The Natural History of Spontaneously Occurred Endometriosis in Cynomolgus Monkeys by Monthly Follow-Up Laparoscopy for Two Years
The Natural History of Spontaneously Occurred Endometriosis in Cynomolgus Monkeys by Monthly Follow-Up Laparoscopy for Two Years
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DOI：
10.1620/tjem.251.241
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发表时间：
2020-08-01
影响因子：
2.2
通讯作者：
Ogasawara, Kazumasa
中科院分区：
文献类型：
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作者：
Hayashi, Kaori;Nakayama, Misako;Ogasawara, Kazumasa
子宫内膜异位症是一种子宫内膜组织在子宫外增殖的疾病，是一种进行性疾病，影响育龄妇女。它会导致腹痛和不孕，严重影响年轻女性的生活质量。由于子宫内膜异位症的发病机制复杂，其发生发展机制尚未完全阐明。非人灵长类动物由于在妇科和解剖学上与人类相似，已被用于研究自发性子宫内膜异位症的发病机制。为了揭示食蟹猴子宫内膜异位症的自然病史，我们选择了11只患有自发性子宫内膜异位症的雌性食蟹猴，并进行了每月的腹腔镜检查，绘制了长达两年的子宫内膜异位症病变和粘连的图像。在最初的腹腔镜检查中，45.4%(5/11)的猕猴子宫内膜异位病变仅见于膀胱袋，并随着时间的推移扩散到道格拉斯袋。100%(11/11)的猴出现新生小病变，18.2%(2/11)的猴部分小病变消失。子宫内膜异位症在所有猴子中都会发生，进展速度在个体之间差异很大，这可能是由于月经逆行的程度或频率以及遗传因素；这些发现支持了人类和猴子之间的相似性，从而验证了这种非人类灵长类动物模型的价值。使用非人灵长类动物模型寻找可靠的量化标记物，并揭示与疾病时空发展相关的潜在因素，将有助于更好地管理人类子宫内膜异位症。
Endometriosis, a disease in which endometrial tissue proliferates outside the uterus, is a progressive disease that affects women in reproductive age. It causes abdominal pain and infertility that severely affects the quality of life in young women. The mechanism of the onset and development of endometriosis has not been fully elucidated because of the complex mechanism involved in the disease. Nonhuman primates have been used to study the pathogenesis of spontaneous endometriosis because of their gynecological and anatomical similarities to humans. To reveal the natural history of endometriosis in cynomolgus monkeys, we selected 11 female cynomolgus monkeys with spontaneous endometriosis and performed monthly laparoscopies, mapping endometriotic lesions and adhesions up to two years. At the initial laparoscopy, endometriotic lesions were exclusively found in the vesicouterine pouch in 45.4% (5/11) of the monkeys and spread to the Douglas' pouch over time. Appearance of small de novo lesions and disappearance of some of the small lesions were observed in 100% (11/11) and 18.2% (2/11) of the monkeys, respectively. Endometriosis developed in all monkeys, and the speed of progression varied greatly among individuals that could be attributed to the degree or frequency of retrograde menstruation and genetic factors; these findings support the similarities between humans and monkeys, thus verifying the value of this nonhuman primate model. Finding reliable quantification markers and unravelling the underlying factors in correlation with the spatiotemporal development of the disease using a nonhuman primate model would be useful for the better management of endometriosis in humans.