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Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations

  • Hiroshi Shigetomi , Shogo Imanaka and Hiroshi Kobayashi EMAIL logo
Published/Copyright: December 2, 2021
Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 43 Issue 2

Abstract

Objectives

The balance between oxidative stress and antioxidant defense has been reported to differ between women with endometriosis and patients with its malignant transformation. The aim of this study is to investigate changes in redox balance in endometriosis and endometriosis-related ovarian cancer (EAOC) by simultaneously measuring iron-related compounds and bilirubin.

Methods

This study included 235 patients with a histopathologically confirmed diagnosis of endometriosis (n=178) and EAOC (n=57). Cyst fluid samples were collected in Nara Medical University hospital from January 2013 to May 2019. The levels of iron-related compounds (total iron, heme iron, free iron, oxyhemoglobin [oxyHb], methemoglobin [metHb], and metHb/oxyHb ratio) and bilirubin were measured.

Results

Total iron, heme iron, free iron, metHb/oxyHb ratio, and bilirubin were significantly elevated in endometriosis compared to EAOC. In both endometriosis and EAOC, iron-related compounds in the cyst were correlated with each other. There was no statistically significant difference in oxyHb and metHb levels between the two groups, but the metHb/oxyHb ratio was significantly higher in endometriosis than in EAOC. Bilirubin was positively correlated with total iron and free iron in EAOC, but there was no correlation between bilirubin and iron-related compounds in endometriosis.

Conclusions

Iron-induced oxidative stress in endometriosis may exceed bilirubin-dependent antioxidant capability, while redox homeostasis in EAOC can be maintained by at least bilirubin.

Keywords: antioxidant; bilirubin; endometriosis; endometriosis-associated ovarian cancer; oxidative stress
Corresponding author: Hiroshi Kobayashi, MD, PhD, Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Nara, Japan; and Ms.Clinic MayOne, Kashihara, 634 0813, Japan, Phone: +81 744 29 8877, Fax: +81 744 23 6557, E-mail:

Funding source: Japan Society for the Promotion of Science

Award Identifier / Grant number: 20K09647 and 20K09648

  1. Research funding: This work was supported by Japan Society for the Promotion of Science (JSPS), Grant Numbers 20K09647 and 20K09648.

  2. Author contributions: HS and SI collected clinical data and performed the literature search using the Web database. SI and HK made substantial contribution to conception of the study. HK contributed to the study design and interpretation of included research studies. HS performed statistical work. The final version of the manuscript has been read and approved by all authors.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was conducted under the guidelines that had been approved by the medical ethics committee of the Nara Medical University. The local Institutional Review Board deemed the study exempt from review.

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Received: 2021-07-27
Accepted: 2021-11-22
Published Online: 2021-12-02

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
  4. The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
  5. A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
  6. Appropriate surgical management of ovarian endometrioma: excision or drainage?
  7. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
  8. Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
  9. Endometriosis at all ages: diagnostic ultrasound
  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
  11. Opinion Paper
  12. Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
  13. Review Articles
  14. Fertility preservation in women with early ovarian cancer
  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
  16. Fertility preservation in borderline ovarian tumor patients and survivors
  17. Regular Issue
  18. Original Articles
  19. Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
  20. miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
  21. Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
  22. The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
  23. Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
  24. The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
  25. Review Articles
  26. What is the optimal luteal support in assisted reproductive technology?
  27. The relation between obesity, kisspeptin, leptin, and male fertility
https://doi.org/10.1515/hmbci-2021-0065
Keywords for this article
antioxidant; bilirubin; endometriosis; endometriosis-associated ovarian cancer; oxidative stress

Articles in the same Issue

  1. Frontmatter
  2. Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
  3. Review Articles
  4. The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
  5. A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
  6. Appropriate surgical management of ovarian endometrioma: excision or drainage?
  7. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
  8. Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
  9. Endometriosis at all ages: diagnostic ultrasound
  10. Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
  11. Opinion Paper
  12. Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
  13. Review Articles
  14. Fertility preservation in women with early ovarian cancer
  15. Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
  16. Fertility preservation in borderline ovarian tumor patients and survivors
  17. Regular Issue
  18. Original Articles
  19. Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
  20. miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
  21. Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
  22. The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
  23. Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
  24. The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
  25. Review Articles
  26. What is the optimal luteal support in assisted reproductive technology?
  27. The relation between obesity, kisspeptin, leptin, and male fertility
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