Lack of association between serotonin transporter 5-HTT gene polymorphism and endometriosis in an Italian patient population

Background: The aim of this study was to determine whether the serotonin transporter gene (5-HTT), a key component in the control of the serotonergic system, is associated with endometriosis in an Italian population. Findings. A case-control study, comprising 137 Italian patients with surgically confirmed endometriosis and 120 healthy controls, was carried out. 5-HTT genotypes (LL, SL and SS) were obtained by polymerase chain reaction and gel electrophoresis analysis. We found no overall difference in genotypic and allelic distributions of the 5-HTT gene between cases and controls. Conclusions: Our results suggest that the 5-HTT L/S promoter polymorphism is not associated with susceptibility to endometriosis in the studied Italian patients. © 2014 Megiorni et al.; licensee BioMed Central Ltd

RELATIONSHIP BETWEEN NICKEL ALLERGIC CONTACT MUCOSITIS AND NICKEL-RICH DIET IN SYMPTOMATIC WOMEN SUFFERING FROM ENDOMETRIOSIS

BACKGROUND AND AIM: Nickel (Ni) is a ubiquitous element in nature (5% of the Earth's crust) and the gastrointestinal tract is an important route of exposure for humans. Once ingested, alimentary Ni often results in allergic contact mucositis (ACM). Ni ACM is an emerging gastrointestinal disorder involving a type IV delayed hypersensitivity reaction and has an estimated prevalence that exceeds 30% of the general population. The resulting Ni-induced low-grade inflammation may present with both IBS-like symptoms and extra-intestinal manifestations. Gastrointestinal symptoms are also present in many women with endometriosis and Ni allergic contact dermatitis has already been observed in these women. Therefore, intestinal and extra-intestinal symptoms complained in endometriosis may depend on a Ni ACM. What is more, a low-Ni diet could suggestively improve symptoms. We wanted to study the prevalence of Ni ACM in women with symptomatic endometriosis and focus on the effects of a low-Ni diet on gastrointestinal, extra-intestinal and gynecological symptoms in this category of patients. MATERIAL AND METHODS: We consecutively recruited 34 women of fertile age (range 23-47 years, mean age 35 years) with endometriosis, symptomatic for gastrointestinal disorders. Sixteen out of 34 patients completed the study. They underwent Ni oral mucosa patch test (omPT), low-Ni diet and questionnaire for intestinal symptoms (abdominal pain, heartburn, acid regurgitation, bloating, nausea, borborygmus, abdominal distension, eructation, flatus, decreased or increased passage of stools, loose or hard stools, urgent need for defecation, incomplete evacuation, oral/tongue lesions), extra-intestinal symptoms (dermatitis, headache, foggy mind, fatigue, numbness of the limbs, joint/muscle pains, fainting) and gynecological symptoms (pelvic pain, dysmenorrhea, dyspareunia). Clinical evaluation was performed at baseline (T0) and after 3 months (T1). RESULTS: Fourteen out 16 (87.5%) patients showed Ni omPT positive results, with Ni ACM diagnosis, whereas 2 out of 16 (12.5%) patients showed negative Ni omPT. After 3 months of low-Ni diet, all gastrointestinal, extra-intestinal and gynecological symptoms showed a statistically significant reduction (p <0.05) or a downward trend. CONCLUSIONS: Given the resulting high prevalence of Ni ACM and the significant clinical benefit obtained with a low-Ni diet, Ni-rich foods may be the trigger of gastrointestinal, extra-intestinal and gynecological symptoms complained by women with endometriosis

Avoiding Inappropriate Surgery on Undetermined Mass: May the Combination of Magnetic Resonance Imaging (MRI) and Ovarian Markers Be Helpful?

In order to avoid inappropriate surgery on an ovarian mass, it is essential to correctly classify the mass whether benign or malignant. The aim of the study is to evaluate diagnostic accuracy of MRI associated to human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA-125) serum levels in discriminating benign and malignant ovarian masses

HPV/Chlamydia trachomatis co-infection: metagenomic analysis of cervical microbiota in asymptomatic women

HPV and Chlamydia trachomatis are the most common causes of sexually transmitted diseases worldwide. Most infections are asymptomatic and left untreated lead to severe reproductive tract sequelae such as cervical cancer and infertility. Interestingly, C. trachomatis may also increase the susceptibility to HPV infection as well as contribute to viral persistence. Recently, a growing body of evidence has suggested that the composition of the cervico-vaginal microbiota plays a key role in the susceptibility and outcome of genital infections caused by several pathogens, including HPV and C. trachomatis. The aim of our study was to undertake a metagenomic analysis of sequenced 16s rRNA gene amplicons to characterize the cervical microbiota from asymptomatic women with HPV/C. trachomatis co-infection. The composition of the cervical microbiota from HPV-positive or C. trachomatis-positive women was also analysed. The main finding of our study showed that the cervical microbiota in HPV/C. trachomatis co-infected women had a higher microbial diversity than the cervical microbiota in healthy controls (p<0.05). In addition, Aerococcus christensenii was associated with C. trachomatis infection. In conclusion, the increased cervical microbial diversity observed in HPV/C. trachomatis co-infected women and the detection of potential microbiological biomarkers of C. trachomatis infection will open the way to innovative approaches that may be helpful to identify women at risk of co-infection

Selected immunological mediators and cervical microbial signatures in women with chlamydia trachomatis infection

ABSTRACT In the female genital ecosystem, the complex interplay between the host immune system and the resident microflora protects against urogenital pathogens, like Chlamydia trachomatis. C. trachomatis is responsible for urethritis and cervicitis; however, most chlamydial infections are asymptomatic and, thus, not treated, potentially leading to severe reproductive sequelae. Here we investigated the interaction between the levels of selected immune mediators and the community state types of the cervical microbiota in C. trachomatis-infected women. Cervical samples from 42 C. trachomatis-positive women and 103 matched healthy controls were analyzed through the metagenomic analysis of the hypervariable region v4 of the 16S rRNA gene and the determination of lactoferrin, interleukin (IL) 1- alpha , IL-6, interferon-alpha IFN- beta, and IFN-gamma by ELISA. Overall, C. trachomatis infection was significantly associated with a microbiota dominated by anaerobic bacteria (P = 0.000002). In addition, a network of Gardnerella vaginalis, Prevotella amnii, Prevotella buccalis, Prevotella timonensis, Aerococcus christensenii, and Variovorax guangxiensis has been identified as a potential biomarker of C. trachomatis infection through multiple statistical approaches. Again, chlamydial infection was significantly correlated with an increased production of lactoferrin, IL-6, IL-1 alpha, IFN-alpha, and IFN-Beta (P &lt; 0.05), whereas very low levels of IFN-gamma were observed in C. trachomatis-infected women, levels similar to those detected in healthy women. Our findings show a distinctive signature of C. trachomatis genital infection, characterized by a specific bacterial network, constituted by anaerobes, as well as by increased levels of lactoferrin and proinflammatory cytokines (IL-1 alpha, IL-6, IFN-alpha, and IFN-beta), accompanied by low levels of IFN-gamma