Iron overload in the peritoneal cavity of women with pelvic endometriosis
Open accessAbstract
Objective To examine the possible involvement of iron in the physiopathology of endometriosis.Design Prospective study.Setting Department of gynecology in a university hospital.Patient(s) Seventy patients undergoing laparoscopy.Intervention(s) Collection of peritoneal fluid (n = 57), blood samples, and biopsy samples from endometrium (n = 62) and from endometriotic (n = 33) and normal-appearing peritoneum (n = 53).Main outcome measure(s) Measurement of iron and ferritin in serum and peritoneal fluid and staining of iron deposits with Prussian blue in tissues.Result(s) Iron and ferritin concentrations were significantly higher in the peritoneal fluid of patients with endometriosis compared with controls during the secretory phase. Higher rates of ferritin and hemosiderin deposits were observed in the peritoneum adjacent to red (100%), black (57%), and white (62%) lesions compared with normal-appearing peritoneum (25%). Deposits were more frequent during the secretory phase than the proliferative phase in healthy peritoneum from controls, whereas they were found throughout the cycle in the vicinity of lesions in patients with endometriosis. Similar rates of iron deposition were observed in the stroma of black and white lesions and in eutopic endometrium from patients with endometriosis.Conclusion(s) Iron overload was observed in the cellular and peritoneal fluid compartments of the peritoneal cavity of women with endometriosis. Iron deposits seem to be related to the presence of lesions, suggesting that iron may be involved in the pathogenesis of endometriosis.
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Proinflammatory factors (heme, iron) and cytokines (TNFα, IL1β) may disrupt PR function and play a role in progesterone resistance, leading to increased NF-kB activity involved in endometriosis development.
“Proinflammatory factors (like heme and iron) and cytokines (like tumor necrosis factor-alpha (TNFα) and interleukin 1 beta (IL1β)) may also disrupt PR function and play a role in progesterone resistance which finally leads to increased nuclear factor kappa B (NF-kB) activity, which is involved in endometriosis development [27,33,34].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [27]
Retrograde menstruation and bleeding of endometriotic lesions are responsible for erythrocytes in the pelvic cavity, which release pro-oxidant and proinflammatory factors like hemoglobin and its byproducts heme and iron.
“Retrograde menstruation and bleeding of endometriotic lesions are responsible for the presence of erythrocytes in the pelvic cavity, which are likely to release pro-oxidant and proinflammatory factors like hemoglobin and its highly toxic byproducts heme and iron [27,28,29,30].”
From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [27]
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- Authors
- Van Langendonckt, A., Casanas-Roux, F., & Donnez, J.
- Affiliations
- UCLouvain (BE)
- Corresponding author
- Donnez, Jacques
- ORCID
- Donnez, Jacques
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2002-10
- Volume
- 78
- Issue
- 4
- Pages
- 712-718
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2031361052
- Cited by
- 137
- References
- 28
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 14 · 2023: 13 · 2022: 9 · 2021: 9 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 6 · 2012: 12
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- DIAL (Catholic University of Leuven) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, iron overload, ferritin, hemosiderin, peritoneal fluid, menstrual cycle, luteal phase, endometriotic lesions, endometrium
- MeSH terms
- Adult, Ascitic Fluid, Biopsy, Endometriosis, Endometrium, Female, Ferritins, Ferrocyanides, Humans, Iron, Peritoneum, Prospective Studies, Staining and Labeling, Macrophages, Peritoneal, Iron Overload
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