L-PGDS (Lipocalin Type- Prostaglandin) Quantification in Genital, Blood and Urine Samples From Adenomyosis Patients Compared to 2 Control Groups.
Prostaglandin D2 (PGD2) has anti-inflammatory activity, particularly via Lipocalin type-prostaglandin (L-PGDS). L-PGDS has been studied in pathologies such as sleep apnea, rheumatoid arthritis, asthma and allergic phenomena, but never in adenomyosis. Adenomyosis is a estrogen-dependent multifactorial pathology whose pathophysiology is still poorly defined. This hyperestrogenism causes chronic inflammation, particularly via the activation of the prostaglandin H2 (PGH2) signaling pathway. This would lead to the excess production of prostaglandins E2 (PGE2) and F2a (PGF2a) and the decrease of PGD2 and therefore of L-PGDS, leading to the proliferation of endometrial cells in the myometrium by the epithelial-mesenchymal transition via aromatase. A preliminary study comparing the expression of L-PGDS found a significant decrease in L-PGDS in the uterus of women with adenomyosis lesions versus healthy controls. However, during this study, some information was not collected, including the patients' symptoms, preoperative radiological data and surgical indication. The study authors hypothesize that L-PGDS could be a potential tissue and circulating diagnostic marker of adenomyosis in its early stages. L-PGDS appears to be a good candidate to aid in the diagnosis of adenomyosis via a minimally invasive assay for patients (blood or urine).
⁃ Common inclusion criteria:
• The patient must have given their free and informed consent and signed the consent form
• The patient must be a member or beneficiary of a health insurance plan
⁃ Adenomyosis + group:
• Female.
• Aged 40 (≥) to 55 (≤) years.
• Multiparous.
• Non-menopausal.
• Having an indication for a total inter-ovarian hysterectomy (excluding oncology).
• Suffering from adenomyosis.
⁃ Adenomyosis - group:
• Female.
• Aged 40 (≥) to 55 (≤) years.
• Multiparous.
• Non-menopausal.
• Having an indication for a total inter-ovarian hysterectomy (excluding oncology).
• Suffering from a functional pathology other than adenomyosis.
⁃ Control Group:
• Female.
• Aged 18 (≥) to 43 (≤) years.
• Nulliparous.
• Asymptomatic: absence of menometrorrhagia and pelvic pain.
• Support at the medically assisted procreation (MAP) center of the Nîmes University Hospital for male or idiopathic infertility.
• Indication to perform an endovaginal ultrasound as part of MAP management.
• Absence of uterine pathology visualized on endovaginal ultrasound.