Colorectal endometriosis: morphofunctional and pathogenetic aspects


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Abstract

Despite more than a century of studying the etiology, pathogenesis, and clinical course of endometriosis, advances in its treatment remain very modest from both therapeutic and surgical viewpoints. Colorectal endometriosis is one of the types of deep infiltrating endometriosis. Occurring mainly in reproductive-aged women, the above disease dramatically reduces quality of life in patients, while taking into account the complexity of clinical, pathophysiological, and cellular manifestations, the study of the etiopathogenesis and morphological manifestations of colorectal endometriosis seems relevant. The paper presents the modern concepts of development of deep infiltrating endometriosis, including colorectal endometriosis, in conjunction with its morphological manifestations. Based on data from the modern literature, it can be concluded that the formation of ectopic endometrial foci may be due to discoordination of immune processes and to infiltration of the lesion with various inflammatory cells that affect the expression of matrix metalloproteinases, cytokines, angiogenic factors, neurotrophins, etc. This stimulates angiogenesis and neurogenesis, epithelial-mesenchymal transition, transdifferentiation of fibroblasts into myofibroblasts, as well as stromal cells into smooth muscle cells, which ensures the survival of endometrioid heterotopias. Conclusion: Further study of the profile of various biological substances in ectopic endometrial lesions may contribute to the development of targeted treatments for endometrioid disease.

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About the authors

Zlata O. Krishtal

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: krishtalzlata@mail.ru
student

Alina S. Magnaeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: alinamagnaeva03@gmail.com
Junior Researcher, 1st Pathology Department

Aleksandra V. Asaturova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_asaturova@oparina4.ru
Dr. Med. Sci., Head of 1st Pathology Department

Anna V. Tregubova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_tregubova@oparina4.ru
Junior Researcher, 1st Pathology Department

Vlada V. Kometova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_kometova@oparina4.ru
PhD, Head of the Oncopathology Department

Madina R. Dumanovskaya

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: dumanovskaya@gmail.com
PhD, Researcher, Gynecological Endocrinology Department

Guzal I. Tabeeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: doctor.gtab@gmail.com
PhD, Senior Researcher, Gynecological Endocrinology Department

Natalya A. Buralkina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: ralkina@yandex.ru
Dr. Med. Sci., Senior Researcher at Surgical Department

Vladimir D. Chuprynin

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of General Surgery Department

Roman B. Matronitsky

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: r_matronitskiy@oparina4.ru
endoscopist, General Surgery Department

Stanislav V. Pavlovich

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: s_pavlovich@oparina4.ru
PhD, Academician Secretary

References

  1. Mason B.R., Chatterjee D., Menias C.O., Thaker P.H., Siegel C.L., Yano M. Encyclopedia of endometriosis: a pictorial rad-path review. Abdom. Radiol. (NY). 2020; 45(6): 1587-607. https://dx.doi.org/10.1007/s00261-019-02381-w.
  2. Wang Y., Nicholes K., Shih I.M. The origin and pathogenesis of endometriosis. Annu. Rev. Pathol. 2020; 15: 71-95. https://dx.doi.org/10.1146/annurev-pathmechdis-012419-032654.
  3. Адамян Л.В., Кулаков В.И., Андреева Е.Н. Эндометриозы. Руководство для врачей. 2-е изд. М.: Медицина; 2006.
  4. Hirata T., Koga K., Osuga Y. Extra-pelvic endometriosis: a review. Reprod. Med. Biol. 2020; 19(4): 323-33. https://dx.doi.org/10.1002/rmb2.12340.
  5. Gordts S., Koninckx P., Brosens I. Pathogenesis of deep endometriosis. Fertil. Steril. 2017; 108(6): 872-85. https://dx.doi.org/10.1016/j.fertnstert.2017.08.036.
  6. Nezhat C., Li A., Falik R., Copeland D., Razavi G., Shakib A. et al. Bowel endometriosis: diagnosis and management. Am. J. Obstet. Gynecol. 2018; 218(6): 549-62. https://dx.doi.org/10.1016/j.ajog.2017.09.023.
  7. Habib N., Centini G., Lazzeri L., Amoruso N., El Khoury L., Zupi E., Afors K. Bowel endometriosis: current perspectives on diagnosis and treatment. Int. J. Womens Health. 2020; 12: 35-47. https://dx.doi.org/10.2147/IJWH.S190326.
  8. Yong P.J., Bedaiwy M.A., Alotaibi F., Anglesio M.S. Pathogenesis of bowel endometriosis. Best Pract. Res. Clin. Obstet. Gynaecol. 2021; 71: 2-13. https://dx.doi.org/10.1016/j.bpobgyn.2020.05.009.
  9. Lapointe M., Pontvianne M., Faller E., Lodi M., Futcher F., Lecointre L. et al. Impact of surgery for colorectal endometriosis on postoperative fertility and pregnancy outcomes. J. Gynecol. Obstet. Hum. Reprod. 2022; 51(4): 102348. https://dx.doi.org/10.1016/j.jogoh.2022.102348.
  10. Barra F., Mikhail E., Villegas-Echeverri J.D., Ferrero S. Infertility in patients with bowel endometriosis. Best Pract. Res. Clin. Obstet. Gynaecol. 2021; 71: 161-71. https://dx.doi.org/10.1016/j.bpobgyn.2020.05.007.
  11. Farolfi A., Altavilla A., Morandi L., Capelli L., Chiadini E., Prisinzano G. et al. Endometrioid cancer associated with endometriosis: from the seed and soil theory to clinical practice. Front. Oncol. 2022; 12: 859510. https://dx.doi.org/10.3389/fonc.2022.859510.
  12. Sampson J.A. Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am. J. Pathol. 1927; 3(2): 93-110.43. https://dx.doi.org/10.1016/s0002-9378(15)30003-x.
  13. Gordts S., Koninckx P., Brosens I. Pathogenesis of deep endometriosis. Fertil. Steril. 2017; 108(6): 872-85. https://dx.doi.org/10.1016/j.fertnstert.2017.08.036.
  14. Wang Y., Nicholes K., Shih I.M. The origin and pathogenesis of endometriosis. Annu. Rev. Pathol. 2020; 15: 71-95. https://dx.doi.org/10.1146/annurev-pathmechdis-012419-032654.
  15. Esfandiari F., Mansouri N., Shahhoseini M., Heidari-Khoei H., Mikaeeli G., Vankelecom H., Baharvand H. Endometriosis organoids: prospects and challenges. Reprod. Biomed. Online. 2022; 45(1): 5-9. https://dx.doi.org/10.1016/j.rbmo.2022.03.016.
  16. Tsamantioti E.S., Mahdy H. Endometriosis. In: StatPearls. Treasure Island (FL): StatPearls; 2022.
  17. Bulun S.E., Yildiz S., Adli M., Wei J.J. Adenomyosis pathogenesis: insights from next-generation sequencing. Hum. Reprod. Update. 2021; 27(6): 1086-97. https://dx.doi.org/10.1093/humupd/dmab017.
  18. Abrao M.S., Neme R.M., Carvalho F.M., Aldrighi J.M., Pinotti J.A. Histological classification of endometriosis as a predictor of response to treatment. Int. J. Gynaecol. Obstet. 2003; 82(1): 31-40. https://dx.doi.org/10.1016/s0020-7292(03)00079-1.
  19. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil. Steril. 1997; 67(5): 817-21. https://dx.doi.org/10.1016/s0015-0282(97)81391-x.
  20. Schweppe K.W., Wynn R.M. Endocrine dependency of endometriosis: an ultrastructural study. Eur. J. Obstet. Gynecol. Reprod. Biol. 1984; 17(2-3): 193-208. https://dx.doi.org/10.1016/0028-2243(84)90143-6.
  21. Kamergorodsky G., Ribeiro P.A., Galvao M.A., Abrao M.S., Donadio N., Lemos N.L., Aoki T. Histologic classification of specimens from women affected by superficial endometriosis, deeply infiltrating endometriosis, and ovarian endometriomas. Fertil. Steril. 2009; 92(6): 2074-7. https://dx.doi.org/10.1016/j.fertnstert.2009.05.086.
  22. Al-Lamee H., Hill C.J., Turner F., Phan T., Drakeley A.J., Hapangama D.K., Tempest N. The role of endometrial stem/progenitor cells in recurrent reproductive failure. J. Pers. Med. 2022; 12(5): 775. https://dx.doi.org/10.3390/jpm12050775.
  23. McKinnon B.D., Lukowski S.W., Mortlock S., Crawford J., Atluri S., Subramaniam S. et al. Altered differentiation of endometrial mesenchymal stromal fibroblasts is associated with endometriosis susceptibility. Commun. Biol. 2022; 5(1): 600. https://dx.doi.org/10.1038/s42003-022-03541-3.
  24. Sahraei S.S., Davoodi Asl F., Kalhor N., Sheykhhasan M., Fazaeli H., Moud S.S., Sheikholeslami A. A comparative study of gene expression in menstrual blood-derived stromal cells between endometriosis and healthy women. Biomed. Res. Int. 2022; 2022: 7053521. https://dx.doi.org/10.1155/2022/7053521.
  25. Chopyak V.V., Koval H.D., Havrylyuk A.M., Lishchuk-Yakymovych K.A., Potomkina H.A., Kurpisz M.K. Immunopathogenesis of endometriosis - a novel look at an old problem. Cent. Eur. J. Immunol. 2022; 47(1): 109-16. https://dx.doi.org/10.5114/ceji.2022.113830.
  26. Samimi M., Pourhanifeh M.H., Mehdizadehkashi A., Eftekhar T., Asemi Z. The role of inflammation, oxidative stress, angiogenesis, and apoptosis in the pathophysiology of endometriosis: Basic science and new insights based on gene expression. J. Cell. Physiol. 2019; 234(11): 19384-92. https://dx.doi.org/10.1002/jcp.28666.
  27. Ortiz C.N., Torres-Reveron A., Appleyard C.B. Metabolomics in endometriosis: challenges and perspectives for future studies. Reprod. Fertil. 2021; 2(2): R35-R50. https://dx.doi.org/10.1530/RAF-20-0047.
  28. Liang Y., Wu J., Wang W., Xie H., Yao S. Pro-endometriotic niche in endometriosis. Reprod. Biomed. Online. 2019; 38(4): 549-59. https://dx.doi.org/10.1016/j.rbmo.2018.12.025.
  29. Golqbek-Grenda A., Olejnik A. In vitro modeling of endometriosis and endometriotic microenvironment - Challenges and recent advances. Cell. Signal. 2022; 97: 110375. https://dx.doi.org/10.1016/j.cellsig.2022.110375.
  30. Abramiuk M., Grywalska E., Malkowska P., Sierawska O., Hrynkiewicz R., Niedzwiedzka-Rystwej P. The role of the immune system in the development of endometriosis. Cells. 2022; 11(13): 2028. https://dx.doi.org/10.3390/cells11132028.
  31. Lee H.C., Tsai S.J. Endocrine targets of hypoxia-inducible factors. J. Endocrinol. 2017; 234(1): R53-R65. https://dx.doi.org/10.1530/JOE-16-0653.
  32. Lai Z.Z., Yang H.L., Ha S.Y., Chang K.K., Mei J., Zhou WJ. et al. Cyclooxygenase-2 in endometriosis. Int. J. Biol. Sci. 2019; 15(13): 2783-97. https://dx.doi.org/10.7150/ijbs.35128.
  33. Wang S., Duan H., Li B., Hong W., Li X., Yiyi Wang Y. et al. BDNF and TrKB expression levels in patients with endometriosis and their associations with dysmenorrhoea. J. Ovarian Res. 2022; 15(1): 35. https://dx.doi.org/10.1186/s13048-022-00963-9.
  34. Yu X., Ren H., Liu T., Yong M., Zhong H. Expression and significance of ERβ and TrkB in endometriosis. Clin. Exp. Obstet. Gynecol. 2016; 43(1): 75-81.
  35. Kobayashi H., Yamada Y., Morioka S., Niiro E., Shigemitsu A., Ito F. Mechanism of pain generation for endometriosis-associated pelvic pain. Arch. Gynecol. Obstet. 2014; 289(1): 13-21. https://dx.doi.org/10.1007/s00404-013-3049-8.
  36. Barcena de Arellano M.L., Arnold J., Lang H., Vercellino G.F., Chiantera V., Schneider A., Mechsner S. Evidence of neurotrophic events due to peritoneal endometriotic lesions. Cytokine. 2013; 62(2): 253-61. https://dx.doi.org/10.1016/j.cyto.2013.03.003.
  37. Wang G., Tokushige N., Markham R., Fraser I.S. Rich innervation of deep infiltrating endometriosis. Hum. Reprod. 2009; 24(4): 827-34. https://dx.doi.org/10.1093/humrep/den464.
  38. Gori M., Luddi A., Belmonte G., Piomboni P., Tosti C., Funghi L. et al. Expression of microtubule associated protein 2 and synaptophysin in endometrium: high levels in deep infiltrating endometriosis lesions. Fertil. Steril. 2016; 105(2): 435-43. https://dx.doi.org/10.1016/j.fertnstert.2015.10.024.
  39. Godin S.K., Wagner J., Huang P., Bree D. The role of peripheral nerve signaling in endometriosis. FASEB Bioadv. 2021; 3(10): 802-13. https://dx.doi.org/10.1096/fba.2021-00063.
  40. Kobayashi H., Yamada Y., Morioka S., Niiro E., Shigemitsu A., Ito F. Mechanism of pain generation for endometriosis-associated pelvic pain. Arch. Gynecol. Obstet. 2014; 289(1): 13-21. https://dx.doi.org/10.1007/s00404-013-3049-8.
  41. Velho R.V., Taube E., Sehouli J., Mechsner S. Neurogenic inflammation in the context of endometriosis-what do we know? Int. J. Mol. Sci. 2021; 22(23): 13102. https://dx.doi.org/10.3390/ijms222313102.
  42. Anaf V., El Nakadi I., Simon P., Van de Stadt J., Fayt I., Simonart T., Noel J.C. Preferential infiltration of large bowel endometriosis along the nerves of the colon. Hum. Reprod. 2004; 19(4): 996-1002. https://dx.doi.org/10.1093/humrep/deh150.

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