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The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis

Widely viewed as an enigmatic disease, adenomyosis is a common gynecological disease with bewildering pathogenesis and pathophysiology. One defining hallmark of adenomyotic lesions is cyclic bleeding as in eutopic endometrium, yet bleeding is a quintessential trademark of tissue injury, which is inv...

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Autor principal: Guo, Sun-Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918158/
https://www.ncbi.nlm.nih.gov/pubmed/36769489
http://dx.doi.org/10.3390/jcm12030842
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author Guo, Sun-Wei
author_facet Guo, Sun-Wei
author_sort Guo, Sun-Wei
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description Widely viewed as an enigmatic disease, adenomyosis is a common gynecological disease with bewildering pathogenesis and pathophysiology. One defining hallmark of adenomyotic lesions is cyclic bleeding as in eutopic endometrium, yet bleeding is a quintessential trademark of tissue injury, which is invariably followed by tissue repair. Consequently, adenomyotic lesions resemble wounds. Following each bleeding episode, adenomyotic lesions undergo tissue repair, and, as such, platelets are the first responder that heralds the subsequent tissue repair. This repeated tissue injury and repair (ReTIAR) would elicit several key molecular events crucial for lesional progression, eventually leading to lesional fibrosis. Platelets interact with adenomyotic cells and actively participate in these events, promoting the lesional progression and fibrogenesis. Lesional fibrosis may also be propagated into their neighboring endometrial–myometrial interface and then to eutopic endometrium, impairing endometrial repair and causing heavy menstrual bleeding. Moreover, lesional progression may result in hyperinnervation and an enlarged uterus. In this review, the role of platelets in the pathogenesis, progression, and pathophysiology is reviewed, along with the therapeutic implication. In addition, I shall demonstrate how the notion of ReTIAR provides a much needed framework to tether to and piece together many seemingly unrelated findings and how it helps to make useful predictions.
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spelling pubmed-99181582023-02-11 The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis Guo, Sun-Wei J Clin Med Review Widely viewed as an enigmatic disease, adenomyosis is a common gynecological disease with bewildering pathogenesis and pathophysiology. One defining hallmark of adenomyotic lesions is cyclic bleeding as in eutopic endometrium, yet bleeding is a quintessential trademark of tissue injury, which is invariably followed by tissue repair. Consequently, adenomyotic lesions resemble wounds. Following each bleeding episode, adenomyotic lesions undergo tissue repair, and, as such, platelets are the first responder that heralds the subsequent tissue repair. This repeated tissue injury and repair (ReTIAR) would elicit several key molecular events crucial for lesional progression, eventually leading to lesional fibrosis. Platelets interact with adenomyotic cells and actively participate in these events, promoting the lesional progression and fibrogenesis. Lesional fibrosis may also be propagated into their neighboring endometrial–myometrial interface and then to eutopic endometrium, impairing endometrial repair and causing heavy menstrual bleeding. Moreover, lesional progression may result in hyperinnervation and an enlarged uterus. In this review, the role of platelets in the pathogenesis, progression, and pathophysiology is reviewed, along with the therapeutic implication. In addition, I shall demonstrate how the notion of ReTIAR provides a much needed framework to tether to and piece together many seemingly unrelated findings and how it helps to make useful predictions. MDPI 2023-01-20 /pmc/articles/PMC9918158/ /pubmed/36769489 http://dx.doi.org/10.3390/jcm12030842 Text en © 2023 by the author. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Guo, Sun-Wei
The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title_full The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title_fullStr The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title_full_unstemmed The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title_short The Role of Platelets in the Pathogenesis and Pathophysiology of Adenomyosis
title_sort role of platelets in the pathogenesis and pathophysiology of adenomyosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918158/
https://www.ncbi.nlm.nih.gov/pubmed/36769489
http://dx.doi.org/10.3390/jcm12030842
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