title: Imbalance between sympathetic and sensory innervation in peritoneal endometriosis.
abstract: To investigate possible mechanisms of pain pathophysiology in patients with peritoneal endometriosis, a clinical study on sensory and sympathetic nerve fibre sprouting in endometriosis was performed. Peritoneal lesions (n=40) and healthy peritoneum (n=12) were immunostained and analysed with anti-protein gene product 9.5 (PGP 9.5), anti-substance P (SP) and anti-tyrosine hydroxylase (TH), specific markers for intact nerve fibres, sensory nerve fibres and sympathetic nerve fibres, respectively, to identify the ratio of sympathetic and sensory nerve fibres. In addition, immune cell infiltrates in peritoneal endometriotic lesions were analysed and the nerve growth factor (NGF) and interleukin (IL)-1β expression was correlate with the nerve fibre density. Peritoneal fluids from patients with endometriosis (n=40) and without endometriosis (n=20) were used for the in vitro neuronal growth assay. Cultured chicken dorsal root ganglia (DRG) and sympathetic ganglia were stained with anti-growth associated protein 43 (anti-GAP 43), anti-SP and anti-TH. We could detect an increased sensory and decreased sympathetic nerve fibres density in peritoneal lesions compared to healthy peritoneum. Peritoneal fluids of patients with endometriosis compared to patients without endometriosis induced an increased sprouting of sensory neurites from DRG and decreased neurite outgrowth from sympathetic ganglia. In conclusion, this study demonstrates an imbalance between sympathetic and sensory nerve fibres in peritoneal endometriosis, as well as an altered modulation of peritoneal fluids from patients with endometriosis on sympathetic and sensory innervation which might directly be involved in the maintenance of inflammation and pain.
authors: Endometriosis Research Centre Charité, Department of Gynaecology, Charité, Campus Benjamin Franklin, Berlin, Germany.
authors: Julia
authors: J
authors: Arnold
authors: Maria L
authors: ML
authors: Barcena de Arellano
authors: Carola
authors: C
authors: Rüster
authors: Giuseppe F
authors: GF
authors: Vercellino
authors: Vito
authors: V
authors: Chiantera
authors: Achim
authors: A
authors: Schneider
authors: Sylvia
authors: S
authors: Mechsner
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000378:metabolism; D049109:Cell Proliferation; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D019922:GAP-43 Protein / Q000378:metabolism; D005727:Ganglia, Spinal / Q000276:immunology / Q000378:metabolism; D005728:Ganglia, Sympathetic / Q000473:pathology; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007150:Immunohistochemistry; D053583:Interleukin-1beta / Q000096:biosynthesis / Q000235:genetics; D010535:Laparoscopy; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009414:Nerve Growth Factors / Q000096:biosynthesis / Q000235:genetics; D011984:Sensory Receptor Cells / Q000473:pathology*; D017154:Stromal Cells / Q000502:physiology; D013373:Substance P / Q000378:metabolism; D013564:Sympathetic Nervous System / Q000473:pathology*; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism; D043222:Ubiquitin Thiolesterase / Q000378:metabolism; D055815:Young Adult
chemical_list: D019922:GAP-43 Protein; D053583:Interleukin-1beta; D009414:Nerve Growth Factors; C482860:UCHL1 protein, human; D013373:Substance P; D014446:Tyrosine 3-Monooxygenase; D043222:Ubiquitin Thiolesterase