{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:49:22Z","timestamp":1790120962091,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T00:00:00Z","timestamp":1430784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsinki University Central Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001774","name":"University of Sydney","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the density of nerve fibers in cases of deep infiltrating endometriosis (<jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content>) of the rectovaginal septum in relation to various clinical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A research laboratory\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A tertiary center together with a research laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Archived <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> tissue samples from 45 women operated upon for rectovaginal septum <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> were re\u2010examined histologically, and by immunohistochemistry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The effect of progestogens or combined oral contraceptives on the density of nerve fibers, and the expression of nerve growth factor (<jats:styled-content style=\"fixed-case\">NGF<\/jats:styled-content>) and its high\u2010affinity receptor (tyrosine kinase receptor A, Trk\u2010A).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The use of hormonal therapy was associated with reduced densities of sympathetic, parasympathetic and sensory nerve fibers in <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> lesions. Density of total nerve fibers (with pan\u2010neuronal marker <jats:styled-content style=\"fixed-case\">PGP<\/jats:styled-content>9.5) was significantly lower (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) in lesions collected from hormone\u2010treated women (8.6\/mm\u00b2, 4.2\u201320.8\/mm\u00b2; median density, from 25th to 75th quartiles) compared with that in lesions from untreated women (24.9\/mm\u00b2, 11.2\u201334.9\/mm\u00b2). <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> lesions stained strongly for <jats:styled-content style=\"fixed-case\">NGF<\/jats:styled-content> and its receptor Trk\u2010A. Expression of <jats:styled-content style=\"fixed-case\">NGF<\/jats:styled-content>, but not of Trk\u2010A, was significantly reduced during use of hormonal therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Use of hormonal therapy was associated with significantly reduced nerve fiber density in <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> lesions. This may be an important mechanism of action of hormonal therapy for controlling <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content> pain symptoms. The expression of estrogen\u2010regulated <jats:styled-content style=\"fixed-case\">NGF<\/jats:styled-content> and its receptor was only partially suppressed during the use of hormonal therapy, suggesting that local estrogen action is often maintained during conventional hormonal therapy in cases of <jats:styled-content style=\"fixed-case\">DIE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12652","type":"journal-article","created":{"date-parts":[[2015,4,11]],"date-time":"2015-04-11T07:23:03Z","timestamp":1428736983000},"page":"693-700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Use of hormonal therapy is associated with reduced nerve fiber density in deep infiltrating, rectovaginal endometriosis"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1113-6328","authenticated-orcid":false,"given":"Satu","family":"Tarjanne","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia H.M.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Neonatology Queen Elizabeth II Research Institute for Mothers and Infants University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Manconi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Neonatology Queen Elizabeth II Research Institute for Mothers and Infants University of Sydney Sydney New South Wales 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