RESUMO
Background: While endometriosis is commonly perceived as a benign gynecological condition, its aggressive biological behavior underscores the critical importance of effective postoperative management. Our research is driven by the ultimate goal of improving postoperative recovery, reducing recurrence rates, and enhancing the overall well-being and fertility of individuals affected by endometriosis. To achieve these objectives, this study conducts a systematic assessment of the therapeutic efficacy of traditional Chinese medicine (TCM) in the context of endometriosis through a comprehensive meta-analysis. By rigorously evaluating both the effectiveness and safety of TCM treatments, our research aims to offer valuable insights that can form a solid foundation for informed clinical decision-making in endometriosis management. The potential impact of our findings extends to enhancing the quality of life for patients and addressing fertility concerns, thereby underscoring the clinical relevance and significance of our research endeavors. Methods: We conducted a literature search from January 2000 to May 2022 using the keywords "TCM, endometriosis, efficacy, safety, infertility, and efficacy analysis." The search covered databases [mention specific databases used, e.g., PubMed, Scopus, etc.]. The retrieved studies encompassed the years within the specified time frame (January 2000 to May 2022), providing a comprehensive overview of relevant literature. The risk of bias was assessed utilizing RevMan 5.3 and Stata software. To evaluate literature heterogeneity, we employed the Q-test and assessed heterogeneity (I2). Results: The results demonstrated low heterogeneity in the efficacy of TCM for treating endometriosis (I2 = 13.76%), a similarly low heterogeneity in the pregnancy rate of endometriosis treated with TCM (I2 = 30.54%), and no heterogeneity in the abortion rate for endometriosis treated with TCM (I2 = 0.00%). However, it is noteworthy that the heterogeneity of adverse reactions associated with TCM treatment for endometriosis was relatively high (I2 = 67.11%). Conclusion: The meta-analysis results confirmed that TCM treatment exhibited better efficacy in managing endometriosis, resulting in higher pregnancy rates, lower abortion rates, and a reduced probability of adverse reactions. These findings not only hold promise for improving the overall quality of life for patients but also offer practical implications for clinicians. The positive outcomes suggest that integrating TCM into endometriosis management could be considered as part of a comprehensive approach to enhance treatment effectiveness and minimize adverse effects, thereby providing clinicians and patients with valuable insights for informed decision-making.
RESUMO
This study was carried out to elucidate the biological function of HOTAIR in granulosa cells of endometriosis and the underlying mechanism. Granulosa cells were extracted from endometriosis patients and subjects with fallopian tube factor alone who received IVF-ET. Relative levels of HOTAIR and p21 in the extracted granulosa cells were determined by quantitative real-time polymerase chain reaction (qRT-PCR). Moreover, HOTAIR level in endometriosis patients in stage I-II or III-IV was determined. Regulatory effects of HOTAIR on the proliferation of KGN cells were evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide), 5-Ethynyl-2'- deoxyuridine (EdU) and colony formation assay. Flow cytometry was conducted to evaluate the potential influence of HOTAIR on apoptosis of KGN cells. The interaction between HOTAIR and EZH2, SUV12 was detected by RNA binding protein immunoprecipitation (RIP) and chromatin immunoprecipitation (ChIP) assay. Finally, the potential role of the HOTAIR/p21 axis in mediating cellular behaviors of KGN cells was explored. HOTAIR was downregulated in granulosa cells extracted from endometriosis patients relative to those with fallopian tube factor alone who received IVF-ET. Knockdown of HOTAIR suppressed the proliferative ability and induced apoptosis of KGN cells. RIP and ChIP assay showed that silence of HOTAIR released EZH2 to suppress the DNA methylation of p21. Knockdown of p21 could reverse the regulatory effect of HOTAIR on the proliferative change of KGN cells. Downregulated HOTAIR suppresses the proliferative ability and induces apoptosis of granulosa cells in endometriosis by upregulating p21.