial stroma and glands. In cases in which immunochemistry was performed, estrogen and…

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CD4, CD8 T lymphocytes gain importance in endometriosis

Immune dysregulation is important in the development of endometriosis where the role of various lymphocyte subpopulations has been investigated up till now. Caihua Li and associates from Anhui Medical University, China, made a unique observation regarding CD4 and CD8 T lymphocyte subpopulations in this regard, publishing their findings at "Reproductive Biology and Endocrinology".  The mucosa-associated invariant T cell is an important T cell subset in the pathogenesis of various autoimmune diseases. There exist three functionally distinct MAIT subsets: CD4-positive, CD8-positive…

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Endometriosis and Insulin dependent Diabetes Mellitus

Simmen and associates from the University of Arkansas for Medical Sciences, Alabama, published a review article about the co-existence of type 1 diabetes mellitus (T1DM)  and endometriosis, in the recent issue of the "Journal of Endocrinology". Insulin-dependent diabetes or T1DM is the result of the destruction of insulin-producing β-cells of the pancreatic islands that are thought to be due to an autoimmune process. Possibly over one million Americans have this disease, with an annual economic cost of ~$14B and around 40,000…

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Thoracic endometriosis: the most frequent endometriosis involvement outside abdominopelvic cavity

Six to ten percent of reproductive-age women are affected by endometriosis, and about 12% are estimated to be outside the abdominopelvic cavity - the most frequent location being the thorax. Endometriosis within the pulmonary parenchyma or on the diaphragm and pleural surfaces presents different manifestations, collectively known as thoracic endometriosis syndrome (TES).  Besides classic theories of retrograde menstruation, coelomic metaplasia, lymphatic and hematogeneous dissemination in TES, a unique prostaglandin theory is also acceptable, where prostaglandin F2α, a potent constrictor of…

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Severity of dysmenorrhea is among the risk factors in recurring ovarian endometriosis

Dr. Yan Li and associates from Beijing, China have recently published their results on the retrospective analysis of a large group of ovarian endometriosis patients who had laparoscopic surgical treatment in the "Journal of Ovarian Research". Endometriosis is a chronic estrogen-dependent disease mainly seen in women of reproductive age where ovarian endometriosis or endometrioma is the most common type. Immune cells, adhesion molecules, extracellular matrix metalloproteinase and pro-inflammatory cytokines affecting peritoneal microenvironment, all seem to favor differentiation, adhesion, proliferation, and…

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Immunotherapy for endometrisosis: Will it be possible?

This comprehensive review on the pathophysiology of endometriosis by Dr. Sciezynska and colleagues from the Medical University of Warshaw, Poland appeared in the September 2019 issue of "Journal of Clinical Medicine". Endometriosis is a considerable health issue where current treatment strategies are mainly limited to analgesic or hormonal therapy and surgery. Currently, there is substantial evidence suggesting endometriosis may be related to the altered immunity, both local and systemic. Peritoneal infiltration of immune cells, activation of macrophages, abnormal lymphocyte responses…

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Is there an association between endometriosis and sexual activity during menstruation ?

This recent case-control study with 185 women having endometriosis and  370 women as a control group was conducted in Tebriz University, Iran by Dr. Mollazadeh and associates.  Contemporarily, retrograde menstruation is a valid theory for disseminating endometrial tissue to the peritoneal cavity through patent uterine tubes. Since about 90% of women with open uterine tubes has been found to have menstrual blood in their peritoneal cavities by laparoscopy, the level and volume of retrograde menstruation and the backward movement of…

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Atherosclerotic cardiovascular disease and endometriosis

Dr. Omur Taskin and associates from British Columbia, Canada, have recently published a review regarding the potential link between atherosclerotic cardiovascular disease (ASCVD) and endometriosis in The Journal of Minimally Invasive Gynecology. Atherosclerotic cardiovascular disease is the leading cause of death in women, with an incidence rising sharply after menopause There are many clinical clues suggesting young women with endometriosis and possibly older women with a history of endometriosis have a higher risk of atherosclerotic cardiovascular disease, particularly with induced…

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Inside to outside or from outside to inside?

Pathogenesis of "adenomyosis", presence of the ectopic endometrium tissue within the uterine muscles, has largely been classically based on origin from basalis endometrium. Khan and associates from Japan have published their new conceptual findings on adenomyosis in Reproductive BioMedicine Online. In a considerable number of cases adenomyosis involving the outer myometrium may be linked to invasion of endometrium-like structures from outside disrupting the uterine serosa.  In this prospective controlled study, surgical specimens from 23 women with intrinsic adenomyosis (i.e., involving inner-mid…

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Association between endometriosis and autoimmune disorders is not clear yet

Endometriosis is a common disorder that may affect up to 10% of women of reproductive age. The causes of endometriosis are largely unknown but abnormalities in immunity have been suggested to explain the origin of ectopic endometrial tissues. Evaluation of currently published results linking the association between endometriosis and autoimmune diseases may help our understanding of the disease process better. Shigesi and associates from the UK have compiled the results from major medical databases and published their analysis in  Human…

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Importance of monocytic myeloid derived supressor cells in endometriosis

Myeloid-derived suppressor cells MDSCs are immature myeloid cells that play a major role in immunosuppression in various disease processes.  Ya Sun and associates have investigated these cells in endometriosis utilizing various laboratory methods. published their results in the "American Journal of Reproductive Immunology". Implantation hypothesis is a well-known theory, but it cannot fully explain why although nearly 90% of women have reflux menstruation but endometriosis occurs in only 5 to 10%. Currently, it is thought that endometriotic growth can be regulated by…

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Endometriosis pathophysiology: research in genes updated

Endometriosis has a broad spectrum of environmental influences and genetic factors. I In this recently published review article in Experimental and Therapeutic Medicine, Vassilopoulou and associates present information about gene‑gene and gene‑environment interactions involved in endometriosis and discuss the effectiveness of GWAS in identifying novel potential therapeutic targets. Familial studies defined inheritance trends, linkage analysis studies revealed the identification of genetic sites related to disease vulnerability. Genetic association studies involve candidate genes and single nucleotide polymorphisms, and at unraveling the…

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New findings in adenomyosis (endometriosis interna) patients with potential theraupetic research implications

Xue Shen and associates from Beijing, China have published their observations related to cannabinoid receptors, i.e., CB1 and CB2, in patients with adenomyosis, recently in the journal  "Biomed Research International".  Adenomyosis is an estrogen-dependent uterine disorder where a nonmalignant invasion of the bioactive endometrium into the myometrium occurs, and little is known about its etiology and its pathogenesis. Since uterus means a lot to women, medical therapy is important in the management of adenomyosis, and the rationale for it rests on…

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Adenomyosis (endometriosis interna): an enigmatic disease that has to be discovered yet

Scientists, Drs. Vannuccini and Petraglia from Italy have published an open access comprehensive review of Adenomyosis in "F1000Research" in March 2019 issue. Adenomyosis is a uterine disorder in which endometrial glands and stroma are pathologically demonstrated within the myometrium, i.e. uterine muscles. For years, adenomyosis has remained a microscopic tissue diagnosis made after hysterectomy in perimenopausal women with heavy menstrual bleeding or pelvic pain. However, adenomyosis has also become a condition identified in young fertile-age women due to recent advances in imaging techniques.…

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The role of adhesion molecules, E-cadherin and hScrib, in endometriosis

Dr. Zhuo Ouyang and associates from the Capital Medical University, Beijing, China have recently published their research related to adhesion molecules in "Medicine (Baltimore)". Endometriosis is a “benign gynecological disease with some similarities to cancer”. Adhesion molecules E-cadherin and hScrib have roles in the establishment of apical-basal polarity besides enhancing cell to cell adhesion, inhibition of cell proliferation and migration thus having an important role in physiological cellular homeostasis.   This retrospective study analyzed 240 women consisting of 80 ovarian endometriosis,…

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A highly sensitive Immunohistochemical Marker for Stromal Cells in endometriosis

Endometriosis is diagnosed histopathologically by the presence of endometrium-like tissues outside the uterus. Positive CD10 immunohistochemistry, highlighting stromal cells of the endometrium, is a useful adjunct for pathologists in the tissue diagnosis. However, CD10 expression is not specific to endometrial stromal cells and is found in other cells such as hematopoietic, renal tubular and smooth muscle cells. Previous studies of endometrial stroma and endometrial stromal neoplasms showed that IFITM1 is more specific to the endometrial stromal cells than CD10.  In this study…

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Anti-inflammatory cytokines: a new horizon in endometriosis with possible clinical relevance

Scientists led by Dr. Li from Shangai PRC, have made a comprehensive review of anti-inflammatory cytokines related to the pathogenesis of endometriosis in a recent issue of Cellular and Molecular Life Sciences.    Inflammation is important in the pathogenesis of endometriosis, particularly at the early stages thus it is stated that endometriosis is an inflammatory disease. It is well known that increased levels of pro-inflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and IL-17A, are present in the…

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Nutraceuticals may help for endometriosis pain

 Dysmenorrhea and chronic pelvic pain occur in endometriosis patients in a significant percentage. Anti-inflammatory medications and lifestyle changes including diet form the integrated approach in this regard. However, the medications can be used only for the short term. Natural substances with anti-inflammatory properties for this purpose may be effective. Italian physicians conducted a multi-center prospective study on 60 women aged between 20 and 39 with ovarian endometrioma and chronic pelvic pain for one year. The results were published in "Minerva Ginecologica". All women…

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