Department of Reproductive Medicine, IVIRMA-Barcelona S.L., 08017 Barcelona, Spain.
Group of Biomedical Research in Gynecology, Vall Hebron Research Institute (VHIR) and University Hospital, 08035 Barcelona, Spain.
Int J Mol Sci. 2019 Jul 31;20(15):3740. doi: 10.3390/ijms20153740.
Endometriosis is characterized by the presence of endometrial tissue outside the uterus. While endometriotic tissue is commonly localized in the pelvic cavity, it can also be found in distant sites, including the brain. The origin and pathophysiology of tissue migration is poorly understood; retrograde menstruation is thought to be the cause, although the presence of endometrium at distant sites is not explained by this hypothesis. To determine whether dissemination occurs via the bloodstream in women with endometriosis, we analyzed circulating blood for the presence of endometrial cells. Circulating endometrial stromal cells were identified only in women with endometriosis but not in controls, while endometrial epithelial cells were not identified in the circulation of either group. Our results support the hypothesis that endometrial stromal cells may migrate through circulation and promote the pathophysiology of endometriosis. The detection of these cells in circulation creates avenues for the development of less invasive diagnostic tools for the disease, and opens possibilities for further study of the origin of endometriosis.
子宫内膜异位症的特征是子宫内膜组织出现在子宫以外的部位。虽然子宫内膜异位组织通常局限于盆腔内，但也可出现在远处部位，包括大脑。组织迁移的起源和病理生理学尚不清楚；虽然逆行性月经被认为是导致这种情况的原因，但这种假说并不能解释远处部位存在子宫内膜的现象。为了确定子宫内膜异位症患者的组织是否通过血液传播，我们分析了循环血液中是否存在子宫内膜细胞。只有在子宫内膜异位症患者的血液中才能识别出循环的子宫内膜基质细胞，而在对照组中则没有识别出子宫内膜上皮细胞。我们的结果支持这样一种假设，即子宫内膜基质细胞可能通过血液循环迁移，并促进子宫内膜异位症的病理生理学。这些细胞在循环中的检测为该疾病的开发提供了更具侵入性的诊断工具，并为进一步研究子宫内膜异位症的起源提供了可能性。
