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An integrated multi-tissue approach for endometriosis candidate biomarkers: a systematic review
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Edité par CCSD ; BioMed Central -
International audience. Biomarker identification could help in deciphering endometriosis pathophysiology in addition to their usein the development of non invasive diagnostic and prognostic approaches, that are essential to greatly improvepatient care. Despite extensive efforts, no single potential biomarker or combination has been clinically validatedfor endometriosis.Many studies have investigated endometriosis-associated biological markers in specific tissues, but an integrativeapproach across tissues is lacking. The aim of this review is to propose a comprehensive overview of identified biomarkersbased on tissue or biological compartment, while taking into account endometriosis phenotypes (superficial,ovarian or deep, or rASRM stages), menstrual cycle phases, treatments and symptoms.We searched PubMed and Embase databases for articles matching the following criteria: ’endometriosis’ presentin the title and the associated term ’biomarkers’ found as Medical Subject Headings (MeSH) terms or in all fields. Werestricted to publications in English and on human populations. Relevant articles published between 01 January 2005(when endometriosis phenotypes start to be described in papers) and 01 September 2022 were critically analysedand discussed.Four hundred forty seven articles on endometriosis biomarkers that included a control group without endometriosisand provided specific information on endometriosis phenotypes are included in this review. Presence of informationor adjustment controlling for menstrual cycle phase, symptoms and treatments is highlighted, and the results arefurther summarized by biological compartment. The 9 biological compartments studied for endometriosis biomarkerresearch are in order of frequency: peripheral blood, eutopic endometrium, peritoneal fluid, ovaries, urine, menstrualblood, saliva, feces and cervical mucus. Adjustments of results on disease phenotypes, cycle phases, treatmentsand symptoms are present in 70%, 29%, 3% and 6% of selected articles, respectively. A total of 1107 biomarkers wereidentified in these biological compartments. Of these, 74 were found in several biological compartments by at leasttwo independent research teams and only 4 (TNF-a, MMP-9, TIMP-1 and miR-451) are detected in at least 3 tissueswith cohorts of 30 women or more.Integrative analysis is a crucial step to highlight potential pitfalls behind the lack of success in the search for clinicallyrelevant endometriosis biomarkers, and to illuminate the physiopathology of this disease.
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