{"title":"Modulating the tumor immune microenvironment as an ovarian cancer treatment strategy.","authors":"Uciane K Scarlett, Jose R Conejo-Garcia","doi":"10.1586/eog.12.41","DOIUrl":"https://doi.org/10.1586/eog.12.41","url":null,"abstract":"<p><p>After more than 30 years of iterations of surgical debulking plus chemotherapy, the need for complementary ovarian cancer treatments has become clear. In the ovarian cancer microenvironment, myeloid immunosuppressive leukocytes, lymphocytes, fibroblasts and endothelial cells, as well as their secreted products, surface molecules and paracrine survival factors, all provide opportunities for novel interventions. The potential of targeting microenvironmental elements in ovarian cancer patients is underscored by recently successful anti-angiogenic therapies. The compartmentalized nature of ovarian cancer, its immunogenicity and its accessibility make it an ideal disease for targeting non-tumor host cells. This review discusses the 'state-of-the-art' of the field, with an emphasis on the potential of modulating the activity of abundant microenvironmental immune cells, which govern both angiogenesis and immunosuppression.</p>","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"7 5","pages":"413-419"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1586/eog.12.41","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31735925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Church, Romana Koppensteiner, T. Yap, D. Fink, K. Dedes
{"title":"PI3K–AKT–mTOR inhibitors for the systemic treatment of endometrial cancer","authors":"D. Church, Romana Koppensteiner, T. Yap, D. Fink, K. Dedes","doi":"10.1586/EOG.12.51","DOIUrl":"https://doi.org/10.1586/EOG.12.51","url":null,"abstract":"Advanced and metastatic endometrial cancer (EC) is associated with a poor prognosis, despite the availability of systemic treatments including endocrine therapy and combination cytotoxic chemotherapy. Response rates of systemic treatments are associated with high toxicity, have poor response rates and responses are genenrally short-lived. Recent findings on the molecular aberrations of the subtypes of EC have enabled in vitro and in vivo studies to exploit targeted treatment for this disease. One of the most common molecular aberrations in EC is the PI3K–AKT–mTOR pathway being activated through different mechanisms in both type I and type II ECs. The aim of this review is to summarize the numerous preclinical and clinical studies, and discuss the future directions.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"1 1","pages":"421-430"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89571892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Timing of planned delivery in uncomplicated monochorionic diamniotic twin pregnancies: a review of the literature","authors":"K. Flood","doi":"10.1586/EOG.12.44","DOIUrl":"https://doi.org/10.1586/EOG.12.44","url":null,"abstract":"Monochorionic diamniotic (MCDA) twins comprise of 20–30% of twin pregnancies; roughly 50% will be undelivered and ‘uncomplicated’ beyond 32 weeks gestation. This review details accumulating data regarding the risk of intrauterine fetal demise (IUFD) in ‘uncomplicated’ MCDA twins and risks associated with prematurity. ‘Uncomplicated’ MCDA twins are at increased risk for IUFD, even when under intensified surveillance in tertiary care centers. The prospective risk of IUFD in uncomplicated MCDA varies among different studies, with reported rates of up to 3.3% at 34 weeks and 2.2% at 36 weeks. If single IUFD occurs, it exposes the surviving co-twin to potential significant morbidity and mortality. It had been suggested that elective preterm delivery would eliminate this risk, but recent evidence of prematurity morbidity are accumulating. With more intensified monitoring from 32 weeks, it is possible that the rate of IUFD is lower than anticipated. We reviewed the data regarding these risks and their contribution to the decision-making process.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"3 1","pages":"483-491"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75975991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Bellver, M. Mundi, F. Esteban, Sandra Mosquera, J. Horcajadas
{"title":"’-omics’ technology and human reproduction: reproductomics","authors":"J. Bellver, M. Mundi, F. Esteban, Sandra Mosquera, J. Horcajadas","doi":"10.1586/EOG.12.48","DOIUrl":"https://doi.org/10.1586/EOG.12.48","url":null,"abstract":"The success of assisted reproduction technology is highly dependent on a precise selection of gametes and embryos and determining the best endometrial window for embryo implantation. For many years, morphological criteria have constituted the only way to assess spermatozoon, oocytes, embryos and endometrial samples in order to improve outcomes. However, this approach has reached a ceiling of success and has been related to unacceptably high rates of multiple pregnancies. New technologies have been developed in order to improve the results and reduce risks via better selection of those gametes and embryos with the highest pregnancy potential, and of more favorable endometrial environments for embryo implantation. In addition, these technologies should ideally be objective, accurate, fast and affordable. Lately, the global strategies that are being employed in reproductive medicine include genomic, transcriptomic, proteomic, metabolomic profiling of oocytes, cummulus cells, granulosa cells, embryos, endomet...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"120 1","pages":"493-506"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84290921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Origoni, C. Gelardi, F. Pasi, S. Salvatore, M. Candiani
{"title":"Postpartum hemorrhage caused by uterine artery pseudoaneurysm and uterine rupture after vaginal delivery","authors":"M. Origoni, C. Gelardi, F. Pasi, S. Salvatore, M. Candiani","doi":"10.1586/EOG.12.33","DOIUrl":"https://doi.org/10.1586/EOG.12.33","url":null,"abstract":"A case of massive hemoperitoneum determined by uterine rupture and uterine artery pseudoaneurysm dissection after vaginal delivery, requiring an emergency laparotomy with arterial ligation, is reported. The authors reviewed the published literature, finding 12 cases of uterine artery pseudoaneurysm and associated postpartum hemorrhage after vaginal delivery, but no cases with uterine rupture have ever been published. Diagnosis is based upon imaging, and management options include arterial embolization, arterial ligation and hysterectomy in particularly severe and life-threatening situations. Vaginal bleeding is associated with favorable outcomes and conservative treatment, while the absence of external blood loss seems to be correlated with a worsened prognosis and the need for an invasive treatment option. Uterine artery pseudoaneurysm rupture after vaginal delivery is a very rare condition of life-threatening postpartum hemorrhage, being more frequently associated with cesarean section. Uterine artery pseudoaneurysm dissection should be suspected in any patient presenting with early or delayed postpartum hemorrhage after a vaginal delivery and can be associated with uterine rupture.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"50 1","pages":"313-319"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86695663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic factors influencing recurrent pregnancy loss: lessons learnt from recent studies","authors":"S. Dasgupta, Aruna Meka, B. M. Reddy","doi":"10.1586/EOG.12.32","DOIUrl":"https://doi.org/10.1586/EOG.12.32","url":null,"abstract":"Recurrent miscarriage (RM) is the loss of three or more consecutive pregnancies before the 24th week of gestation. RM occurs chiefly owing to either a problem with the pregnancy or the environment where it implants and further development occurs. A large number of pathological factors have been attributed to the etiology of RM. A number of genetic association studies in different populations, including that of India, have been conducted, yet with no definite conclusions. This review analyzes various genetic association studies that have been conducted based on the underlying immunological, thrombophilic and endocrine factors in RM, and outlines the salient features of the findings and lessons from those, suggesting possible future directions for research in this area.","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"4 1","pages":"363-378"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76767081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"First-trimester ultrasound volumetry: measurement techniques and potential application in the prediction of pregnancy complications","authors":"Kwok-Yin Leung, T. Ma, B. Lau, Min Chen","doi":"10.1586/EOG.12.37","DOIUrl":"https://doi.org/10.1586/EOG.12.37","url":null,"abstract":"First-trimester prediction of intrauterine growth restriction (IUGR), preeclampsia (PE), birthweight, aneuploidy, miscarriage, complications in multiple pregnancies and homozygous α0-thalassemia is a challenging and emerging field. Placenta volumes (PV) and embryo volume/fetal volume ratios are correlated with crown–rump length (CRL) or gestational age. Measurement of PV or placental quotient (PV/CRL ratio) is an early method to identify impaired trophoblast invasion and predict subsequent development of IUGR or PE. In early-onset IUGR caused by triploidy, or trisomy 13 or 18, a larger deficit in fetal volume than CRL is observed. Fetal and placental volume measurements may be applied to predict other conditions such as aneuploidy, miscarriage or stillbirth. Standardization of the 3D volumetric methodology is needed to improve reproducibility of measurement. Further studies are required to determine the use of first-trimester volumetry alone or in combination with Doppler ultrasound and other parameters t...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"17 1","pages":"379-386"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87190229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Precancerous lesions and an emerging model of endometrial serous carcinogenesis: clinical implications","authors":"O. Fadare, Wenxin Zheng","doi":"10.1586/EOG.12.27","DOIUrl":"https://doi.org/10.1586/EOG.12.27","url":null,"abstract":"Endometrial serous carcinomas (ESCs; also known as uterine papillary serous carcinomas) only represent approximately 10% of endometrial carcinomas [1], but are responsible for up to 40% of all deat...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"95 1","pages":"297-299"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77414761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Traeger-Synodinos, G. Kakourou, C. Vrettou, E. Kanavakis
{"title":"Looking to the future: developments in preimplantation genetic diagnosis","authors":"J. Traeger-Synodinos, G. Kakourou, C. Vrettou, E. Kanavakis","doi":"10.1586/EOG.12.28","DOIUrl":"https://doi.org/10.1586/EOG.12.28","url":null,"abstract":"Since the first clinical preimplantation genetic diagnosis (PGD) cycles carried out in 1989, continuous technical improvements have supported progression from what was initially perceived to be an experimental procedure to a widely acceptable alternative to conventional prenatal diagnosis. PGD requires the use of assisted reproductive technology (ART) to create the preimplantation-stage embryo, followed by biopsy to obtain cell(s) for genetic analysis and, finally, transfer of selected embryos to the womb to establish a pregnancy. PGD is an important reproductive option for parents at high risk of transmitting a single-gene or specific chromosomal abnormality to their children (high-risk PGD), supporting the establishment of a healthy pregnancy while precluding possible pregnancy termination. Alternatively, embryos may be tested for ploidy status, a test widely known as preimplantation genetic screening (PGS). PGS is considered to be a lowrisk form of PGD, offered to women of advanced maternal age or couples with poor reproductive history, which aims to select euploid embryos for transfer to improve the implantation and live birth rates after ART. However, low-risk PGD is controversial and constitutes one of the most highly debated topics in reproductive medicine over the last decade, chiefly because it was introduced into routine clinical practice before its clinical benefit was clarified. Reports to date evaluating ART outcomes following PGS have shown contradicting evidence, mainly complicated by the numerous parameters involved in PGS procedures, many of which may introduce bias. It is paramount to resolve this issue and the only way is through large multicenter randomized controlled studies, such as one currently being organized with the support of the European Society of Human Reproduction and Embryology (ESHRE) [1].","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"47 1","pages":"293-295"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78233527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Lalitkumar, P. Lalitkumar, K. Gemzell‐Danielsson
{"title":"Germline stem cells: new insights into female infertility management","authors":"S. Lalitkumar, P. Lalitkumar, K. Gemzell‐Danielsson","doi":"10.1586/EOG.12.34","DOIUrl":"https://doi.org/10.1586/EOG.12.34","url":null,"abstract":"Evaluation of: White YA, Woods DC, Takai Y, Ishihara O, Seki H, Tilly JL. Oocyte formation by mitotically active germ cells purified from ovaries of reproductive-age women. Nat. Med. 18(3), 413–421 (2012).Ovarian aging was long considered to be irrevocable in the journey of a woman´s reproductive life. But with the identification of germline stem cells, differentiating into oocytes is a landmark innovation in the field of reproductive medicine. The existing clinical and biochemical information about the ovarian reserve has been very limited. As global infertility rates are increasing, research in recent years has focused on ingenious treatments, offering promising solutions to infertile couples with ovarian failure. The article under evaluation demonstrates for the first time that candidate oogonial stem cells can be reliably isolated from adult mice and human ovaries through a FACS-based approach. This was achieved by targeting the cytoplasmic germ cell proteins Ddx4 and DDX4 in mice and humans, respecti...","PeriodicalId":12242,"journal":{"name":"Expert Review of Obstetrics & Gynecology","volume":"70 1","pages":"309-311"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84457320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}