title: Panel of Autoimmune Markers for Noninvasive Diagnosis of Minimal-Mild Endometriosis.
abstract: Endometriosis, characterized by the presence of endometrial-like tissue at extrauterine sites, is a common, chronic, estrogen-dependent, inflammatory condition associated with pelvic pain, subfertility, dysmenorrhea, and dyspareunia, affecting about 10% of reproductive-age women in any population. The diagnosis of endometriosis is usually delayed on an average by 8 to 11 years leading to significant consequences in terms of disease progression. The current study was aimed to validate enzyme-linked immunosorbent assay based on the epitopes of stomatin-like protein 2, tropomodulin 3 (TMOD3), and tropomyosin 3 (TPM3) for diagnosis of minimal-mild endometriosis (revised American Fertility Society Classification (rAFS) stage I-II) and to compare the performance with the reported markers: cancer antigen (CA) 125, CA19-9, α-enolase, Serine/threonine-protein kinase (PDIK1L), and syntaxin 5. This was a cross-sectional, multicenter study conducted during the year 2012 to 2015. Women with minimal-mild endometriosis (rAFS stage I-II [n = 133]) and healthy controls (n = 104) were screened for 11 novel autoimmune markers and reported markers α-enolase, PDIK1L, syntaxin 5, CA-125, and CA19-9. The sensitivity and diagnostic accuracy of serum antibodies against all the 11 epitopes were higher than that of CA-125, CA19-9, α-enolase, PDIK1L, and syntaxin 5 for diagnosis of rAFS stage I to II endometriosis. The sensitivity of 6 biomarkers (anti-TMOD3b-autoAb, anti-TMOD3c-autoAb, anti-TMOD3d-autoAb, anti-TPM3a-autoAb, anti-TPM3c-autoAb, and anti-TPM3d-autoAb) was higher at the specificity of ≥80% for diagnosis of rAFS stage I to II endometriosis as well as ultrasound-negative endometriosis. Further, logistic regression models of this panel of biomarkers showed increase in sensitivity, specificity, and diagnostic accuracy than individual biomarkers. The panel of 6 autoimmune biomarkers could be useful in setting up of noninvasive diagnostic test for detection of minimal-mild endometriosis.
authors.affiliation: 1 Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gajbhiye
authors.affiliation: 1 Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Trupti
authors.initials: T
authors.lastname: Bendigeri
authors.affiliation: 1 Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Arun
authors.initials: A
authors.lastname: Ghuge
authors.affiliation: 1 Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Kashmira
authors.initials: K
authors.lastname: Bhusane
authors.affiliation: 2 Department of Biostatistics, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Shahina
authors.initials: S
authors.lastname: Begum
authors.affiliation: 3 Sanjivani Diagnostic Centre and General Maternity Home, Mumbai, India.
authors.forename: Neeta
authors.initials: N
authors.lastname: Warty
authors.affiliation: 3 Sanjivani Diagnostic Centre and General Maternity Home, Mumbai, India.
authors.forename: Raj
authors.initials: R
authors.lastname: Sawant
authors.affiliation: 4 Dr Kedar's Maternity, Infertility, and Surgical Hospital, Endoscopy and IVF Center, Goa, India.
authors.forename: Kedar
authors.initials: K
authors.lastname: Padte
authors.affiliation: 5 Department of Obstetrics and Gynecology, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Humane
authors.affiliation: 6 Spectrum Clinic and Endoscopy Research Institute, Kolkata, West Bengal, India.
authors.forename: Pramathes
authors.initials: P
authors.lastname: Dasmahapatra
authors.affiliation: 7 Department of Obstetrics and Gynecology, Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, India.
authors.forename: Anahita
authors.initials: A
authors.lastname: Chauhan
authors.affiliation: 1 Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Shagufta
authors.initials: S
authors.lastname: Khan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000097:blood / Q000175:diagnosis*; D000939:Epitopes; D005260:Female; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D017346:Protein Serine-Threonine Kinases / Q000097:blood; D050765:Qa-SNARE Proteins / Q000097:blood; D012680:Sensitivity and Specificity; D051348:Tropomodulin / Q000097:blood*; D014335:Tropomyosin / Q000097:blood*
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D000939:Epitopes; D008565:Membrane Proteins; D050765:Qa-SNARE Proteins; C406287:STOML2 protein, human; C495836:TMOD3 protein, human; C498783:TPM3 protein, human; D051348:Tropomodulin; D014335:Tropomyosin; C482688:PDIK1L protein, human; D017346:Protein Serine-Threonine Kinases; D010751:Phosphopyruvate Hydratase
keywords: SLP2; TMOD3; TPM3; biomarkers; minimal–mild endometriosis