@article {10445, title = {Cytokine profiles of women with vulvodynia: Identification of a panel of pro-inflammatory molecular targets.}, journal = {Eur J Obstet Gynecol Reprod Biol}, volume = {226}, year = {2018}, month = {2018 Jul}, pages = {66-70}, abstract = {

OBJECTIVE: The vulvar pain syndrome (VPS) is a multifactorial disease severely influencing the lifestyle of affected women. Among possible etiological factors, local injury, peripheral and/or central sensitization of the nervous system, and a chronic inflammatory status have been positively associated with the development of VPS. The identification of a constitutive altered local inflammatory profile in VPS women may represent an important point in the characterization of patients{\textquoteright} phenotype as a useful marker influencing the vulvar micro-environment. The aim of this study was to investigative the possible role of the local cytokines production in women with VPS in comparison to healthy women.

STUDY DESIGN: In this study were collected vaginal swabs from 57 healthy women (HC) who never suffered from VPS and from 30 patients diagnosed with vulvodynia (VPS) by at least 3 years and currently symptomatic. All patients included in this study showed the absence of Sexually Transmitted (STD) diseases and Reproductive Tract Infection. Real-time PCR was performed to assess the genomic sequences of ST pathogens. The Luminex Bio-Plex platform was used for the analysis of a panel of 48 immune factors.

RESULTS: Eleven molecules, specifically involved in the pro-inflammatory pathway were significantly modulated in VPS patients in comparison to healthy women, suggesting a persistent inflammatory process.

CONCLUSIONS: Therefore, these inflammatory factors could be possible biological markers involved in this disease. Nevertheless, other studies are needed to consider this specific immune profile as a valid marker of the vulvodynia.

}, keywords = {Adult, Aged, Cytokines, Female, Humans, Inflammation, Middle Aged, Vaginal Smears, Vulva, Vulvodynia, Women{\textquoteright}s Health}, issn = {1872-7654}, doi = {10.1016/j.ejogrb.2018.05.035}, author = {Zanotta, Nunzia and Campisciano, Giuseppina and Scrimin, Federica and Blendi, Ura and Marcuzzi, Annalisa and Vincenti, Ezio and Crovella, Sergio and Comar, Manola} } @article {10435, title = {Dysregulated chaperones associated with cell proliferation and negative apoptosis regulation in the uterine leiomyoma.}, journal = {Oncol Lett}, volume = {15}, year = {2018}, month = {2018 May}, pages = {8005-8010}, abstract = {

Uterine leiomyomas are benign smooth muscle cell tumors that originate from the myometrium. In this study we focus on dysregulated chaperones associated with cell proliferation and apoptosis. Paired tissue samples of 15 leiomyomas and adjacent myometria were obtained and analyzed by two-dimensional gel electrophoresis (2-DE). Mass spectrometry was used for protein identification and western blotting for 2-DE data validation. The values of 6 chaperones were found to be significantly different in the leiomyoma when compared with the myometrium. A total of 4 proteins were upregulated in the leiomyoma and 2 proteins were downregulated. Calreticulin and 78 kDa glucose-regulated protein were further validated by western blotting because the first is considered a marker of cell proliferation, while the second protects against apoptotic cell death. In addition, we also validated the two downregulated proteins heat shock protein β-1 and heat shock 70 kDa protein 1A. Our study shows the existence of a dysregulation of chaperone proteins associated with leiomyoma development. Functional studies are needed to ascertain the role of these chaperones in the leiomyoma. This may be crucial for the further development of specific inhibitors against the activity of these proteins in order to block the growth of the leiomyoma.

}, issn = {1792-1074}, doi = {10.3892/ol.2018.8325}, author = {Ura, Blendi and Scrimin, Federica and Arrigoni, Giorgio and Aloisio, Michelangelo and Monasta, Lorenzo and Ricci, Giuseppe} } @article {10803, title = {Interstitial Fluid in Gynecologic Tumors and Its Possible Application in the Clinical Practice.}, journal = {Int J Mol Sci}, volume = {19}, year = {2018}, month = {2018 Dec 12}, abstract = {

Gynecologic cancers are an important cause of worldwide mortality. The interstitium consists of solid and fluid phases, situated between the blood vessels and cells. The interstitial fluid (IF), or fluid phase, is an extracellular fluid bathing and surrounding the tissue cells. The TIF (tumor interstitial fluid) is a dynamic fluid rich in lipids, proteins and enzyme-derived substances. The molecules found in the IF may be associated with pathological changes in tissues leading to cancer growth and metastatization. Proteomic techniques have allowed an extensive study of the composition of the TIF as a source of biomarkers for gynecologic cancers. In our review, we analyze the composition of the TIF, its formation process, the sampling methods, the consequences of its accumulation and the proteomic analyses performed, that make TIF valuable for monitoring different types of cancers.

}, keywords = {Biomarkers, Tumor, Biophysical Phenomena, Extracellular Fluid, Female, Genital Neoplasms, Female, Humans, Practice Patterns, Physicians{\textquoteright}, Tumor Microenvironment}, issn = {1422-0067}, doi = {10.3390/ijms19124018}, author = {Ura, Blendi and Di Lorenzo, Giovanni and Romano, Federico and Monasta, Lorenzo and Mirenda, Giuseppe and Scrimin, Federica and Ricci, Giuseppe} } @article {10540, title = {Essure Permanent Birth Control, Effectiveness and Safety: An~Italian 11-Year Survey.}, journal = {J Minim Invasive Gynecol}, volume = {24}, year = {2017}, month = {2017 May - Jun}, pages = {640-645}, abstract = {

STUDY OBJECTIVE: To describe safety, tolerability, and effectiveness results through a minimum 2-year follow-up of patients who underwent permanent sterilization with the Essure insert.

DESIGN: A retrospective multicenter study (Canadian Task Force classification II2).

SETTING: Seven general hospitals and 4 clinical teaching centers in Italy.

PATIENTS: A total of 1968 women, mean age 39.5~years (range, 23-48~years) who underwent office hysteroscopic sterilization using the Essure insert between April 1, 2003, and December 30,~2014.

INTERVENTION: The women underwent office hysteroscopic bilateral Essure insert placement, with satisfactory device location and tube occlusion based on hysterosalpingography or hysterosalpingo-contrast sonography (HyCoSy).

MEASUREMENTS AND MAIN RESULTS: Placement rate, successful bilateral tubal occlusion, perioperative adverse events, early postoperative (during the first 3~months of follow-up), and late complications were evaluated. Satisfactory insertion was accomplished in 97.2\% of women and, in 4, perforation and 1 expulsion were detected during hysterosalpingography. Three unintended pregnancies occurred before the 3-month confirmation test. Two pregnancies were reported among women relying on the Essure inserts. Postprocedure pain was minimal and brief; in 9 women, pelvic pain became intractable, necessitating removal of the devices via laparoscopy. On telephone interviews, overall satisfaction was rated as "very satisfied" by the majority of women (97.6\%), and no long-term adverse events were reported.

CONCLUSION: The findings from this extended Italian survey further support the effectiveness, tolerability, and satisfaction of Essure hysteroscopic sterilization when motivated women are selected and well informed of the potential risks of the device. Moreover, the results do not demonstrate an increased incidence of complications and pregnancies associated with long-term Essure use. Patients with a known hypersensitivity to nickel may be less suitable candidates for the Essure insert.

}, keywords = {Adult, Fallopian Tubes, Female, Follow-Up Studies, Humans, Hypersensitivity, Hysterosalpingography, Hysteroscopy, Italy, Laparoscopy, Middle Aged, Nickel, Pain, Pregnancy, Pregnancy, Unplanned, Retrospective Studies, Sterilization, Reproductive, Sterilization, Tubal, Surveys and Questionnaires, Young Adult}, issn = {1553-4669}, doi = {10.1016/j.jmig.2017.02.004}, author = {Franchini, Mario and Zizolfi, Brunella and Coppola, Carmela and Bergamini, Valentino and Bonin, Cecilia and Borsellino, Giovanni and Busato, Enrico and Calabrese, Stefania and Calzolari, Stefano and Fantin, Gian Piero and Giarr{\`e}, Giovanna and Litta, Piero and Luerti, Massimo and Mangino, Francesco Paolo and Marchino, Gian Luigi and Molinari, Maria Antonietta and Scatena, Elisa and Scrimin, Federica and Telloli, Paolo and Di Spiezio Sardo, Attilio} } @article {10542, title = {Identification of proteins with different abundance associated with cell migration and proliferation in leiomyoma interstitial fluid by proteomics.}, journal = {Oncol Lett}, volume = {13}, year = {2017}, month = {2017 May}, pages = {3912-3920}, abstract = {

Uterine leiomyoma is the most common female reproductive tract benign tumor. Little is known about protein composition and changes in the leiomyoma interstitial fluid (IF). The present study focused on changes in protein abundance in the IF of leiomyoma. Leiomyoma IFs and adjacent myometrial IFs were obtained and analyzed by two-dimensional electrophoresis (2-DE) coupled with mass spectrometry and western blotting for 2-DE data validation. A total of 25 unique proteins were observed to change significantly (P<0.05). Of these proteins with different abundance, 22 had not been previously identified in leiomyoma IF. analysis predicted that three of these proteins were secreted via classical mechanisms, while 22 were secreted via non-classical mechanisms. Ingenuity Pathway Analysis identified 17 proteins associated with cellular migration and proliferation. Among these, phosphoglycerate mutase 1 had not been previously associated with leiomyoma. The abundance of seven proteins was further validated by western blotting. A comparative proteomic approach identified a number of proteins associated with cellular migration and proliferation, with changes in abundance in IF likely to be involved in tumor development. Further studies will be required to investigate the role of these proteins in leiomyoma IF and their possible association with tumor development and growth.

}, issn = {1792-1074}, doi = {10.3892/ol.2017.5943}, author = {Ura, Blendi and Scrimin, Federica and Franchin, Cinzia and Arrigoni, Giorgio and Licastro, Danilo and Monasta, Lorenzo and Ricci, Giuseppe} } @article {10573, title = {A premenarcheal girl with urogenital bleeding.}, journal = {Arch Dis Child}, volume = {102}, year = {2017}, month = {2017 May}, pages = {472}, issn = {1468-2044}, doi = {10.1136/archdischild-2016-311730}, author = {Lora, Angela and Scrimin, Federica and Taddio, Andrea and Ventura, Alessandro and Barbi, Egidio} } @article {8322, title = {Abnormal expression of leiomyoma cytoskeletal proteins involved in cell migration.}, journal = {Oncol Rep}, volume = {35}, year = {2016}, month = {2016 May}, pages = {3094-100}, abstract = {

Uterine leiomyomas are monoclonal tumors. Several factors are involved in the neoplastic transformation of the myometrium. In our study we focused on dysregulated cytoskeletal proteins in the leiomyoma as compared to the myometrium. Paired tissue samples of ten leiomyomas and adjacent myometria were obtained and analyzed by two-dimensional gel electrophoresis (2-DE). Mass spectrometry was used for protein identification, and western blotting for 2-DE data validation. The values of ten cytoskeletal proteins were found to be significantly different: eight proteins were upregulated in the leiomyoma and two proteins were downregulated. Three of the upregulated proteins (myosin regulatory light polypeptide 9, four and a half LIM domains protein 1 and LIM and SH3 domain protein 1) are involved in cell migration, while downregulated protein transgelin is involved in replicative senescence. Myosin regulatory light polypeptide 9 (MYL9) was further validated by western blotting because it is considered to be a cell migration marker in several cancers and could play a key role in leiomyoma development. Our data demonstrate significant alterations in the expression of cytoskeletal proteins involved in leiomyoma growth. A better understanding of the involvement of cytoskeletal proteins in leiomyoma pathogenesis may contribute to the identification of new therapeutic targets and the development of new pharmacological approaches.

}, issn = {1791-2431}, doi = {10.3892/or.2016.4688}, author = {Ura, Blendi and Scrimin, Federica and Arrigoni, Giorgio and Athanasakis, Emmanouil and Aloisio, Michelangelo and Monasta, Lorenzo and Ricci, Giuseppe} } @article {8341, title = {A Proteomic Approach for the Identification of Up-Regulated Proteins Involved in the Metabolic Process of the Leiomyoma.}, journal = {Int J Mol Sci}, volume = {17}, year = {2016}, month = {2016}, pages = {540}, abstract = {

Uterine leiomyoma is the most common benign smooth muscle cell tumor of the uterus. Proteomics is a powerful tool for the analysis of complex mixtures of proteins. In our study, we focused on proteins that were upregulated in the leiomyoma compared to the myometrium. Paired samples of eight leiomyomas and adjacent myometrium were obtained and submitted to two-dimensional gel electrophoresis (2-DE) and mass spectrometry for protein identification and to Western blotting for 2-DE data validation. The comparison between the patterns revealed 24 significantly upregulated (p < 0.05) protein spots, 12 of which were found to be associated with the metabolic processes of the leiomyoma and not with the normal myometrium. The overexpression of seven proteins involved in the metabolic processes of the leiomyoma was further validated by Western blotting and 2D Western blotting. Four of these proteins have never been associated with the leiomyoma before. The 2-DE approach coupled with mass spectrometry, which is among the methods of choice for comparative proteomic studies, identified a number of proteins overexpressed in the leiomyoma and involved in several biological processes, including metabolic processes. A better understanding of the mechanism underlying the overexpression of these proteins may be important for therapeutic purposes.

}, issn = {1422-0067}, doi = {10.3390/ijms17040540}, author = {Ura, Blendi and Scrimin, Federica and Arrigoni, Giorgio and Franchin, Cinzia and Monasta, Lorenzo and Ricci, Giuseppe} } @article {8031, title = {Hysteroscopic chasing for endometrial cancer in a low-risk population: risks of overinvestigation.}, journal = {Arch Gynecol Obstet}, year = {2015}, month = {2015 Aug 28}, abstract = {

PURPOSE: To evaluate the appropriateness of the indications for hysteroscopy done, in fertile and postmenopausal women, for the detection of endometrial cancer.

METHODS: A retrospective analysis of 2673 consecutive women who underwent office hysteroscopy chasing for endometrial cancer between January 2012 and June 2014. According to their medical history only low-risk women entered the study.

RESULTS: A total of 1070 patients entered the study. The main outcome measure was the appropriateness of the indications for hysteroscopy. Appropriateness was assessed on the basis of guidelines of scientific societies and histologic report. According to the algorithm developed for appropriateness, 44~\% of procedures resulted in being inappropriate. In reproductive-aged women 57~\% of hysteroscopies were inappropriate. In postmenopausal women inappropriate hysteroscopies were 45~\%. In reproductive-aged women, the reasons for inappropriateness were: absence of abnormal uterine bleeding (AUB) or AUB without a trial of progestin therapy. In postmenopausal women, the reasons for inappropriateness were: ultrasound report of endometrial thickening or polyp without bleeding.

CONCLUSIONS: Hysteroscopy is often recommended for inappropriate indications. More evidence is needed to identify the risks of overinvestigation, overdiagnosis, and related overtreatment and to better identify the threshold beyond which benefits are likely to outweigh harms.

}, issn = {1432-0711}, doi = {10.1007/s00404-015-3868-x}, author = {Scrimin, Federica and Wiesenfeld, Uri and Galati, Emanuele F and Monasta, Lorenzo and Ricci, Giuseppe} } @article {7754, title = {Two-dimensional gel electrophoresis analysis of the leiomyoma interstitial fluid reveals altered protein expression with a possible involvement in pathogenesis.}, journal = {Oncol Rep}, volume = {33}, year = {2015}, month = {2015 May}, pages = {2219-26}, abstract = {

Uterine leiomyoma is the most common smooth benign neoplasm. In the present study, we analyzed the global interstitial fluid (IF) profile of leiomyoma vs. normal myometrium to identify protein dysregulation involved in leiomyoma pathogenesis. Two-dimensional gel electrophoresis and mass spectrometry were used to generate and compare the global interstitial fluid profiles of the leiomyoma and of the normal tissue. Two proteins were validated by immunohistochemistry. By comparing the interstitial fluid profile of the leiomyoma with that of the normal myometrium, the levels of seven proteins were found to be significantly different: four structural organization proteins (desmin, prelamin-A/C, transgelin and α-actinin-1), an inflammatory response (α1-antitrypsin), a response to oxidative stress (peroxiredoxin-2), and a folding protein (heat shock 70 kDa protein 1A/1B). Desmin, α1-antitrypsin and peroxiredoxin-2 were upregulated in the leiomyoma, whereas heat shock 70 kDa protein 1A/1B, α-actinin-1, prelamin-A/C and transgelin were downregulated. Desmin and α1-antitrypsin were further validated by immunohistochemistry. By identifying proteins with altered expression levels compared to the myometrium from several pathways of the leiomyoma pathogenesis, we found the leiomyoma interstitial fluid to have a characteristic proteomic profile. A better appreciation of the pathophysiology of the disease can be useful in the development of conservative treatments that serve as viable alternatives to hysterectomy.

}, issn = {1791-2431}, doi = {10.3892/or.2015.3827}, author = {Ura, Blendi and Scrimin, Federica and Zanconati, Fabrizio and Arrigoni, Giorgio and Monasta, Lorenzo and Romano, Andrea and Banco, Rubina and Zweyer, Marina and Milani, Daniela and Ricci, Giuseppe} } @article {3629, title = {Risk of Essure microinsert abdominal migration: case report and review of literature.}, journal = {Ther Clin Risk Manag}, volume = {10}, year = {2014}, month = {2014}, pages = {963-8}, abstract = {

PURPOSE: To report a case of Essure microinsert abdominal migration and literature review.

METHODS: A 41-year-old woman was counseled to undergo Essure sterilization. The procedure was hampered by the presence of endometrial cavity adhesions, obscuring left tubal ostium. By using microscissors the adhesions were progressively lysed. Since the procedure had become very painful, the patient required general anesthesia. Once adhesion lysis was completed, the tubal ostium was well visible. Both devices were then easily introduced into the fallopian tubes. At the end of the procedure, five coils were visible on the right side and five coils on the left side, as recommended.

RESULTS: The 3-month hysterosalpingogram follow-up suspected abdominal migration of the left device. Laparoscopy confirmed the device displacement in the left lower abdominal quadrant. Both fallopian tubes and the uterus appeared normal. No signs of perforation were detected. The device was embedded into the omentum, but it was easily removed. Bilateral tubal sterilization was performed by bipolar coagulation.

CONCLUSION: There are only 13 cases, including the present, of Essure abdominal migration in the literature. In most cases, abdominal displacement of the microinsert is asymptomatic and does not induce tissue damage. However, in some cases, it may cause a severe adverse event, requiring major surgery. Therefore, removal of the migrated device should be performed as soon as possible. Moreover, during presterilization counseling, the patient should also be correctly informed about the risk of this rare but relevant complication, as well as about the surgical interventions that could be required to solve it.

}, issn = {1176-6336}, doi = {10.2147/TCRM.S65634}, author = {Ricci, Giuseppe and Restaino, Stefano and Di Lorenzo, Giovanni and Fanfani, Francesco and Scrimin, Federica and Mangino, Francesco P} }