Eylül GÜN, MD
Dr. Gun is a Turkish histopathologist who currently works in the United Kingdom. She is a member of some national societies as well as international ones such as the European Society of Pathology and the Royal College of Pathologists, UK. She is interested in gynecological and urological pathology and has been doing research on these subjects.
The role of IL-33 and "T-regs" in lesion progression and fibrosis in endometriosis
It has been recognized that immune regulation likely plays a crucial role in endometriosis. Regulatory T cells (Tregs) are important immune regulators, and studies have linked Tregs to endometriosis development through signaling pathways involving TGF-β1 and PDGF. IL-33, an inflammatory molecule, has been found to play a role in tissue injury and fibrogenesis in various organs. It is elevated in endometriosis patients promoting fibrosis. It interacts with Tregs, promoting their activation and secretion of Th2 cytokines, thereby driving type 2…
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Neuroendocrine pathway in endometriosis-related infertility
Dr. Robert Taylor from Jacobs School of Medicine, University at Buffalo presented on the newly defined neuroendocrine pathway and its role in endometriosis-related infertility and how implantation and pregnancy establishment might be disrupted in endometriosis at the Annual International Medical Conference of the Endometriosis Foundation of America held in New York on April 1-2, 2023. It was shown that within the eutopic endometrial cavity, the decidualized stromal phenotype in women with endometriosis is quite different at a molecular level than the normal population. He…
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From inflammation to remission: The promising role of jun kinase inhibitors in endometriosis
Stephen Palmer from Baylor College of Medicine presented his speech at the Annual International Medical Conference of the Endometriosis Foundation of America held in New York on April 1-2, 2023. Dr. Palmer began his talk with a philosophy and a personal statement “Endometriosis is an inflammatory disease." He began by addressing the immune system as a way to resolve pain and inflammation associated with endometriosis. Even though 90% of women experience retrograde menstruation, only 10-15% get endometriosis so there is something fundamentally different about…
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The role of neurogenic inflammation in endometriosis
Prof. Mechsner from Charité—Universitätsmedizin Berlin, Germany presented on neuroimmunomodulation and its clinical impact on endometriosis at the Annual International Medical Conference of the Endometriosis Foundation of America. Endometriosis is a complex disease and the main symptoms are all pain-related. The pain mechanisms are also very complex and involve visceral-somatic pain and peripheral and central sensitization. Dr. Mechsner stated, “That is why I focused my research also on the pathogenesis of endometriosis-related pain. All the patients tell us that they suffer from really severe…
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The relationship between p53 gene polymorphism and endometriosis
The p53 gene is a well-known tumor suppressor gene that plays a crucial role in preventing cancer by regulating cell growth and division. Recent studies suggest that the p53 gene may also be linked to endometriosis. To investigate the relationship between p53 gene polymorphism and endometriosis, Ma et al from China conducted a meta-analysis of published clinical control case studies from 2001 to 2022 with the aim of providing more evidence-based medical data for understanding the internal relationship between gene…
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Anti-IL-8 antibody ameliorates inflammation and fibrosis: A promising treatment for endometriosis
Endometriosis is a condition associated with chronic inflammation and fibrosis, and there are limitations and side effects with current treatments such as hormonal therapy and surgery. Interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP1) are inflammatory cytokines that play a crucial role in the progression of endometriosis by augmenting infiltration and activating immune cells. In an effort to create a disease-modifying drug, a team of researchers from Japan, led by Nishimoto-Kakiuchi, developed a long-lasting antibody that targets IL-8 called AMY109 and…
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Is alcohol a risk factor for endometriosis?
As complex and unclear as endometriosis pathogenesis is, the influence of environmental factors on the inflammation that underlies the pathogenesis of endometriosis has been thoroughly investigated. Lifestyle factors such as diet, caffeine, environment, smoking, and alcohol consumption have been explored for their impact on endometriosis risk. In a previous meta-analysis by the same group of authors in 2013, a significant correlation between alcohol intake and endometriosis occurrence was found. The authors then aimed to confirm these findings through a systematic…
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Hypoxia and endometriosis: A review of mechanisms
Various mechanisms have been suggested to explain the development of endometriosis lesions. One of these is hypoxia, which can induce changes in endometrial cells, but the exact mechanism is not yet clear. Zhou et al from China wrote a review paper about how hypoxia contributes to the disease. It was published in the October 2022 issue of the journal Frontiers in Endocrinology (Lausanne). Lack of oxygen in bodily tissues is a pathological phenomenon called hypoxia, which can lead to cellular…
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Activities of cytotoxic cells in endometriosis
Immunological dysfunction is thought to be involved in the etiopathogenesis of endometriosis, leading to defective immunosurveillance and the growth of endometriotic lesions. In this pathway, reduced cytotoxicity of peripheral and peritoneal natural killer (NK) cells is seen as a contributing factor, however, it is shown that stimulation with interleukin-2 (IL-2) may increase their potential against tumor cells. CD28 and CD160 are markers of T lymphocyte cytotoxicity that have been studied in peripheral blood mononuclear cells of women with endometriosis. CD28…
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The emotions and experiences of women with endometriosis during and after pregnancy
It is well-known that endometriosis patients have a high rate of infertility and a hard time getting pregnant compared to women without endometriosis. Despite the belief that pregnancy can alleviate endometriosis symptoms, some studies have shown that women with endometriosis had a recurrence of moderate or severe pain after delivery. However, pregnancy remains a special period for these women due to the difficulties in achieving pregnancy, temporary relief from symptoms, and higher risk of complications. Researchers from Marseille, France conducted…
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Endometriosis-Associated Pain: The Role of Sensitization
As the most common symptom of the disease, endometriosis-associated pain (EAP) is experienced as dysmenorrhea, non-cyclical pelvic pain, and cyclical pain related to organ function. EAP is contributed to by different mechanisms, including local factors, peripheral sensitization, central sensitization, cross-sensitization, and comorbid persistent pain conditions. McNamara et al. from Melbourne, Australia wrote a mini-review study that aimed to investigate the mechanisms of pain in women with endometriosis and comorbid pain conditions. The study was published in the September 2021 issue…
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Do not underestimate the power of red blood cell evaluation in endometriosis
In an effort to develop an easy-to-use diagnostic marker, research has focused on the pro-inflammatory nature of endometriosis and the raised levels of inflammatory markers. The neutrophil-to-lymphocyte ratio (NLR) has emerged as one of these markers. Moreover, endometriosis has been shown to impact several other red blood cells (RBC) parameters. To assess the associations between different RBC parameters namely the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC), red cell distribution width (RDW), hemoglobin (Hb), hematocrit blood…
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Gastrointestinal symptoms in colorectal deep endometriosis
The colon, particularly the recto-sigmoid is the most commonly involved area in deep endometriosis. These patients suffer from gastrointestinal symptoms almost as much as pelvic pain symptoms the most common being reported as frequent and painful defecation. Gastrointestinal symptoms may be seen in endometriosis patients without deep endometriosis as well owing to various mechanisms such as local irritation, anatomical impairments, inflammatory environment, and coexistence of irritable bowel syndrome. Researchers from Austria and Belgium performed a prospective questionnaire-based study with colorectal deep…
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Creating a reliable indirect immunofluorescence protocol as a promising diagnostic tool for endometriosis
Owing to its inflammatory nature, endometriosis results in the overproduction of reactive oxygen species (ROS) which disrupt the cellular functions and eventually lead the cell to apoptosis and cell cycle arrest. Senescence, the natural state of irreversible cell cycle arrest, induces inflammation and production of ROS just like in endometriosis. The biomarkers that are used in evaluating cellular senescence are shown to be p16 and lamin B1 and the method used for this purpose is indirect immunofluorescence. Palmieri et al.…
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How accurate is ultrasonography in evaluating deep infiltrating endometriosis?
Deep infiltrating endometriosis (DIE) appears to be the most severe form of endometriosis comprising 15-30% of all endometriosis patients. The difference in the presentation of the lesions ranges from simple adhesions to infiltrative nodules. Even though there is no consensus on evaluating the severity of endometriosis, the American Society of Reproductive Medicine classification is widely used but it falls short of accurately capturing the traits of DIE. It is stated that pelvic ultrasonographic examination including transvaginal and rectal ultrasonography is…
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Which parameter is useful in predicting cardiovascular disease risk in perimenopausal endometriosis patients?
Cardiovascular disease is known to be the leading cause of death among women worldwide. Studies have shown that postmenopausal women are at a greater risk as well as women who undergo premature menopause proving the effect of hormonal imbalances on the development of cardiovascular events. The main contributor to cardiovascular disease is atherosclerosis. The assessment of vascular function is performed with arterial stiffness tests: cardio-ankle vascular index (CAVI) which shows arterial elasticity and ankle-brachial index (ABI) which is the ratio…
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Endometriosis Hospitalization Trends in Spain
According to the general assumption, one in every ten women is believed to have endometriosis. However, recent literature shows a big difference in the prevalence rates ranging from 1 to 5%, likely because most cases remain undiagnosed. The need for hospital admissions in endometriosis patients on the other hand has decreased in the latest years owing to the fact that outpatient care for these patients has increased. A group of researchers from Alicante, Spain, led by Dr. A. Queseda conducted…
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Anhedonia and its relation to endometriosis as a sole symptom
"Anhedonia may be defined as a broad category of hedonic function deficiencies, including diminished motivation or enjoyment capacity. It has been an area of interest for a long time in psychiatric disorders and has been crucial in some diagnoses such as being a major criteria component in the diagnosis of major depression. Recently, research on anhedonia has expanded beyond psychiatric illnesses, particularly in chronic health conditions. Upon the newly discovered findings of chronic pain sufferers having increased rates of anhedonia,…
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Epigenetic changes in endometriosis: A new target area for therapy
Epigenetics is the heritable genetic modifications and changes in chromosomes without alterations in the DNA sequence. Numerous mechanisms, like DNA methylation and RNA editing to mention a couple, have been discovered as epigenetic alterations that are triggered by environmental factors. Epigenetics play a role in maintaining the body's homeostasis, and any abnormalities in these mechanisms make way for certain diseases. In autoimmune diseases, the immune system attacks its own cells and many cells have roles in it as immune effectors.…
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Adenomyosis and the anti-mullerian hormone levels
The presence of endometrial glands and stroma in the myometrial layer of the uterus is called adenomyosis. It is considered a form of endometriosis and affects up to 35% of women with varying symptomatology, from asymptomatic to subfertility. For a long time, the diagnosis could only be made in the histological sections of the hysterectomy specimens. Nowadays, new technology and advances in radiological techniques may have made it possible to detect it via transvaginal ultrasound and magnetic resonance imaging. The…
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