{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:51:16Z","timestamp":1777881076744,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Endometriosis is a chronic gynecological disease associated with inflammation and severe pelvic pain in 6%\u201310% of women of reproductive age. Although the pathophysiology and management of endometriosis are currently understood, further research is needed to develop new diagnostic methods, particularly those involving inflammatory pathways, which could guide targeted therapies. This study aims to analyze the differences in levels of Chitinase-3-like protein 1 (CHI3L1) and Cyclooxygenase-2 (COX-2) in the walls of endometriosis cysts compared to non-endometriosis cysts (controls) and to evaluate the correlation of CHI3L1 with COX-2 and menstrual pain level using the Visual Analog Scale (VAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This observational analytical study utilized a cross-sectional design and included 64 samples divided into 2 groups: 32 endometriosis cysts and 32 non-endometriosis cysts. Diagnosis is made through ultrasound and laparoscopic surgery or laparotomy, with histopathological confirmation. Samples were taken from the cyst walls and analyzed for CHI3L1 and COX-2 levels using the Enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis was conducted using the Mann-Whitney test and Spearman\u2019s Rank correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The results showed that CHI3L1 and COX-2 levels in the walls of endometriosis cysts were significantly higher than in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A strong positive correlation was found between CHI3L1 and COX-2 (r\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.767;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and between CHI3L1 and menstrual pain level (VAS) (r\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.511;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study concludes that CHI3L1 may play a role in the pathogenesis of endometriosis through an inflammatory pain pathway involving COX-2 and prostaglandins.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121251409312","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:57:55Z","timestamp":1770980275000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Elevated CHI3L1 and COX-2 levels correlate with menstrual pain severity in endometriosis"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5191-8972","authenticated-orcid":false,"given":"Dewi Karlina","family":"Rusly","sequence":"first","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"},{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Syiah Kuala Medical School, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wiryawan","family":"Permadi","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hartanto","family":"Bayuaji","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3352-8664","authenticated-orcid":false,"given":"Hanom Husni","family":"Syam","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tita Husnitawati","family":"Madjid","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulyanusa Amarullah","family":"Ritonga","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Padjadjaran Medical School, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2268-6838","authenticated-orcid":false,"given":"Muhammad","family":"Rusda","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology and Infertility Subdivision, Universitas Sumatera Utara Medical School, Adam Malik Hospital, Medan, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Speroff\u2019s clinical gynecologic endocrinology and infertility","author":"Taylor HS","year":"2019","unstructured":"Taylor HS, Pal L, Sell E. Endometriosis. In: Speroff\u2019s clinical gynecologic endocrinology and infertility. Wolters Kluwer, 2019."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00935"},{"key":"e_1_3_2_4_2","first-page":"102","article-title":"Endometriosis in the adolescent patient","volume":"35","author":"Stuparich MA","year":"2017","unstructured":"Stuparich MA, Donnellan NM, Sanfilippo JS. Endometriosis in the adolescent patient. Semin Reprod Med 2017; 35: 102\u2013109.","journal-title":"Semin Reprod Med"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.07.497"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms221910554"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13669-017-0187-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.01.014"},{"key":"e_1_3_2_9_2","volume-title":"Endometrioma","author":"Hoyle AT","year":"2024","unstructured":"Hoyle AT, Puckett Y. Endometrioma. StatPearls Publishing, 2024."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9010054"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2014.887671"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.12891\/ceog1882.2015"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.24021"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-020-00303-7"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110680"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.02.007"},{"key":"e_1_3_2_17_2","volume-title":"Immunology of endometriosis pathogenesis and management","author":"Barra F","year":"2021","unstructured":"Barra F, Evangelisti G, Scala C, et al. The role of immune factors in endometriosis-related conditions. In: Koga K (ed.) Immunology of endometriosis pathogenesis and management. Elsevier Science, 2021."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.06.029"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh054"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21082815"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.3.561"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0894439305281503"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222111700"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11030978"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-020-00468-7"},{"key":"e_1_3_2_27_2","article-title":"Understanding diagnostic delay for endometriosis: a scoping review","volume":"233","author":"Fryer J","year":"2024","unstructured":"Fryer J, Mason-Jones AJ, Woodward A. Understanding diagnostic delay for endometriosis: a scoping review. medRxiv 2024; 233: 24300988.","journal-title":"medRxiv"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037095"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.22541\/AU.169516724.49578158\/V1"},{"key":"e_1_3_2_30_2","first-page":"649","article-title":"Laparoscopic evaluation of female factors in infertility","volume":"20","author":"Aziz N.","year":"2010","unstructured":"Aziz N. Laparoscopic evaluation of female factors in infertility. J Coll Physicians Surg Pak 2010; 20: 649\u2013652.","journal-title":"J Coll Physicians Surg Pak"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.53347\/rid-9042"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.53347\/rid-14473"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.53347\/rid-1808"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmu046"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-023-01406-6"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.35128"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0897.2002.01101.x"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2015.03.004"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0245-z"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.3390\/ph17030307"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.21037\/apm-21-3471"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2008.04.003"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des364"}],"container-title":["Sage Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121251409312","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20503121251409312","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121251409312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:31:36Z","timestamp":1777595496000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20503121251409312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":42,"alternative-id":["10.1177\/20503121251409312"],"URL":"https:\/\/doi.org\/10.1177\/20503121251409312","relation":{},"ISSN":["2050-3121","2050-3121"],"issn-type":[{"value":"2050-3121","type":"print"},{"value":"2050-3121","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"20503121251409312"}}