High
density of small nerve fibres in the funcational layer
of the endometrium in women with endometriosis
Researchers in Australia suggest that small nerve fibres
detected in the functional layer in all women with endometriosis
may have important implications for understanding why
pain occurs in these patients.
Tokushige et al prepared histological sections of endometrial
tissue from endometrial curettings and hysterectomies
performed on women with endometriosis (n=25 and n=10,
respectively) and without endometriosis ((n=47 andn=35,
respectively). These were stained immunohistochemically
for the highly specific polyclonal rabbit anti-protein
gene product 9.5 (PGP9.5) and monoclonal mouse anti-neurofilament
protein (NF) in order to demonstrate both myelinated
and unmyelinated nerve fibres.
The team was able to identify small nerve fibres throughout
the basal and functional layer of the endometrium in
all endometriosis patients, but these were not seen
in the functional layer of the endometrium in any of
the women without endometriosis (p<0.001).
NF-immunoreactive nerve fibres were present in the
basal layer in all endometriosis patients but not in
non-endometriosis patients, with on exception (p<0.001).
Tokushige et al summarises: "This demonstration
of small nerve fibres in the functinal layer of eutopic
endometrium of women with endometriosis is so striking
in the present study that we believe it could become
a relatively simple surrogate marker of this condition
using endometrial biopsies. It is even possible that
an endometrial biopsy may demonstrate nerve fibres in
women destined to develop the condition later in life".
They conclude that further research is required to
define the possible roles and mechanisms of these nerve
fibres in endometriosis and other gynaecological conditions.
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