EXPRESS: Seeking the Root Causes of Menstrual Pain: A Systematic Review of Biomarkers in Menstrual Effluent.

IF 2.8 3区 医学 Q2 NEUROSCIENCES
Chandrashekara N Kyathanahalli, Frank F Tu, Gabriela Ashenafi, Margaret S Schroer, Kevin M Hellman
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引用次数: 0

Abstract

Dysmenorrhea (period pain) affects over 40% of women and is a leading cause of missed school and workdays. However, the molecular mechanisms underlying this pain are not fully understood. We conducted a systematic review (Prospero registration: CRD42024535081) to identify and evaluate the biomolecules in menstrual effluent that may contribute to dysmenorrhea and assess how non-hormonal medications (e.g., NSAIDs) impact these biomarkers. Fifteen studies involving 223 participants met the inclusion criteria. We used the Newcastle-Ottawa Scale (for observational studies) and the Cochrane RoB2 tool (for randomized controlled trials) to evaluate the risk of bias and the quality of studies. Eight studies consistently reported elevated prostaglandin levels in the menstrual effluent of women with dysmenorrhea, though sample sizes were generally small, and methodological issues were noted. Seven studies demonstrated that NSAIDs reduce prostaglandin concentrations; however, these trials utilized multiple-day dosing protocols instead of single-dose regimens, leaving questions about acute treatment effects. Two studies highlighted alternative molecular targets, such as 12-HETE and platelet-activating factor (PAF), that may also play key roles in menstrual pain. Overall, elevated prostaglandins are a recurring finding, but the limited scope and design of existing studies indicate a need for larger, methodologically rigorous investigations. Nevertheless, the few studies that identified molecules other than prostaglandins suggest there are viable druggable targets for clinical trials to reduce menstrual pain.

EXPRESS:寻找月经疼痛的根本原因:月经流出物生物标志物的系统综述。
痛经(经期疼痛)影响着超过40%的女性,是缺课和旷工的主要原因。然而,这种疼痛背后的分子机制尚不完全清楚。我们进行了一项系统综述(Prospero注册:CRD42024535081),以确定和评估月经流出物中可能导致痛经的生物分子,并评估非激素药物(如非甾体抗炎药)如何影响这些生物标志物。包括223名受试者的15项研究符合纳入标准。我们使用纽卡斯尔-渥太华量表(用于观察性研究)和Cochrane RoB2工具(用于随机对照试验)来评估偏倚风险和研究质量。8项研究一致报告了痛经妇女月经流出物中前列腺素水平升高,尽管样本量一般较小,并且注意到方法学问题。七项研究表明,非甾体抗炎药可降低前列腺素浓度;然而,这些试验采用多日给药方案,而不是单次给药方案,留下了关于急性治疗效果的问题。两项研究强调了其他分子靶点,如12-HETE和血小板活化因子(PAF),它们也可能在月经疼痛中发挥关键作用。总的来说,前列腺素升高是一个反复出现的发现,但现有研究的范围和设计有限,表明需要更大的、方法学上严格的调查。尽管如此,为数不多的确定前列腺素以外分子的研究表明,有可行的药物靶点可以用于临床试验,以减少月经疼痛。
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来源期刊
Molecular Pain
Molecular Pain 医学-神经科学
CiteScore
5.60
自引率
3.00%
发文量
56
审稿时长
6-12 weeks
期刊介绍: Molecular Pain is a peer-reviewed, open access journal that considers manuscripts in pain research at the cellular, subcellular and molecular levels. Molecular Pain provides a forum for molecular pain scientists to communicate their research findings in a targeted manner to others in this important and growing field.
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