Anti-relapse therapy of endometriosis: possible variations

Authors

DOI:

https://doi.org/10.18370/2309-4117.2021.57.38-42

Keywords:

endometriosis, anti-relapse therapy, systemic inflammation, dienogest, bioavailable curcumin

Abstract

Research aim: to determine the clinical efficacy and safety of bioavailable curcumin Longimin® in the complex anti-relapse therapy of patients with extragenital endometriosis after surgery.
Materials and methods. Study involved 45 women with a mean age of 29.3 ± 3.6 years with a diagnosis of extragenital endometriosis. After surgical treatment of this disease all patients were prescribed dienogest 2 mg/day for 6 months with anti-relapse purpose. After that, 22 patients did not receive drug treatment (group 1) and other 23 women started a six-month course of 400 mg bioavailable curcumin (group 2).
Results. After 12 months of observation 3 cases (13.6%) of newly formed foci of endometriosis were found among patients of group 1, two of which were multi-endometriomas, and the third was retrocervical heterotopia. There were no signs of recurrence in the group of sequential use of dienogest and bioavailable curcumin. In addition, 6 months after completion of hormonal treatment the number of women with chronic pelvic pain in group 1 was increased and average score on a visual analogue scale (VAS) was increased by 80% (p ≤0.05). It was accompanied by a stable moderately high level of anxiety throughout the observation period. At the same time the number of women who complained of intermenstrual pain in group 2 decreased from 15 to 13, and the average VAS score decreased by 13% (p ≥0.05) during the treatment period. Patients in group 2 noted an improvement in emotional control during treatment, which resulted in the average score decrease on the scale of personal and situational anxiety of the Spielberg-Hanin's questionnaire (25% and 30% respectively, p ≤0.05).
Conclusions. The nature of the endometriosis development and progression is multipathogenetic. Blocking only its hormonal link, especially in cases of extragenital forms, may not be sufficient to stop the pathological process and prevent recurrence
in the long term. Оbtained results of sequential course of dienogest and bioavailable curcumin Longimin® with anti-relapse purpose showed the wider clinical effectiveness of this therapy, which is probably based on additional inhibition of systemic inflammation, proliferation, stroma and psychogenic component of disease.

Author Biographies

N.F. Zakharenko, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”; Institute for Planning Family Clinic

MD, senior researcher, Endocrine Gynecology Department;

Chairman of the Academic Council

S.I. Regeda, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”; SSI “Center for Innovative Medical Technologies of the NAS of Ukraine”

PhD, senior researcher, Endocrine Gynecology Department;

Head of the Gynecology Department

I.P. Manoliak, SI “O.M. Lukyanova IPOG of the NAMS of Ukraine”

PhD, junior researcher, Endocrine Gynecology Department

V.S. Solskyy, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

PhD, senior researcher, Endocrine Gynecology Department

References

  1. Zaporozhan, V.M., Tatarchuk, T.F., Kaminskyi, V.V., et al. “National consensus on management patients with endometriosis.” Reproductive endocrinology 4.24 (2015): 7–12.
  2. Guo, S.W. “Recurrence of endometriosis and its control.” Hum Reprod 15.4 (2009): 441–61.
  3. Sinaii, N., et al.“Differences in characteristics among 1.000 women with endometriosis based on extent of disease.” Fertil Steril, 89.3 (2008): 538–45.
  4. Seliukova, N.Y., Gladkova, A.I., Koreneva, E.M., et al. “Stress and reproductive disorders: Modern views on the problem and own research experience.” Problemi Endokrinnoi Patologii 1 (2019): 87–94.
  5. Society of Obstetricians and Gynaecologists of Canada. “Endometriosis: Diagnosis and Management. SOGC Clinical practice guideline.” JOGC 32.7 Suppl 2 (2010): S1–S3. DOI: 10.1016/S1701-2163(16)34589-3
  6. Startseva, N.V., Chernikova, I.A., Goncharov, D.V. “Psychosomatic aspects of pain syndrome in endometriosis.” Perm Medical Journal 4.XII (1995): 82–4.
  7. Rizner, T.L. “Estrogen metabolism and action in endometriosis.” Mol Cell Endocrinol 307 (2009): 8–18.
  8. Vouk, K., Smuc, T., Guggenberger, C., et al. “Novel estrogen-related genes end potential biomarkers of ovarian endometriosis identified by differential expression analysis.” J Steroid Biochem Mol Biol 125 (2011): 231–42.
  9. Takahashi, K., Nagata, H., Kitao, M. “Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis.” Nihon Sanka Fujinka Gakkai Zasshi 41 (1989): 1849–50.
  10. Barcz, E., Milewski, Ł., Dziunycz, P., et al. “Peritoneal cytokines and adhesion formation in endometriosis: an inverse association with vascular endothelial growth factor concentration.” Fertil Steril 97.6 (2012): 1380–6.e1.
  11. Taniguchi, F., Harada, T., Miyakoda, H., et al. “TAK1 activation for cytokine synthesis and proliferation of endometriotic cells.” Mol Cell Endocrinol 307.1–2 (2009): 196–204.
  12. Kaponis, A., Iwabe, T., Taniguchi, F., et al. “The role of NF-kappaB in endometriosis.” Front Biosci (Schol Ed) 4 (2012): 1213–34.
  13. Bogatova, I.K., Semenova, O.K. “Psychological features of women with genital endometriosis.” Bulletin of new medical technologies 1.II (2008): 60.
  14. Rubinow, D.R., Schmidt, P.J. “Gonadal steroids, brain and behavior: role of context. Dialogues in clinical neuroscience.” CNS Aspects of Reproductive Endocrinology 4.2 (2002): 123–47.
  15. Donnez, J., Tatarchuk, T.F., Taylor, H.S., et al. “Treatment of endometriosis-associated pain with linzagolix, an oral gonadotropin-releasing hormone–antagonist: a randomized clinical trial.” Fertility and Sterility 114.1 (2020): 44–55.
  16. Brandenberger, A.W., Lebovic, D.I., Tee, M.K., et al. “Oestrogen receptor (ER)-alpha and ER-beta isoforms in normal endometrial and endometriosis-derived stromal cells.” Mol Hum Reprod 5 (1999): 651–5.
  17. Sinha, D., Biswas, J., Sung, B., et al. “Chemopreventive and chemotherapeutic potential of curcumin in breast cancer.“ Curr Drug Targets 13 (2012): 1799–1819. DOI: 10.2174/138945012804545632
  18. Singh, M., Singh, N. “Curcumin counteracts the proliferative effect of estradiol and induces apoptosis in cervical cancer cells.” Molecular and Cellular Biochemistry 347 (2011): 1–11.
  19. Bachmeier, B.E., Mirisola, V., Romeo, F., et al. “Reference profile correlation reveals estrogen-like trancriptional activity of curcumin.” Cell Physiol Biochem 26 (2010): 471–82.
  20. Owens, J.W., Ashby, J. “Critical review and evaluation of the uterotrophic bioassay for the identification of possible estrogen agonists and antagonists: in support of the validation of the OECD uterotrophic protocols for the laboratory rodent.” Crit Rev Toxicol 32 (2002): 445–520.
  21. Ying Zhang, Hong Cao, Zheng Yu, et al. “Curcumin inhibits endometriosis endometrial cells by reducing estradiol production.” Iran J Reprod Med 11.5 (2013): 415–22.
  22. El-Demerdash, F.M., Yousef, M.I., Radwan, F.M. “Ameliorating effect of curcumin on sodium arsenite-induced oxidative damage and lipid peroxidation in different rat organs.” Food Chem Toxicol 47 (2009): 249–54.
  23. Jana, S., Paul, S., Swarnakar, S. “Curcumin as anti-endometriotic agent: Implication of MMP-3 and intrinsic apoptotic pathway.” Biochem Pharmacol 83 (2012): 797–804. DOI: 10.1016/j.bcp.2011.12.030
  24. Sanmukhani, J., Satodia, V., Trivedi, J., et al. “Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial.” Phytother Res 28.4 (2014): 579–85. DOI: 10.1002/ptr.5025

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Published

2021-03-31

How to Cite

Zakharenko, N. ., Regeda, S. ., Manoliak, I. ., & Solskyy, V. . (2021). Anti-relapse therapy of endometriosis: possible variations. REPRODUCTIVE ENDOCRINOLOGY, (57), 38–42. https://doi.org/10.18370/2309-4117.2021.57.38-42

Issue

No. 57 (2021)

Section

Gynecology

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Copyright (c) 2021 Н. Ф. Захаренко, С.І. Регеда Регеда, I.П. Маноляк, В.С. Сольський

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