Тазовая боль является одним из наиболее часто встречающихся и значимых клинических симптомов эндометриоза. Многогранность патогенеза и парадоксальность эндометриоз-ассоциированного болевого синдрома, хронизация и централизация боли, выраженное снижение качества жизни больных, отсутствие «идеального», не имеющего ограничений и эффективного для всех пациенток лекарственного средства, а также прогрессирующий и рецидивирующий характер заболевания – факторы, определяющие необходимость поиска новых, дополнительных, терапевтических возможностей. На основании литературных данных, представленных в электронных базах PubMed, CyberLeninka, Google Scholar, рассмотрены механизмы формирования боли при эндометриозе, а также возможности патогенетического влияния транс-ресвератрола и индол-3-карбинола на различные аспекты эндометриоз-ассоциированного болевого синдрома. Описанные фармакологические свойства соединений позволяют предположить, что сочетанное применение транс-ресвератрола и индол-3-карбинола является патогенетически обоснованным и многообещающим направлением лечения многогранного эндометриоз-ассоциированного болевого синдрома.
Pelvic pain is one of the most common and significant clinical symptoms of endometriosis. The complex pathogenesis and paradoxical nature of endometriosis-associated pain, its chronicity and centralization, a marked decrease in the quality of life of patients, the lack of an "ideal" and effective remedy with no limitation for all patients, as well as the progressive and recurrent nature of the disease are factors that determine the need for novel, additional therapeutic options. The pain mechanisms in endometriosis and the potential pathogenetic effects of trans-resveratrol and indole-3-carbinol on various aspects of endometriosis-associated pain are addressed based on the literature sources presented in electronic databases PubMed, CyberLeninka, and Google Scholar. The described pharmacological properties of the compounds suggest that the combined use of trans-resveratrol and indole-3-carbinol is a pathogenetically justified and promising treatment for complex endometriosis-associated pain.
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2. Ben-Meir LC, Soriano D, Zajicek M, et al. The Association Between Gastrointestinal Symptoms and Transvaginal Ultrasound Findings in Women Referred for Endometriosis Evaluation: A Prospective Pilot Study. Ultraschall MED. 2022;43(05):81-9. DOI:10.1055/a-1300-1887
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4. Coxon L, Horne AW, Vincent K. Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms. Best Pract Res Clin Obstet Gynaecol. 2018;51:53-67. DOI:10.1016/j.bpobgyn.2018.01.014
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9. Maddern J, Grundy L, Castro J, et al. Pain in endometriosis. Front Cell Neurosci. 2020;14:590823. DOI:10.3389/fncel.2020.590823
10. Tamari M, Ver Heul AM, Kim BS. Immunosensation: neuroimmune cross talk in the skin. Ann Rev Immunol. 2021;39:369-93. DOI:10.1146/annurev-immunol-101719-113805
11. Gao D, Gao X, Yang F, et al. Neuroimmune Crosstalk in Rheumatoid Arthritis. Int J Mol Sci. 2022;23(15):8158. DOI:10.3390/ijms23158158
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DOI:10.1080/14656566.2018.1494154
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27. Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992;339(8808):1523-6. DOI:10.1016/0140-6736(92)91277-f
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________________________________________________
1. Rasheed HAM, Hamid P. Inflammation to infertility: panoramic view on endometriosis. Cureus. 2020; 12(11):e11516. DOI:10.7759/cureus.11516
2. Ben-Meir LC, Soriano D, Zajicek M, et al. The Association Between Gastrointestinal Symptoms and Transvaginal Ultrasound Findings in Women Referred for Endometriosis Evaluation: A Prospective Pilot Study. Ultraschall MED. 2022;43(05):81-9. DOI:10.1055/a-1300-1887
3. Hsu AL, Sinaii N, Segars J, et al. Relating pelvic pain location to surgical findings of endometriosis. Obstet Gynecol. 2011;118(2):223-30. DOI:10.1097/AOG.0b013e318223fed0
4. Coxon L, Horne AW, Vincent K. Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms. Best Pract Res Clin Obstet Gynaecol. 2018;51:53-67. DOI:10.1016/j.bpobgyn.2018.01.014
5. Laux-Biehlmann A, d’Hooghe T, Zollner TM. Menstruation pulls the trigger for inflammation and pain in endometriosis. Trends Pharmacol Sci. 2015;36(5):270-6. DOI:10.1016/j.tips.2015.03.004
6. Morotti M, Vincent K, Becker CM. Mechanisms of pain in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2017;209:8-13. DOI:10.1016/j.ejogrb.2016.07.497
7. Zhou J, Chern BSM, Barton-Smith P, et al. Peritoneal fluid cytokines reveal new insights of endometriosis subphenotypes. Int J Mol Sci. 2020;21(10):3515. DOI:10.3390/ijms21103515
8. de Arellano MLB, Arnold J, Vercellino F, et al. Overexpression of nerve growth factor in peritoneal fluid from women with endometriosis may promote neurite outgrowth in endometriotic lesions. Fertil Steril. 2011;95(3):1123-6. DOI:0.1016/j.fertnstert.2010.10.023
9. Maddern J, Grundy L, Castro J, et al. Pain in endometriosis. Front Cell Neurosci. 2020;14:590823. DOI:10.3389/fncel.2020.590823
10. Tamari M, Ver Heul AM, Kim BS. Immunosensation: neuroimmune cross talk in the skin. Ann Rev Immunol. 2021;39:369-93. DOI:10.1146/annurev-immunol-101719-113805
11. Gao D, Gao X, Yang F, et al. Neuroimmune Crosstalk in Rheumatoid Arthritis. Int J Mol Sci. 2022;23(15):8158. DOI:10.3390/ijms23158158
12. Li T, Mamillapalli R, Ding S, et al. Endometriosis alters brain electrophysiology, gene expression and increases pain sensitization, anxiety, and depression in female mice. Biol Reprod. 2018;99(2):349-59. DOI:10.1093/biolre/ioy035
13. Aredo JV, Heyrana KJ, Karp BI, et al. Relating chronic pelvic pain and endometriosis to signs of sensitization and myofascial pain and dysfunction. Semin Reprod Med. 2017;35(1):88-97. DOI:10.1055/s-0036-1597123
14. Cao B, Scherrer G, Chen L. Spinal cord retinoic acid receptor signaling gates mechanical hypersensitivity in neuropathic pain. Neuron. 2022;S0896-6273(22):00866-2. DOI:10.1016/j.neuron.2022.09.027
15. Petrelluzzi KF, Garcia MC, Petta CA, et al. Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain. Stress. 2008;11(5):390-7. DOI:10.1080/10253890701840610
16. As-Sanie S, Harris RE, Napadow V, et al. Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. PAIN. 2012;153(5):1006-14. DOI:10.1016/j.pain.2012.01.032
17. Orazov MR, Radzinsky VE, Orekhov RE. The effectiveness of therapy for endometriosis-associated pelvic pain resistant to surgical treatment. Gynecology. 2021;23(4):314-23
(in Russian). DOI:10.26442/20795696.2021.4.201097
18. Singh SS, Gude K, Perdeaux E, et al. Surgical outcomes in patients with endometriosis: a systematic review. J Obstet Gynaecol (Canada). 2020;42(7):881-8. DOI:10.1016/j.jogc.2019.08.004
19. Ferrero S, Evangelisti G, Barra F. Current and emerging treatment options for endometriosis. Expert Opin Pharmacother. 2018;19(10):1109-25.
DOI:10.1080/14656566.2018.1494154
20. Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Ppen. 2022;2022(2):hoac009. DOI:10.1093/hropen/hoac009
21. Адамян Л.В., Андреева Е.Н., Абсатарова Ю.С., Артымук Н.В., и др. Эндометриоз. Клинические рекомендации. М.: Министерство здравоохранения Российской Федерации, 2020. Режим доступа: https://yadi.sk/i/yYPwxWe4uTZcWg. Ссылка активна на 10.11.2022 [Adamian LV, Andreeva EN, Absatarova IuS, Artymuk NV, et al. Endometrioz. Klinicheskie rekomendatsii. Moscoe: Ministry of Health of Russian Federation, 2020. Available: https://yadi.sk/i/yYPwxWe4uTZcWg. Accessed: 10.11.2022 (in Russian)].
22. Yarmolinskaya MI, Florova MS. The possibility of treatment with dienogest 2 mg in patients with genital endometriosis. Russian Journal of Human Reproduction. 2017;23(1):70‑9 (in Russian). DOI:10.17116/repro201723170-79
23. Lan S, Ling L, Jianhong Z, et al. Analysis of the levonorgestrel-releasing intrauterine system in women with endometriosis. J Int Med Res. 2013;41(3):548-58. DOI:10.1177/0300060513479865
24. Margatho D, Carvalho NM, Bahamondes L. Endometriosis-associated pain scores and biomarkers in users of the etonogestrel-releasing subdermal implant or the 52-mg levonorgestrel-releasing intrauterine system for up to 24 months. Eur J Contracept Reprod Health Care. 2020;25(2):133-40.
DOI:10.1080/13625187.2020.1725461
25. Horne AW, Vincent K, Hewitt CA, et al. Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2020;396(10255):909-17. DOI:10.1016/S0140-6736(20)31693-7
26. Fiod Riccio BV, Fonseca-Santos B, Colerato Ferrari P, et al. Characteristics, Biological Properties and Analytical Methods of Trans-Resveratrol: A Review. Crit Rev Anal Chem. 2020;50(4):339-58. DOI:10.1080/10408347.2019.1637242
27. Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992;339(8808):1523-6. DOI:10.1016/0140-6736(92)91277-f
28. Bruner-Tran KL, Osteen KG, Taylor HS, et al. Resveratrol inhibits development of experimental endometriosis in vivo and reduces endometrial stromal cell invasiveness in vitro. Biol Reprod. 2011;84(1):106-12. DOI:10.1095/biolreprod.110.086744
29. Yarmolinskaya MI, Shalina MA, Beganova AK, Seyidova ChI. Prospects for the combined use of trans-resveratrol and indole-3-carbinol in endometriosis. Akusherstvo i ginekologiia. 2022;4:14-24 (in Russian). DOI:10.18565/aig.2022.4
30. Dull AM, Moga MA, Dimienescu OG, et al. Therapeutic Approaches of Resveratrol on Endometriosis via Anti-Inflammatory and Anti-Angiogenic Pathways. Molecules. 2019;24(4):667. DOI:10.3390/molecules24040667
31. Britton RG, Kovoor C, Brown K. Direct molecular targets of resveratrol: identifying key interactions to unlock complex mechanisms. Ann N Y Acad Sci. 2015;1348(1):124-33. DOI:10.1111/nyas.12796
32. Singh AK, Vinayak M. Resveratrol alleviates inflammatory hyperalgesia by modulation of reactive oxygen species (ROS), antioxidant enzymes and ERK activation. Inflamm Res. 2017;66(10):911-21. DOI:10.1007/s00011-017-1072-0
33. Abrao MS, Andres MP, Miller CE, et al. AAGL 2021 Endometriosis Classification: An Anatomy-based Surgical Complexity Score. J Minim Invasive Gynecol. 2021;28(11):1941-50.e1. DOI:10.1016/j.jmig.2021.09.709
34. Madanes D, Meresman G, Valla SA, et al. Resveratrol impairs cellular mechanisms associated with the pathogenesis of endometriosis. Reprod Biomed Online. 2022;44(6):976-90. DOI:10.1016/j.rbmo.2022.02.008
35. Khazaei MR, Rashidi Z, Chobsaz F, et al. Inhibitory effect of resveratrol on the growth and angiogenesis of human endometrial tissue in an In Vitro three-dimensional model of endometriosis. Reprod Biol. 2020;20(4):484-90. DOI:10.1016/j.repbio.2020.07.012
36. Gołąbek A, Kowalska K, Olejnik A. Polyphenols as a Diet Therapy Concept for Endometriosis-Current Opinion and Future Perspectives. Nutrients. 2021;13(4):1347. DOI:10.3390/nu13041347
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1 ФГБНУ «Научно-исследовательский институт акушерства, гинекологии и репродуктологии им. Д.О. Отта», Санкт-Петербург, Россия;
2 ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия
*m.yarmolinskaya@gmail.com
________________________________________________
Maria I. Yarmolinskaya*1,2, Aleksandra K. Beganova1, Anastasia S. Revenko1
1 Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russia;
2 Mechnikov North-Western State Medical University, Saint Petersburg, Russia
*m.yarmolinskaya@gmail.com