Nerve
fibres may play an important role in the mechanisms
of pain generation in endometriosis
Researchers in Australia
have identified more nerve fibres in peritoneal endometriotic
lesions than in normal peritoneum
Peritoneal endometriotic lesions and normal peritoneum
were prepared from women with and without endometriosis
(n = 40 and 36, respectively). Specimens were also prepared
from endosalpingiosis lesions (n = 9). These sections
were stained immunohistochemically with antibodies against
protein gene product 9.5, neurofilament (NF), nerve
growth factor (NGF), NGF receptor p75 (NGFRp75), substance
P (SP), calcitonin gene-related peptide (CGRP), acetylcholine
(ACh) and tyrosine hydroxylase (TH) to demonstrate myelinated,
unmyelinated, sensory, cholinergic and adrenergic nerve
fibres.
The authors identified significantly more nerve fibresin
peritoneal endometriotic lesions than in normal peritoneum
(P < 0.001) or endosalpingiosis lesions (P < 0.001).
These nerve fibres were SP, CGRP, ACh or TH immunoreac-tive.
Many of these markers were co-localized. There was an
intense NGF immunoreactivity near endometriotic glands,
and NGFRp75 immunoreactive nerve fibres were present
near endometriotic glands and blood vessels in the peritoneal
endometriotic lesions.
The team concluded that peritoneal endometriotic lesions
were innervated by sensory Ad, sensory C, cholinergic
and adrenergic nerve fibres, and that these nerve fibres
may play an important role in the mechanisms of pain
generation in endometriosis.
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