Estrogens hypersensitivity syndrome in endometriosis

Objectives. The aim of the study was to develop a diagnostic method for estrogen hypersensitivity syndrome in proliferative benign diseases of the female reproductive system. Using the example of endometriosis, changes in the activity of the chaperone protein Hsp90α were determined as a diagnostic biomarker.

Methods. The study included 60 women aged 30 to 50 years, thirty of whom had a laparoscopically confirmed diagnosis of endometriosis and 30 were included in the control group. After blood sampling to determine the baseline levels of Hsp90α, the patients were prescribed a single oral dose of estradiol valerate 2 mg tablet. The plasma Hsp90α levels were remeasured 6 h later.

Results. No significant change (p>0.05) in baseline Hsp90α concentrations was found between the group of patients with endometriosis and the control group. Six hours after estradiol valerate administration, a significant difference (p<0.001) in Hsp90α levels was observed between the group of patients with endometriosis and the control group. The increase in Hsp90α concentration following the test-load was also more pronounced in women with confirmed endometriosis compared to controls (27.29±15.62 ng/ml and 3.16±4.36 ng/ml, respectively) (p<0.001). ROC analysis indicated that the absolute increase in Hsp90α level of more than 8.6 ng/ml in patients with endometriosis has a sensitivity of 0.93 and a specificity of 0.97 (compared to the control group). This change in relative concentration corresponded to an increase of over 28.7%.

Conclusion. The increase in Hsp90α plasma level of more than 30% within 6 h after the test-load is a specific criterion for estrogen hypersensitivity syndrome in endometriosis. Further investigation including other nosological forms (myoma, adenomyosis, endometrial hyperplasia) is required.