Experimental modeling, prevention, and treatment of endometriosis-associated adhesion formation in NIH/3T3 fibroblast cell line using bovhyaluronidase azoximer (in vitro)

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Endometriosis is a gynecological disease characterized by the presence of tissue that is morphologically and functionally similar to the endometrium, but located outside the uterine cavity, with a chronic and recurrent course. According to literature, endometriosis affects approximately 10% of women of reproductive age worldwide. Fibrosis plays a key role in both the pathogenesis and progression of endometriosis, as well as in the manifestation of its symptoms. The fibrotic process is initiated by inflammation, which is accompanied by the release of cytokines, such as TGF-β1, IL-17, and others, leading to the activation of fibroblasts and their transformation into myofibroblasts. Myofibroblasts contribute to the excessive production of collagen, hyaluronic acid, and other components of the extracellular matrix, resulting in the formation of fibrous tissue and adhesions. This mechanism underlies the progression of endometriosis-associated adhesion processes, exacerbating the clinical picture of the disease, causing pain, dyspareunia, bleeding, organ dysfunction, infertility, and overall reduced quality of life. The study evaluated the effectiveness of bovhyaluronidase azoximer (an enzyme preparation that is a modified form of hyaluronidase, with azoximer being a biopolymer that enhances the pharmacological properties of hyaluronidase by increasing its stability and duration of action in the body) in both the prevention and treatment of endometriosis-associated adhesion processes. An in vitro cellular model was used for this purpose. Thus, in a cell model (in vitro), it was demonstrated that bovhyaluronidase azoximer inhibits key profibrotic mechanisms induced by transforming growth factor-β1 (TGF-β1), such as collagen I expression, metabolic activity, and myofibroblast migration, which confirms its antifibrotic potential. The application of bovhyaluronidase azoximer suppressed the metabolic activity and migration of myofibroblasts, confirming its antifibrotic potential. These results demonstrate promising prospects for the prevention and targeted therapy of fibrotic changes in endometriosis, as well as reducing the risk of adhesion formation, opening new possibilities for the comprehensive treatment of the disease.

Keywords:

Endometriosis

adhesion formation

pain

infertility

hyaluronic acid

Authors:

Adamyan L.V.

Russian University of Medicine;
Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

SPIN RSCI: 9836-2713
Scopus AuthorID: 7006372422
ResearcherID: Q-1722-2018
ORCID: 0000-0002-3253-4512

Pivazyan L.G.

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

ORCID: 0000-0002-6844-3321

Mailova K.S.

Russian University of Medicine

ORCID: 0000-0003-2723-3114

Peshkova Yu.O.

Russian University of Medicine

ORCID: 0000-0003-3833-3380

Stepanian A.A.

Academy of Women’s Health and Endoscopic Surgery

Received:

08.10.2024

Accepted:

31.10.2024

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