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Background: Endometriosis affects women of reproductive age, and its pathogenesis is still unclear. Typically, it overlaps other similar medical and surgical conditions, determining a delay in early diagnosis. Metabolomics allows studying metabolic changes in different physiological or pathological states to discover new potential biomarkers. We used the gas chromatography–mass spectrometer (GC–MS) to explore metabolic alterations in endometriosis to better understand its pathophysiology and find new biomarkers. Methods: Twenty-two serum samples of patients with symptomatic endometriosis and ten without it were collected and subjected to GC–MS analysis. Multivariate and univariate statistical analyses were performed, followed by pathway analysis. Results: Partial least squares discriminant analysis was performed to determine the differences between the two groups (p = 0.003). Threonic acid, 3-hydroxybutyric acid, and proline increased significantly in endometriosis patients, while alanine and valine decreased. ROC curves were built to test the diagnostic power of metabolites. The pathway analysis identified the synthesis and degradation of ketone bodies and the biosynthesis of phenylalanine, tyrosine, and tryptophan as the most altered pathways. Conclusions: The metabolomic approach identifies metabolic alterations in women with endometriosis. These findings may improve our understanding of the pathophysiological mechanisms of disease and the discovery of new biomarkers.

/pdf/gas-chromatography-mass-spectrometry-gc-ms-metabolites-26afcwg3.pdf

Gas Chromatography–Mass Spectrometry (GC–MS) Metabolites Analysis in Endometriosis Patients: A Prospective Observational Translational Study

Endometriosis is a chronic inflammatory disease of women of reproductive age. Small bowel (SB) permeability and lipopolysaccharides (LPS) could play a role in the perduration of low grade inflammat...

How is small bowel permeability in endometriosis patients? a case control pilot study

Thirty-three women diagnosed as suffering from vulvar vestibulitis syndrome, marked by a significant history of long-term moderate to severe chronic introital dyspareunia and tenderness of the vulvar vestibule, were selected for treatment.

Vulvar Vestibulitis Syndrome with Electromyographic Biofeedback of Pelvic Floor Musculature

Endometriosis is a common disease affecting women in reproductive age. There are several hypotheses on the pathogenesis of this disease. Often, its lesions and symptoms overlap with those of many other medical and surgical conditions, causing a delay in diagnosis. Metabolomics represents a useful diagnostic tool for the study of metabolic changes during a different physiological or pathological status. We used 1H-NMR to explore metabolic alteration in a cohort of patients with endometriosis in order to contribute to a better understanding of the pathophysiology of the disease and to suggest new useful biomarkers. Thirty-seven patients were recruited for the metabolomic analysis: 22 patients affected by symptomatic endometriosis and 15 not affected by it. Their serum samples were collected and analyzed with 1H-NMR. Multivariate statistical analysis was conducted, followed by univariate and pathway analyses. Partial Least Square Discriminant Analysis (PLS-DA) was performed to determine the presence of any differences between the non-endometriosis and endometriosis samples (R2X = 0.596, R2Y = 0.713, Q2 = 0.635, and p < 0.0001). β-hydroxybutyric acid and glutamine were significantly increased, whereas tryptophan was significantly decreased in the endometriosis patients. ROC curves were built to test the diagnostic power of the metabolites (β-hydroxybutyric acid: AUC = 0.85 CI = 0.71–0.99; glutamine: AUC = 0.83 CI = 0.68–0.98; tryptophan: AUC = 0.75 CI = 0.54–0.95; β-hydroxybutyric acid + glutamine + tryptophan AUC = 0.92 CI = 0.81–1). The metabolomic approach enabled the identification of several metabolic alterations occurring in women with endometriosis. These findings may provide new bases for a better understanding of the pathophysiological mechanisms of the disease and for the discovery of new biomarkers. Trial registration number NCT02337816

/pdf/metabolic-profile-of-patients-with-severe-endometriosis-a-ottc2clchb.pdf

Metabolic profile of patients with severe endometriosis: a prospective experimental study

Endometriosis is a chronic disease that affects women of reproductive age. Chronic pelvic pain, dysmenorrhea, and dyspareunia are its main symptoms; pain alters the quality of life of the patient and affects her health. Since pain is a highly subjective experience, the purpose of this study is to assess the sensory component of pain perception in endometriosis, alongside the affective-emotional and cognitive aspects. These aspects were linked with anamnestic data, anxiety, and depression. We administered appropriate instruments in order to assess these dimensions (QUID — Italian Pain Questionnaire, Biberoglu's Scale, and the HADS Scale), and we evaluated their relationships.

Multidimensional assessment of pain in women with endometriosis: Preliminary results of the experience in Cagliari

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Multidimensional assessment of pain in women with endometriosis: Preliminary results of the experience in Cagliari