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Molecular Studies of Endometriosis and Associated Diseases

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Biology".

Deadline for manuscript submissions: 21 August 2025 | Viewed by 4852

Special Issue Editor


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Guest Editor
1. Julia Argyrou Endometriosis Centre, Epworth HealthCare, Richmond, VIC 3121, Australia
2. Gynaecology Research Centre, Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and The Royal Women’s Hospital, Parkville, VIC 3052, Australia
Interests: adenomyosis; autoimmune diseases; cardiometabolic conditions; endometriosis

Special Issue Information

Dear Colleagues,

Endometriosis is a common condition, impacting approximately 190 million women, girls and those presumed female at birth. While classically considered a gynecological condition, endometriosis is a chronic, inflammatory and systemic disease that demonstrates short- and long-term detrimental consequences on the whole body. Endometriosis symptomology may include pelvic pain that is cyclical or non-cyclical in nature, heavy menstrual bleeding, infertility, gastrointestinal disturbance, nausea, migraine and or fatigue. It has massive socioeconomical costs for individuals, including financial pressures, absenteeism and reduced quality of life.

Endometriosis is a complex disease, meaning that both environmental and genetic factors play a role in its etiology. Other complexities add weight to the burden of the condition: the exact cause of endometriosis remains to be determined, with several plausible theories existing; both symptom presentation and responsiveness to treatments are extremely heterogenous; there is no definitive cure; non-invasive diagnostic tests are lacking; and people with endometriosis frequently present with other comorbid diseases or are at risk of developing other diseases.

Previous research has shown that individuals with endometriosis will often have several comorbid conditions, which may be directly or indirectly related to endometriosis, including (but not limited to) adenomyosis, pelvic floor muscle dysfunction and mood disorders. The co-existence of multiple conditions can lead to the misdiagnosis or diagnostic delay of endometriosis. It is also recognized that a diagnosis of endometriosis may increase a person’s risk of developing other chronic or life-threatening conditions, including autoimmune diseases, ovarian cancer and cardiometabolic diseases (like cardiovascular disease or stroke). This Special Issue aims to explore the latest studies that improve our understanding of the molecular pathways involved in endometriosis and its associated diseases.

We are encouraging the submission of original research papers and review papers that describe “Molecular Studies of Endometriosis and Associated Diseases”.

Papers that highlight the translational potential of molecular research to clinical applications (including novel technologies that identify new disease biomarkers and diagnostics) are also welcome.

Topics include, but are not limited to, the following:

  • New insights into the molecular and genomic mechanisms of endometriosis and its associated diseases demonstrating causal relationships, similarities and associations.
  • Research studies applying cutting-edge emerging technologies (for example, ‘omics and multi-omics platforms) or the repurposing of existing technologies and methodologies, not previously employed in the setting of endometriosis.
  • New discovery research studying the molecular biomarkers and profiling of endometriosis and associated diseases, including the exploration and comparisons of different phenotypes of disease.
  • Pre-clinical research, including in vitro and animal models, that tests new potential therapies or diagnostics for endometriosis and its associated diseases.

Dr. Sarah J Holdsworth-Carson
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • adenomyosis
  • autoimmune diseases
  • cardiometabolic conditions
  • endometriosis
  • fatigue
  • heavy menstrual bleeding
  • irritable bowel syndrome
  • migraine
  • painful bladder syndrome
  • pelvic floor muscle dysfunction
  • pelvic inflammatory disease
  • pelvic pain
  • peritoneal adhesions
  • polycystic ovarian syndrome
  • pregnancy complications
  • ovarian cancer
  • uterine fibroids

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Published Papers (4 papers)

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Research

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21 pages, 1868 KiB  
Article
Methylation Risk Score Modelling in Endometriosis: Evidence for Non-Genetic DNA Methylation Effects in a Case–Control Study
by Li Ying Thong, Allan F. McRae, Marina Sirota, Linda Giudice, Grant W. Montgomery and Sally Mortlock
Int. J. Mol. Sci. 2025, 26(8), 3760; https://doi.org/10.3390/ijms26083760 - 16 Apr 2025
Viewed by 328
Abstract
Endometriosis is a chronic gynaecological disease characterised by endometrial-like tissue found external to the uterus. While several studies have reported strong evidence of a genetic contribution to the disease, studies on the environmental impact on endometriosis are limited. DNA methylation (DNAm) can be [...] Read more.
Endometriosis is a chronic gynaecological disease characterised by endometrial-like tissue found external to the uterus. While several studies have reported strong evidence of a genetic contribution to the disease, studies on the environmental impact on endometriosis are limited. DNA methylation (DNAm) can be influenced by genetic and environmental factors and serves as a useful biological marker of the effects of genetic and environmental exposures on complex diseases. This study aims to develop a methylation risk score (MRS) for endometriosis to increase the power to detect DNAm signals associated with the disease and enhance our understanding of the pathogenesis of the disease. Endometrial methylation and genotype data from 318 controls and 590 cases were analysed. MRSs were developed using several different models. MRS performances were evaluated by splitting samples into training and test sets based on independent cohort institutions, and the area under the receiver-operator curve (AUC) was calculated. The maximum AUC obtained from the best-performing MRS is 0.6748, derived from 746 DNAm sites. The classification performance of MRS and polygenic risk score (PRS) combined was consistently higher than PRS alone. This study demonstrates that there are DNAm signals independent of common genetic variants associated with endometriosis. Full article
(This article belongs to the Special Issue Molecular Studies of Endometriosis and Associated Diseases)
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18 pages, 3278 KiB  
Article
Cell Migration in Endometriosis Responds to Omentum-Derived Molecular Cues Similar to Ovarian Cancer
by Kah Yee Goh, Su Chin Tham, Terence You De Cheng, Ravichandran Nadarajah, Ronald Chin Hong Goh, Shing Lih Wong, Tew Hong Ho, Ghee Kheng Chew, Andy Wei Keat Tan, Hemashree Rajesh, Hong Liang Chua, Tze Tein Yong, Su Ling Yu, Jia Min Kang, Kah Weng Lau, Amos Zhi En Tay, Sangeeta Mantoo, Inny Busmanis, Sung Hock Chew, Timothy Yong Kuei Lim, Wai Loong Wong, Qiu Ju Ng, Junjie Wang, Sun Kuie Tay, Chit Fang Cheok, Darren Wan-Teck Lim and Elaine Hsuen Limadd Show full author list remove Hide full author list
Int. J. Mol. Sci. 2025, 26(5), 1822; https://doi.org/10.3390/ijms26051822 - 20 Feb 2025
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Abstract
Endometriosis is common and poses significant morbidity of lasting impact to young, pre-menopausal women, while ovarian cancer is a lethal gynecologic condition. Both conditions need better treatment. The human omentum is an apron of adipose tissue in the abdominopelvic cavity, the same space [...] Read more.
Endometriosis is common and poses significant morbidity of lasting impact to young, pre-menopausal women, while ovarian cancer is a lethal gynecologic condition. Both conditions need better treatment. The human omentum is an apron of adipose tissue in the abdominopelvic cavity, the same space in which endometriosis and ovarian cancer manifest. We aim to determine molecular cues emitted by the omentum that aid the trans-coelomic spread of endometriosis and ovarian cancer in the abdomen–pelvic/peritoneal space. Endometriosis and ovarian cancer patients were prospectively recruited. Primary cell cultures of surgically-resected omentum, endometriosis and ovarian cancer were generated, and conditioned media (CM) from the omentum was derived. They were used for in vitro assays to evaluate the effect of the omentum on cell migration, angiogenesis and proliferation in endometriosis and ovarian cancer. Omental CM promoted cell migration in primary cultures of endometriosis and ovarian cancer. Omental CM contained high levels of HGF, SDF-1a, MCP-1, VEGF-A, IL-6 and IL-8. The observed cell migration was blocked by c-MET inhibition, suggesting that HGF/c-MET signaling mediates cell migration in endometriosis and ovarian cancer. Furthermore, PTTG1 was consistently upregulated in the migrated cells in both endometriosis and ovarian cancer. The omentum provides a favorable environment for trans-coelomic spread of endometriosis and ovarian cancer. HGF, c-MET and PTTG1 are potential therapeutic targets for inhibiting the abdomen–pelvic/peritoneal spread of endometriosis and ovarian cancer. Full article
(This article belongs to the Special Issue Molecular Studies of Endometriosis and Associated Diseases)
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24 pages, 3076 KiB  
Article
The Role of NK and T Cells in Endometriosis
by José Lourenço Reis, Natacha Nurdine Rosa, Catarina Martins, Miguel Ângelo-Dias, Luís Miguel Borrego and Jorge Lima
Int. J. Mol. Sci. 2024, 25(18), 10141; https://doi.org/10.3390/ijms251810141 - 21 Sep 2024
Cited by 6 | Viewed by 2051
Abstract
Endometriosis, a debilitating condition, affects one in ten women of reproductive age. Its pathophysiology remains unclear, though deficiencies in immune surveillance are thought to create an environment conducive to the evasion of ectopic endometrial cells from the immune system. Our research explores the [...] Read more.
Endometriosis, a debilitating condition, affects one in ten women of reproductive age. Its pathophysiology remains unclear, though deficiencies in immune surveillance are thought to create an environment conducive to the evasion of ectopic endometrial cells from the immune system. Our research explores the immunological impact of endometriosis both locally and systemically, emphasizing natural killer (NK) and T cell subpopulations. We incorporated 62 female patients who underwent laparoscopic surgery; of those, 47 had endometriosis, and 15 were controls. We collected peritoneal fluid (PF) and peripheral blood (PB) samples which were tagged with monoclonal antibodies and subsequently scrutinized using flow cytometry. Our findings revealed significant differences in immunological profiles based on demographic factors and symptomatology. In the endometriosis cohort, there was an increase in PB CD56HiCD16dim and PF CD8+ CD56dimCD16Hi NK cells. CD16+ CD4 T cell levels were significantly lower in the PB of endometriosis patients who smoke. Individuals with more severe disease displayed significantly higher levels of PB CD16+ CD8 T cells, which also increased in those with non-menstrual pelvic pain. Dysmenorrhea severity correlated with a progressive increase in PF CD8+ CD56dimCD16Hi NK cells. These variations in specific lymphocyte subsets, namely, within NK and T cells, suggest potential immunological mechanisms in the evolution and clinical presentation of endometriosis. Full article
(This article belongs to the Special Issue Molecular Studies of Endometriosis and Associated Diseases)
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Review

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20 pages, 2567 KiB  
Review
Improving Replication in Endometrial Omics: Understanding the Influence of the Menstrual Cycle
by Jessica Chung and Peter Adrian Rogers
Int. J. Mol. Sci. 2025, 26(2), 857; https://doi.org/10.3390/ijms26020857 - 20 Jan 2025
Viewed by 856
Abstract
The dynamic nature of human endometrial tissue presents unique challenges in analysis. Despite extensive research into endometrial disorders such as endometriosis and infertility, recent systematic reviews have highlighted concerning issues with the reproducibility of omics studies attempting to identify biomarkers. This review examines [...] Read more.
The dynamic nature of human endometrial tissue presents unique challenges in analysis. Despite extensive research into endometrial disorders such as endometriosis and infertility, recent systematic reviews have highlighted concerning issues with the reproducibility of omics studies attempting to identify biomarkers. This review examines factors contributing to poor reproducibility in endometrial omics research. Hormonal fluctuations in the menstrual cycle lead to widespread molecular changes in the endometrium, most notably in gene expression profiles. In this review, we examine the variability in omics data due to the menstrual cycle and highlight the importance of accurate menstrual cycle dating for effective statistical modelling. The current standards of endometrial dating lack precision and we make the case for using molecular-based modelling methods to estimate menstrual cycle time for endometrium tissue samples. Additionally, we discuss statistical considerations such as confounding and interaction effects, as well as the importance of recording the detailed and accurate clinical information of patients. By addressing these methodological challenges, we aim to establish more robust and reproducible research practises, increasing the reliability of endometrial omics research and biomarker discovery. Full article
(This article belongs to the Special Issue Molecular Studies of Endometriosis and Associated Diseases)
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