Eylül GÜN, MD

Dr Gun is a histopathologist who graduated from Aydin Adnan Menderes University and completed her surgical pathology training in Izmir Katip Celebi University Ataturk Training and Research Hospital in Turkey. She has presented her studies as a bursary awardee many times in the international congresses of the European Society of Pathology. She is a Diplomate of the Royal College of Pathologists, UK. She is interested in gynecological and urological pathology and has been doing research on these subjects. 

Molecular alterations in endometriosis pathogenesis

Endometriosis has been in our lives for decades, however little is known about its pathogenesis making it hard to diagnose and manage. A review study conducted by Balasubramanian et al. from India reveals all the characteristics and the underlying conditions in the pathogenesis of endometriosis from a wide angle aiming to help understand the problem better and find new therapeutic targets. The article was recently published in the journal Cellular Signaling. The authors talk briefly about the incidence, pathophysiology, suggested…

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Endometriosis, pelvic inflammatory disease and ovarian cancer

Endometriosis is a locally aggressive and chronic inflammatory disease and it is now known that with various genetic pathways it creates susceptibility to certain cancers, the most common being ovarian cancer. Pelvic inflammatory disease on the other hand creates a dysbiotic pelvic microenvironment that results in extensive chronic inflammation and genomic instability which may then cause endometriosis and ovarian cancer. In order to assess this possible relationship, a group of researchers from Taiwan conducted a large retrospective cohort study where…

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“Sirtuin-3” as a novel target in endometriosis pathogenesis

The energy that is needed for a normal cell function is produced in the mitochondria. While producing this energy, a complex and cyclical process occurs with many proteins and enzymes. Enzymes such as glutamate dehydrogenase and succinate dehydrogenase play important roles in mitochondrial metabolism namely oxidative phosphorylation which is responsible for the formation and the mediation of reactive oxygen species. The activities of these enzymes are regulated by some acetylation and deacetylation reactions. Sirtuins are a protein family that takes…

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Ovarian cancer risk in endometriosis and adenomyosis

Through the historical development of the nomenclature for endometriotic tissue found inside and/or outside the uterus, many terminologies have been used. The accepted terminology is still the one introduced by Sampson: “Endometriosis”. “Adenomyosis” also known as “endometriosis interna” which is the presence of endometrial glands and stroma in the myometrial tissue, was later described as a separate entity. Even though the latest research has been mostly about endometriosis, there is an increasing focus on adenomyosis as well. It has been…

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Endogenous cannabinoids are related to endometriosis pain

Pain, specifically dysmenorrhea is the most important symptom of endometriosis. Prostaglandins are the main director of the pain process in dysmenorrhea, therefore the mechanisms affecting the prostaglandin metabolism have been studied in order to find a treatment for pain, and found that in primary dysmenorrhea, the pain originates from the released prostaglandins at the beginning of the menses, leading to abnormal uterine contractions. Cannabinoids are compounds found in cannabis. Two key endogenous cannabinoids in tissues, anandamide (AEA) and 2-arachidonoylglyerol (2-AG) are similar to cannabinoids, but produced…

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Not all endometriotic lesions behave similar to the eutopic endometrium

The most widely accepted theory of endometriosis pathophysiology is Sampson’s theory of retrograde menstruation which suggests the ectopic lesions undergo the same hormonal and morphological changes as eutopic endometrium during the menstrual cycle. Recent studies have shown that only a proportion of endometriotic lesions follow this rule whereas others behave independently in terms of the changes during the menstrual cycle. Dr. Colgrave and colleagues from Australia and New Zealand have published an opinion article in the September issue of the…

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A new "nonhormonal" treatment target in endometriosis

Endometriosis is a chronic inflammatory condition that affects millions of women globally. With pelvic pain being its most common symptom, the cost of the treatment of disease-associated symptoms has been found to be almost as high as type 2 diabetes. The severity of the pain does not correlate well with the surgical stage because of neural sensitization and all available treatment options are limited. With the aim of finding a new treatment target, researchers from various countries including the UK,…

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A new assessment tool for the multi-dimensional burden of endometriosis

Endometriosis is a disease that has multiple effects on patients’ lives in various ways. The quality of life, the status of the patient’s relationships, the continuity and productivity in the patient’s education and work environment, and psychological, emotional, and even financial condition of the patient all hang on by a thread. One of the most important things that impact the patient’s well-being is patient-physician communication. Most patients complain about not being understood well by their healthcare provider in terms of…

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Non-invasive Construction of Endometrial Organoids

Organoids are 3D culture structures established in vitro and they reflect the aspects of the tissue or the organ they represent. They are seen as important tools in the evaluation of normal development, disease course, and the prediction of the drug effects. Endometrial organoids have been shown to be useful in evaluating the pathogenesis of many processes including maternal-fetal interactions in early pregnancy and pathophysiology of certain gynecological disorders such as endometriosis and endometrial cancer. In previous studies, endometrial organoids…

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Endometriosis & adolescents: Overcoming the diagnostic delay via education

Although the diagnosis of endometriosis is still not timely even in adults, due to its common under- or misdiagnosis in adolescents, the diagnostic delay may further cause the adolescent women to wait to seek medical treatment.  A group of researchers from the USA has published a review article that brings together a total of 27 studies about the diagnostic delay of endometriosis with the aim of finding the major causes of the delay in adolescents. They used the quality assessment…

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How to measure the length of recto-sigmoid deep endometriosis reliably?

An in-depth assessment is needed when rectosigmoid deep endometriosis is decided to be treated surgically. Surgery carries a lot of risks and it is not always easy to decide which procedure the patient would benefit the most from. Patient-oriented surgical techniques such as discoid resection and shaving have been established as alternatives to more radical methods such as segmental resection. In the pre-surgical diagnosis of deep endometriosis, transvaginal ultrasonography has shown high specificity and sensitivity.  "The International Deep Endometriosis Analysis"…

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Exploring a bonafide biomarker to predict endometriosis

Endometriosis is a complex disease affecting many women in the reproductive age group. As it is important to figure out the mechanisms responsible for the disease, it is also crucial to identify biomarkers that can be used in the diagnosis of the disease knowing the fact that the median delay of endometriosis diagnosis was found to be 8 years. Dr. Kralickova et al. recently published a review in the June issue of "Reproductive Sciences" analyzing the results of the studies…

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Is the presence of nerve fibers in the endometrium associated with endometriosis?

Endometriosis is a common disease in reproductive women and diagnostic imaging have a limited role in its diagnosis. The gold standard diagnostic method remains to be the histopathological examination of the tissue obtained via laparoscopy. One of its most common symptoms is pain and the pain generation pathways are still not well understood. Researchers from All India Institute of Medical Sciences, Jodhpur, India performed a prospective study to detect the nerve fibers in patients who presented with chronic pelvic pain…

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Ureteral endometriosis and its management

Urinary tract endometriosis prevalence is hard to determine since almost half of the women with this condition appear asymptomatic. The most common form is bladder endometriosis followed by ureteral endometriosis which is seen more rarely. Ureteral endometriosis is usually located in the distal ureter and may go unnoticed for a long time which may cause the loss of renal function. Dr. Kunlin Yang and colleagues from Peking University First Hospital in Beijing, China have shared their experience on ureteral endometriosis;…

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MicroRNAs in the pathogenesis of endometriosis and infertility

The gold standard in the diagnosis of endometriosis is laparoscopy and histopathological diagnosis, however search for a non-invasive method has been ongoing. Some biomarkers such as Cancer Antigen 125 have been thought to be useful, but because of their low specificity and sensitivity, they cannot aid as a definitive biomarker. In their review study, researchers from Karachi, Pakistan have discussed the role of MicroRNAs as a potential biomarker in endometriosis diagnosis and their role in various mechanisms in the pathogenesis of…

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The relationship between microbiota and endometriosis

Endometriosis is a multifactorial and complex disease that results in an inflammatory state. This persistent inflammatory state is known to cause immune dysregulation. In the immunopathogenesis of endometriosis, activated macrophages, increased neutrophils, impaired natural killer cells, altered T-cell differentiation, and activated B cells all play a role. The presence of bacteria in the gut and uterine microbiome has been thought to contribute to the pathogenetic mechanisms of immune dysfunction in endometriosis. Dr. Jiang and colleagues from the University of British…

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Is the information on Facebook groups about endometriosis accurate?

The use of social media platforms has been increasing day by day. The coronavirus pandemic has attributed to this immensely. Facebook pages and groups are among the most commonly used platforms to share knowledge, seek emotional support, and learn. While there is no control of the posts whatsoever, scientists have been investigating the posted content’s accuracy on many levels. As endometriosis is a chronic disease that affects millions of women worldwide, it’s natural that there are a lot of support…

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What causes distress in women with endometriosis?

Endometriosis is a disease that affects a woman’s life from many different aspects; emotionally, sexually, and physiologically. With the burden of the distress caused by the disease, most women suffer from anxiety and depression. This results in lower self-esteem and poorer body image. The link between endometriosis and physiological distress symptoms is unclear. In order to address and simplify this confusion, Geller et al. from Tel-Aviv, Israel aimed to identify the physiological distress symptoms and mechanisms that are responsible and…

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Migraine, endometriosis and plasma "Calcitonin Gene-Related Peptide"

Calcitonin gene-related peptide (CGRP) is a neurotransmitter that takes part in migraine and is now thought to have a role in endometriosis. The role of CGRP is well known in migraine, it is released from neurons during acute attacks and some findings indicate it also plays a role in the pain in endometriosis. Migraine and endometriosis are frequently seen together, however the role of CGRP during the menstrual period where both of these diseases present with pain has not been studied…

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The genomic linkage between ovarian cancer and endometriosis

Endometriosis has been proven to be the precursor of ovarian clear cell and endometrioid carcinomas, however, it is not well understood why and how endometriosis goes into malignant transformation.  To address this issue, in their review article, Dr. Yachida and colleagues from Niigata University in Japan have shed some light on the molecular mechanisms responsible for the development of ovarian cancer in endometriosis patients which was recently published in "Cancers".  The genes that play a crucial role in the chromatin…

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