المؤلفون: Wesevich, Victoria¹ (AUTHOR), Arici, Aydin¹ (AUTHOR)

المصدر: Gynecological Endocrinology. Apr2021, Vol. 37 Issue 4, p285-286. 2p.

مصطلحات موضوعية: *ENDOMETRIOSIS, *MICRORNA, *RNA, *PROGNOSIS

مستخلص: Endometriosis, defined as the presence of estrogen-responsive endometrial glands and stroma outside the uterus, remains a considerable health challenge. While this allowed for all patients to receive the gold standard in endometriosis diagnosis, ideal to investigate the prognostic value of the serum miRNA panel, it also likely selected for women who had already undergone empiric medical treatment for presumed endometriosis, i.e. were relatively late in their clinical course (average age of 34). [Extracted from the article]

المؤلفون: Özkan, Sebiha¹ sozkan1972@yahoo.com, Arici, Aydin²

المصدر: Gynecologic & Obstetric Investigation. Feb2009, Vol. 67 Issue 2, p81-91. 11p. 4 Charts.

مصطلحات موضوعية: *ENDOMETRIOSIS, *FEMALE reproductive organ diseases, *INFERTILITY, *WOMEN'S health, *GYNECOLOGY

مستخلص: Endometriosis, defined as the presence of endometrial tissue outside the uterus, is a challenging condition associated with substantial morbidity. Management of endometriosis must be individualized according to the desired treatment outcome, whether it is relief of pain, improvement of fertility, or the prevention of recurrence. For alleviation of endometriosis-associated pain, medical treatment is generally successful, with no medical agent being more efficacious than another in spite of significantly differing side-effect profiles. Surgical therapy has also been demonstrated to reduce pain scores in comparison with expectant management, although conservative surgery has been frequently associated with recurrence. The efficacy of combination therapies still remains to be clarified. For treatment of endometriosis-associated infertility, suppressive medical treatment has been proven to be detrimental to fertility and should be discouraged, while surgery is probably efficacious for all stages. Controlled ovarian hyperstimulation with intrauterine insemination is recommended in early-stage and surgically corrected endometriosis. Combined surgery with GnRH analog treatment has been proposed to be first-line therapy, followed by IVF as second-line therapy in advanced cases. More rigorously designed randomized clinical trials focusing on the endocrinological, immunological, and genetic aspects of endometriosis are necessary to refine conclusions regarding the etiopathogenesis and therapeutic innovations of this perplexing disease. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

المؤلفون: Matalliotakis, Ioannis^1,2 matakgr@yahoo.com, Arici, Aydin¹, Cakmak, Hakan¹, Goumenou, Anastasia G.², Koumantakis, Georgios², Mahutte, Neal G.¹

المصدر: Archives of Gynecology & Obstetrics. Dec2008, Vol. 278 Issue 6, p507-511. 5p. 5 Charts.

مصطلحات موضوعية: *ENDOMETRIOSIS, *FEMALE reproductive organ diseases, *FAMILIAL diseases, *OBSTETRICS, *GYNECOLOGY

مستخلص: To investigate the familial aggregation and the risk of endometriosis among the female relatives of women with endometriosis. We also compared the epidemiologic characteristics of women with and without family history of endometriosis. A total of 485 women with endometriosis and 197 infertile women without endometriosis underwent surgical investigation between August 1996 and February 2002. The relative risk of endometriosis in a first-degree relative and the association between potential risk factors was estimated by χ2 and by crude adjusted odds ratios (95% CI). Endometriosis was identified in 9.5% of first-degree relatives of women with endometriosis versus only 1% of controls. The odds ratio for endometriosis in a first-degree relative was 10.21 (95% CI 2.45–42.5; P < 0.001). In 3.9% of cases women with endometriosis reported that their mother had been diagnosed with endometriosis and 5.6% of cases that at least one sister had been diagnosed. Compared to the control group the odds ratio for the mother having endometriosis (7.99, 95% CI 1.06–60.1) or at least one sister having (11.55, 95% CI 1.56–85.59) were significantly elevated. Among women with endometriosis who reported a family history of endometriosis, and women with endometriosis who did not report a family history of endometriosis, there were no differences in demographic characteristics, body habitus, or menstrual parameters. Women with endometriosis have a tenfold increased risk of endometriosis in their first-degree relatives. [ABSTRACT FROM AUTHOR]

المؤلفون: Mahutte, Neal G.¹ Neal.Mahutte@Dartmouth.edu, Arici, Aydin²

المصدر: Fertility & Sterility. Feb2007, Vol. 87 Issue 2, p241-249. 9p.

مصطلحات موضوعية: *LUTEINIZING hormone releasing hormone antagonists, *MEDICAL protocols, *GONADOTROPIN, *PREGNANCY

مستخلص: Objective: To evaluate the role of GnRH antagonists in poor-responder protocols. Design: Literature review. Conclusion(s): The optimum stimulation protocol for poor responders is unknown. Although many IVF programs currently use GnRH antagonists for poor responders, there have been only four prospective, randomized trials comparing GnRH antagonists to alternate protocols. None of these studies had sufficient power to evaluate a difference in pregnancy rates (PRs), and in all four cases, IVF outcomes were comparable. Nevertheless, interest in the use of GnRH antagonists in poor responders has continued. GnRH antagonists may be associated with simpler stimulation protocols, lower gonadotropin requirements, reduced patient costs, and shorter downtimes between consecutive cycles. However, the greatest advantage of GnRH antagonists may lie in the ability to assess ovarian reserves immediately prior to deciding whether or not to initiate gonadotropin stimulation. The ability to respond to cycle-to-cycle variation in antral follicle counts may allow the optimization of oocyte yield and reduce cycle cancellation rates. It remains to be seen if this approach (initiating gonadotropins only in cycles where an adequate antral follicle count is present) also translates into higher clinical PRs for poor responders. [Copyright &y& Elsevier]

المؤلفون: Arici, Aydin¹ aydin.arici@yale.edu, Matalliotakis, Ioannis^1,2, Goumenou, Anastasia², Koumantakis, Georgios², Vassiliadis, Simon³, Mahutte, Neal G.¹

المصدر: Fertility & Sterility. Oct2003, Vol. 80 Issue 4, p889-894. 6p.

مصطلحات موضوعية: *PERITONEUM, *CARCINOGENESIS, *ENDOMETRIOSIS, *INTERLEUKINS

مستخلص: : Objective:Peritoneal fluid (PF) inflammatory factors may participate in the pathogenesis of endometriosis. The aim of this study was to investigate PF interleukin (IL)-18 levels in women with and without endometriosis.: Design:Controlled clinical study.: Setting:Women undergoing laparoscopy at a university hospital.: Patient(s):Fifty women with previously untreated endometriosis, 8 women on GnRH agonists for endometriosis, and 18 control women with normal pelvic anatomy who were undergoing tubal ligation.: Intervention(s):Peritoneal fluid IL-18 levels as measured by ELISA.: Main outcome measure(s):Peritoneal fluid IL-18 levels.: Result(s):Peritoneal fluid IL-18 levels were significantly higher in women with previously untreated endometriosis (mean ± SEM, 91.1 ± 6.5 pg/mL) than in control women (59.4 ± 2.0 pg/mL). Interestingly, women with superficial (100.0 ± 10.2 pg/mL) and deep peritoneal implants (94.0 ± 10.8 pg/mL) had significantly higher PF IL-18 levels than did women with endometriomas (57.8 ± 1.8 pg/mL). Similarly, women with stage I–II endometriosis (97.3 ± 8.0 pg/mL), but not women with stage III–IV endometriosis (74.9 ± 9.9 pg/mL), had significantly higher PF IL-18 levels than did control women. Peritoneal fluid IL-18 levels were significantly higher in the luteal phase than in the follicular phase but did not discriminate between women with pelvic pain or infertility.: Conclusion(s):Peritoneal fluid IL-18 is elevated in women with peritoneal, minimal- to mild-stage endometriosis. [Copyright &y& Elsevier]

المؤلفون: Berkkanoglu, Murat¹, Arici, Aydin¹

المصدر: American Journal of Reproductive Immunology. Jul2003, Vol. 50 Issue 1, p48-59. 12p.

مصطلحات موضوعية: *ENDOMETRIOSIS, *MENSTRUATION, *FEMALE infertility, *FEMALE reproductive organ diseases, *IMMUNOLOGY, *KILLER cells

مستخلص: Problem: Accumulating data suggests that aberrant immune responses during retrograde menstruation may be involved in the development of endometriosis. Method of Study: The role of immunology in the etiology of endometriosis is reviewed and summarized from the available literature. Results: Immunologic factors may affect a woman's susceptibility to implantation of exfoliated endometrial cells. Immune alterations include increased number and activation of peritoneal macrophages, decreased T cell reactivity and natural killer cell cytotoxicity, increased circulating antibodies, and changes in the cytokine network. Conclusion: There is substantial evidence that immunologic factors play a role in the pathogenesis of endometriosis and endometriosis-associated infertility. Decreased natural killer cell cytotoxicity leads to an increased likelihood of implantation of endometriotic tissue. In addition, macrophages and a complex network of locally produced cytokines modulate the growth and inflammatory behavior of ectopic endometrial implants. [ABSTRACT FROM AUTHOR]

المؤلفون: Arici, Aydin, Matalliotakis, Ioannis, Goumenou, Anastasia, Koumantakis, Georgios, Fragouli, Yvoni, Mahutte, Neal G.

المصدر: American Journal of Reproductive Immunology. Feb2003, Vol. 49 Issue 2, p70. 5p.

مصطلحات موضوعية: *BLOOD proteins, *PREGNANCY

مستخلص: PROBLEM: Pregnancy-associated plasma protein-A (PAPP-A) belongs to a group of glycoproteins isolated from extracts of human placenta. Healthy ovarian and uterine tissues are also known to express PAPP-A. We hypothesized that PAPP-A levels might also be elevated in the peritoneal fluid (PF) of women with endometriosis, and examined variations in PF PAPP-A during the menstrual cycle and with the severity of the disease. METHOD OF STUDY: PF PAPP-A were measured in 60 women with endometriosis and 38 women without endometriosis using a highsensitivity immunofluorometric assay. RESULTS: We found that the mean level of PAPP-A was higher in PF from patients with endometriosis than controls (p = 0.003). Furthermore, significant correlation was found between the stages of endometriosis and the levels of PAPP-A in these patients (r = 0.39, p = 0.009). The concentrations of PAPP-A in PF were significantly higher in the secretory phase than the proliferative phase of the menstrual cycle in both women with and without endometriosis (p = 0.009 and P = 0.002, respectively). Finally, among the controls, women undergoing tubal ligation had significantly lower mean PF levels of PAPP-A than women with infertility or pelvic pain (p = 0.001). CONCLUSION: We conclude that PF levels of PAPP-A vary during the menstrual cycle, and are highest in the secretory phase. We also find that PF PAPP-A levels are significantly increased in women with endometriosis, and that the degree of elevation corresponds to the extent of disease. [ABSTRACT FROM AUTHOR]

المؤلفون: Cermik, Dilek¹, Arici, Aydin¹, Taylor, Hugh S.¹ hugh.taylor@yale.edu

المصدر: Fertility & Sterility. Nov2002, Vol. 78 Issue 5, p979-984. 6p.

مصطلحات موضوعية: *GENE expression, *MYOMETRIUM, *MENSTRUAL cycle, *COMPARATIVE studies, *RESEARCH methodology, *MEDICAL cooperation, *PROTEINS, *RESEARCH, *TRANSCRIPTION factors, *UTERINE fibroids, *UTERINE tumors, *EVALUATION research

مستخلص: Objective: To measure HOXA10 gene expression in uterine myometrium and leiomyoma throughout the menstrual cycle.Design: HOXA10 gene expression was measured in paired myometrium and leiomyoma from the same uterus.Setting: University medical center.Patient(s): Thirty-one patients with leiomyoma.Intervention(s): Collection of leiomyoma and myometrial tissue during hysterectomy.Main Outcome Measure(s): HOXA10 gene expression was analyzed by Northern analysis and quantified by laser densitometry.Result(s): Both myometrium and leiomyoma continued to express HOXA10 in the adult and menstrual cycle stage-specific regulation was evident in both tissues. During the mid-secretory phase of the menstrual cycle, HOXA10 expression decreased in both leiomyoma and myometrium. At all points in the menstrual cycle HOXA10 expression in leiomyoma was similar to expression in paired myometrium.Conclusion(s): HOXA10 is expressed in both myometrium and leiomyoma. Coordinated regulation of this transcript factor suggests similar gene activation in both leiomyoma and myometrium. Diminished expression of HOXA10, a gene that normally causes differentiation, may allow increased growth resulting in the increased mitosis seen in the secretory phase. The identification of this developmental control gene in myometrium and leiomyoma may lead to a better understanding of the molecular mechanisms responsible for growth and differentiation of these tissues. [ABSTRACT FROM AUTHOR]

المؤلفون: Matalliotakis, Ioannis, Arici, Aydin, Goumenou, Anastasia, Koumantakis, Georgios, Selam, Belgin, Matalliotakis, Georgios, Koumantakis, Evgenios

المصدر: American Journal of Reproductive Immunology. Sep2002, Vol. 48 Issue 3, p170. 6p. 3 Charts, 5 Graphs.

مصطلحات موضوعية: *CYTOKINES, *SEMINAL proteins

مستخلص: Deals with a study which evaluated the possible relevance of cytokines in seminal plasma of patients with accessory gland infection and oligo-terato-asthenozoospermia. Methods; Results; Discussion; Conclusions.

المؤلفون: Sozen, Ibrahim¹, Arici, Aydin¹ aydin.arici@yale.edu

المصدر: Fertility & Sterility. Jul2002, Vol. 78 Issue 1, p1-12. 12p.

مصطلحات موضوعية: *UTERINE fibroids, *CYTOKINES, *GROWTH factors, *EXTRACELLULAR matrix

مستخلص: Objective: To review the available information regarding the role of cytokines, growth factors, and the extracellular matrix in the pathophysiology of uterine leiomyomata and to integrate this information in a suggested model of disease at the cellular level.Design: A thorough literature and MEDLINE search was conducted to identify the relevant studies in the English literature published between January, 1966 and October, 2001. A model of disease at the cellular level was developed using the most likely cytokines to be involved in the pathogenesis of leiomyomata as determined by our assessment of the available literature.Result(s): A number of cytokines and growth factors, including transforming growth factor-beta (TGF-beta), epidermal growth factor, monocyte chemotactic protein-1, insulin-like growth factors 1 and 2, prolactin, parathyroid-hormone-related peptide, basic fibroblast growth factor, platelet-derived growth factor, interleukin-8, and endothelin, have been investigated in myometrium and leiomyoma. Among these cytokines, TGF-beta appears to be the only growth factor that has been shown to be overexpressed in leiomyoma vs. myometrium, be hormonally-regulated both in vivo and in vitro, and be both mitogenic and fibrogenic in these tissues. In addition to the cytokines, extracellular matrix components such as collagen, fibronectin, proteoglycans, matrix metalloproteinases, and tissue inhibitors of metalloproteinases seem to play pivotal roles in the pathogenesis of leiomyomata.Conclusion(s): We believe that, given the extent and depth of the current research on the cellular biology of leiomyomata, the cellular mechanisms responsible in the pathogenesis of leiomyomata will be identified clearly within the foreseeable future. This will enable researchers to develop therapy directed against the molecules and mechanisms at the cellular level. [ABSTRACT FROM AUTHOR]