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Tissue-Predominant Estrogen Metabolic Remodeling in Adenomyosis Revealed by LC-MS/MS Profiling
Qing Wang1, BoYang Liu2, Lei Kuang3
1Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China; Department of Obstetrics and Gynecology, Xuzhou Central Hospital, Xuzhou 221009, China.
Adenomyosis (AM) involves altered estrogen metabolism primarily within endometrial tissue, not systemically. This local shift, particularly increased catechol estrogens, correlates with severe dysmenorrhea and may indicate specific diagnostic markers.
Area of Science:
- Endocrinology
- Gynecology
- Metabolomics
Background:
- Adenomyosis (AM) is an estrogen-dependent gynecological condition.
- Clinical heterogeneity in AM may stem from local steroid metabolism.
- Understanding estrogen handling in AM is crucial for characterizing the disease.
Purpose of the Study:
- To characterize estrogen metabolic profiles in endometrial tissue and serum of patients with adenomyosis.
- To investigate the relationship between specific estrogen metabolites and clinical symptoms like dysmenorrhea.
- To identify potential biomarkers for adenomyosis based on estrogen metabolism.
Main Methods:
- Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed to quantify 13 estrogens and metabolites.
- Analysis was performed on both endometrial tissue and serum samples.
- Pathway- and ratio-based analyses, correlation, regression, and ROC analyses were conducted.
Main Results:
- Marked increases in catechol estrogens (2-hydroxyestrone and 4-hydroxyestrone) were observed in endometrial tissue.
- Serum metabolite changes were less pronounced, with 2-methoxyestrone showing the main difference.
- Tissue 2-hydroxyestrone and 4-hydroxyestrone levels were independently associated with dysmenorrhea severity.
Conclusions:
- Adenomyosis is associated with localized remodeling of estrogen metabolism in endometrial tissue.
- Enhanced hydroxylation, rather than generalized estrogen elevation, characterizes AM tissue metabolism.
- Tissue catechol estrogens show potential as discriminatory markers for AM and its symptom severity.
