Colorectal endometriosis: morphofunctional and pathogenetic aspects

DOI

https://dx.doi.org/10.18565/aig.2022.10.28-36

Krishtal Z.O., Magnaeva A.S., Asaturova A.V., Tregubova A.V., Kometova V.V., Dumanovskaya M.R., Tabeeva G.I., Buralkina N.A., Chuprynin V.D., Matronitsky R.B., Pavlovich S.V.
1) I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia

Despite more than a century of studying the etiology, pathogenesis, and clinical course of endometriosis, advances in its treatment remain very modest from both therapeutic and surgical viewpoints. Colorectal endometriosis is one of the types of deep infiltrating endometriosis. Occurring mainly in reproductive-aged women, the above disease dramatically reduces quality of life in patients, while taking into account the complexity of clinical, pathophysiological, and cellular manifestations, the study of the etiopathogenesis and morphological manifestations of colorectal endometriosis seems relevant. The paper presents the modern concepts of development of deep infiltrating endometriosis, including colorectal endometriosis, in conjunction with its morphological manifestations. Based on data from the modern literature, it can be concluded that the formation of ectopic endometrial foci may be due to discoordination of immune processes and to infiltration of the lesion with various inflammatory cells that affect the expression of matrix metalloproteinases, cytokines, angiogenic factors, neurotrophins, etc. This stimulates angiogenesis and neurogenesis, epithelial-mesenchymal transition, transdifferentiation of fibroblasts into myofibroblasts, as well as stromal cells into smooth muscle cells, which ensures the survival of endometrioid heterotopias.
Conclusion: Further study of the profile of various biological substances in ectopic endometrial lesions may contribute to the development of targeted treatments for endometrioid disease.

deep infiltrating endometriosis

colorectal endometriosis

endometrioid heterotopia

Full text (in Russian)

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Received 19.09.2022

Accepted 03.10.2022

Zlata O. Krishtal, student, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), krishtal.zlata@mail.ru
https://orcid.org/0000-0003-4698-1994 119991, Russia, Moscow, Trubetskaya str., 8-2.
Alina S. Magnaeva, Junior Researcher, 1st Pathology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, alinamagnaeva03@gmail.com, https://orcid.org/0000-0001-5223-9767, 117997, Russia, Moscow, Oparina str., 4.
Aleksandra V. Asaturova, Dr. Med. Sci., Head of 1st Pathology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
a_asaturova@oparina4.ru, https://orcid.org/0000-0001-8739-5209, 117997, Russia, Moscow, Oparina str., 4.
Anna V. Tregubova, Junior Researcher, 1st Pathology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, a_tregubova@oparina4.ru.
https://orcid.org/0000-0003-4601-1330, 117997, Russia, Moscow, Oparina str., 4.
Vlada V. Kometova, PhD, Head of the Oncopathology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, v_kometova@oparina4.ru, https://orcid.org/0000-0001-9666-6875, 117997, Russia, Moscow, Oparina str., 4.
Madina R. Dumanovskaya, PhD, Researcher, Gynecological Endocrinology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, dumanovskaya@gmail.com, https://orcid.org/0000-0001-7286-6047, 117997, Russia, Moscow, Oparina str., 4.
Guzal I. Tabeeva, PhD, Senior Researcher, Gynecological Endocrinology Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
doctor.gtab@gmail.com, https://orcid.org/0000-0003-1498-6520, 117997, Russia, Moscow, Oparina str., 4.
Natalya A. Buralkina, Dr. Med. Sci., Senior Researcher, General Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
n_buralkina@oparina4.ru, https://orcid.org/0000-0001-5109-6725, 117997, Russia, Moscow, Oparina str., 4.
Vladimir D. Chuprinin, PhD, Head of General Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, v_chuprynin@oparina4.ru,
https://orcid.org/0000-0002-2997-9019, 117997, Russia, Moscow, Oparina str., 4.
Roman B. Matronitsky, endoscopist, General Surgery Department, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, r_matronitskiy@oparina4.ru https://orcid.org/0000-0001-8739-5209, 117997, Russia, Moscow, Oparina str., 4.
Stanislav V. Pavlovich, PhD, Academician Secretary, Academician V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, s_pavlovich@oparina4.ru,
https://orcid.org/0000-0002-1313-7079, 117997, Russia, Moscow, Oparina str., 4.

Authors’ contributions: The authors declare that their authorship complies with the international ICMJE criteria. All the authors have equally participated in the preparation of the publication: Krishtal Z.O., Magnaeva A.S., Asaturova A.V., Tregubova A.V., Kometova V.V., Dumanovskaya M.R., Tabeeva G.I., Buralkina N.A., Chuprynin V.D., Matronitsky R.B., Pavlovich S.V. – development of the concept of the article, obtaining and analysis of the actual data, writing and editing the text of the article, verification and approval of the text of the article.
Conflicts of interest: The authors declare that there are no manifest and potential conflicts of interest related to the publication of the present article.
Funding: The literature review has been supported by the Government of the Russian Federation. The investigation has been conducted within the framework of the state assignment of the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology (No. 122020900125-8).
For citation: Krishtal Z.O., Magnaeva A.S., Asaturova A.V., Tregubova A.V., Kometova V.V., Dumanovskaya M.R., Tabeeva G.I., Buralkina N.A., Chuprynin V.D., Matronitsky R.B., Pavlovich S.V. Colorectal endometriosis: morphofunctional and pathogenetic aspects.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 10: 28-36 (in Russian)
https://dx.doi.org/10.18565/aig.2022.10.28-36

Colorectal endometriosis: morphofunctional and pathogenetic aspects

Krishtal Z.O., Magnaeva A.S., Asaturova A.V., Tregubova A.V., Kometova V.V., Dumanovskaya M.R., Tabeeva G.I., Buralkina N.A., Chuprynin V.D., Matronitsky R.B., Pavlovich S.V.

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