{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:37:14Z","timestamp":1787675834887,"version":"build-2784847793"},"reference-count":70,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo Research Foundation","doi-asserted-by":"publisher","award":["FAPESP - 2018\/11042-0)."],"award-info":[{"award-number":["FAPESP - 2018\/11042-0)."]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Endometriosis causes immunological and cellular alterations. Endometriosis lesions have lower levels of lamin b1 than the endometrium. Moreover, high levels of pro-inflammatory markers are observed in the peritoneal fluid, follicular fluid, and serum in endometriosis lesions. Thus, we hypothesized that the accumulation of senescent cells in endometriosis tissues would facilitate endometriosis maintenance in an inflammatory microenvironment. To study senescent cell markers and the senescence-associated secretory phenotype (SASP) in endometriosis lesions, we conducted a cross-sectional study with 27 patients undergoing video laparoscopy for endometriosis resection and 19 patients without endometriosis. Endometriosis lesions were collected from patients with endometriosis, while eutopic endometrium was collected from patients both with and without endometriosis. Tissues were evaluated for senescence markers (p16Ink4a, lamin b1, and IL-1\u03b2) and interleukin concentrations. The expression of p16Ink4a increased in lesions compared to that in eutopic endometrium from endometriosis patients in the secretory phase. In the proliferative phase, lesions exhibited lower lamin b1 expression but higher IL-4 expression than the eutopic endometrium. Further, IL-1\u03b2 levels were higher in the lesions than in the eutopic endometrium in both the secretory and proliferative phases. We believe that our findings may provide targets for better therapeutic interventions to alleviate the symptoms of endometriosis.<\/jats:p>","DOI":"10.3390\/ijms23052476","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T07:22:35Z","timestamp":1645687355000},"page":"2476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Altered p16Ink4a, IL-1\u03b2, and Lamin b1 Protein Expression Suggest Cellular Senescence in Deep Endometriotic Lesions"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5504-6116","authenticated-orcid":false,"given":"Helena","family":"Malvezzi","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristine","family":"Dobo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee Zon","family":"Filippi","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Mendes do Nascimento","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Palmieri da Silva e Sousa","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2514-4011","authenticated-orcid":false,"given":"Juliana","family":"Meola","sequence":"additional","affiliation":[{"name":"School of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Gynecology and Obstetrics, Av. Bandeirantes, 3900, Vila Monte Alegre 14049-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla Azevedo","family":"Piccinato","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio","family":"Podgaec","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Morumbi 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.molmed.2018.07.004","article-title":"The Immunopathophysiology of Endometriosis","volume":"24","author":"Symons","year":"2018","journal-title":"Trends Mol. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s10815-016-0782-5","article-title":"Intrafollicular interleukin-8, interleukin-12, and adrenomedullin are the promising prognostic markers of oocyte and embryo quality in women with endometriosis","volume":"33","author":"Singh","year":"2016","journal-title":"J. Assist. Reprod Genet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1530\/REP-19-0050","article-title":"Is there an immune modulating role for follicular fluid in endometriosis? A narrative review","volume":"159","author":"Prins","year":"2020","journal-title":"Reproduction"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1470-y","article-title":"Mass cytometry analysis reveals a distinct immune environment in peritoneal fluid in endometriosis: A characterisation study","volume":"18","author":"Guo","year":"2020","journal-title":"BMC Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1177\/1933719116653677","article-title":"The Presence of Endometrial Cells in Peritoneal Fluid of Women with and Without Endometriosis","volume":"24","author":"Dorien","year":"2017","journal-title":"Reprod. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1159\/000496607","article-title":"Interleukin-15 and Interleukin-7 are the Major Cytokines to Maintain Endometriosis","volume":"84","author":"Bellelis","year":"2019","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"eAO5294","DOI":"10.31744\/einstein_journal\/2020AO5294","article-title":"Regulatory T cells isolated from endometriotic peritoneal fluid express a different number of Toll-like receptors","volume":"18","author":"Hernandes","year":"2020","journal-title":"Einstein"},{"key":"ref_8","first-page":"1033","article-title":"Angiogenesis, lymphangiogenesis and neurogenesis in endometriosis","volume":"5","author":"Peters","year":"2013","journal-title":"Front. Biosci. (Elite Ed.)"},{"key":"ref_9","first-page":"8","article-title":"Angiogenesis and endometriosis","volume":"53","author":"Olartecoechea","year":"2009","journal-title":"Rev. Med. La Univ. Navar."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3139","DOI":"10.1093\/humrep\/dem262","article-title":"Endometrial cells from women with endometriosis have increased adhesion and proliferative capacity in response to extracellular matrix components: Towards a mechanistic model for endometriosis progression","volume":"22","author":"Klemmt","year":"2007","journal-title":"Hum. Reprod."},{"key":"ref_11","first-page":"591","article-title":"Endometriosis and cancer","volume":"10","author":"Losan","year":"2014","journal-title":"Womens Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2147\/IJWH.S66824","article-title":"Endometriosis and ovarian cancer: Links, risks, and challenges faced","volume":"7","author":"Pavone","year":"2015","journal-title":"Int. J. Womens Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S0301-2115(99)00263-8","article-title":"Is endometriosis an endometrial disease?","volume":"91","author":"Vinatier","year":"2000","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1530\/REP-16-0278","article-title":"Macrophages promote the growth and invasion of endometrial stromal cells by downregulating IL-24 in endometriosis","volume":"152","author":"Shao","year":"2016","journal-title":"Reproduction"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/aji.12408","article-title":"Natural Killer Cells: Key Players in Endometriosis","volume":"74","author":"Thiruchelvam","year":"2015","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jmig.2011.12.021","article-title":"Patients with Endometriosis of the Rectosigmoid Have a Higher Percentage of Natural Killer Cells in Peripheral Blood","volume":"19","author":"Dias","year":"2012","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1210\/en.2005-0790","article-title":"Neutrophils and macrophages promote angiogenesis in the early stage of endometriosis in a mouse model","volume":"147","author":"Lin","year":"2006","journal-title":"Endocrinology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1093\/humrep\/det401","article-title":"Can chemokines be used as biomarkers for endometriosis? A systematic review","volume":"29","author":"Borrelli","year":"2014","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"79","DOI":"10.2174\/138161210789941874","article-title":"Cellular Senescence in the Development and Treatment of Cancer","volume":"16","author":"Saretzki","year":"2010","journal-title":"Curr. Pharm. Des."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.it.2015.02.009","article-title":"Senescence-associated inflammatory responses: Aging and cancer perspectives","volume":"36","author":"Lasry","year":"2015","journal-title":"Trends Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.tcb.2018.02.001","article-title":"Hallmarks of Cellular Senescence","volume":"28","author":"Nehme","year":"2018","journal-title":"Trends Cell Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.cell.2019.10.005","article-title":"Cellular Senescence: Defining a Path Forward","volume":"179","author":"Gorgoulis","year":"2019","journal-title":"Cell"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1038\/nm.4000","article-title":"Cellular senescence in aging and age-related disease: From mechanisms to therapy","volume":"21","author":"Childs","year":"2015","journal-title":"Nat. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1038\/nrm3823","article-title":"Cellular senescence: From physiology to pathology","volume":"15","author":"Serrano","year":"2014","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.cyto.2019.01.013","article-title":"The senescence-associated secretory phenotype and its regulation","volume":"117","author":"Rowell","year":"2019","journal-title":"Cytokine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3","DOI":"10.18632\/aging.100871","article-title":"Markers of cellular senescence. Telomere shortening as a marker of cellular senescence","volume":"8","author":"Bernadotte","year":"2016","journal-title":"Aging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/molehr\/gav074","article-title":"Oxidative stress damage-associated molecular signaling pathways differentiate spontaneous preterm birth and preterm premature rupture of the membranes","volume":"22","author":"Dutta","year":"2015","journal-title":"Mol. Hum. Reprod."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10815-016-0865-3","article-title":"Intrafollicular inflammatory cytokines but not steroid hormone concentrations are increased in naturally matured follicles of women with proven endometriosis","volume":"34","author":"Wu","year":"2017","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s00404-018-4691-y","article-title":"Depleted lamin B1: A possible marker of the involvement of senescence in endometriosis?","volume":"297","author":"Malvezzi","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/cas.12118","article-title":"Roles and mechanisms of cellular senescence in regulation of tissue homeostasis","volume":"104","author":"Ohtani","year":"2013","journal-title":"Cancer Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1146\/annurev-pathol-121808-102144","article-title":"The senescence-associated secretory phenotype: The dark side of tumor suppression","volume":"5","author":"Desprez","year":"2010","journal-title":"Annu. Rev. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1530\/REP-18-0618","article-title":"Interleukin in endometriosis-associated infertility-pelvic pain: Systematic review and meta-analysis","volume":"158","author":"Malvezzi","year":"2019","journal-title":"Reproduction"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11613\/BM.2019.030501","article-title":"Hallmarks of senescence and aging","volume":"29","author":"Dodig","year":"2019","journal-title":"Biochem. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1038\/nrc3960","article-title":"Forging a signature of in vivo senescence","volume":"15","author":"Sharpless","year":"2015","journal-title":"Nat. Rev. Cancer."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/j.1474-9726.2006.00231.x","article-title":"p16INK4A is a robust in vivo biomarker of cellular aging in human skin","volume":"5","author":"Ressler","year":"2006","journal-title":"Aging Cell"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wang, A.S., Ong, P.F., Chojnowski, A., Clavel, C., and Dreesen, O. (2017). Loss of lamin B1 is a biomarker to quantify cellular senescence in photoaged skin. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-15901-9"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/MCB.00586-18","article-title":"Uncoupling the Senescence-Associated Secretory Phenotype from Cell Cycle Exit via Interleukin-1 Inactivation Unveils Its Protumorigenic Role","volume":"39","author":"Lau","year":"2019","journal-title":"Mol. Cell Biol."},{"key":"ref_38","first-page":"460","article-title":"Senescence-Associated Secretory Phenotype (SASP) involvement in the development of cancer, aging and age related diseases","volume":"151","author":"Diazguerrero","year":"2015","journal-title":"Gac. M\u00e9dica M\u00e9xico"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/acel.12946","article-title":"IL-1\u03b1 cleavage by inflammatory caspases of the noncanonical inflammasome controls the senescence-associated secretory phenotype","volume":"18","author":"Wiggins","year":"2019","journal-title":"Aging Cell"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"17031","DOI":"10.1073\/pnas.0905299106","article-title":"Cell surface-bound IL-1\u03b1 is an upstream regulator of the senescence-associated IL-6\/IL-8 cytokine network","volume":"106","author":"Orjalo","year":"2009","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1073\/pnas.1818313116","article-title":"Cells exhibiting strong p16 INK4a promoter activation in vivo display features of senescence","volume":"116","author":"Liu","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1038\/nm.3464","article-title":"Rejuvenation of the muscle stem cell population restores strength to injured aged muscles","volume":"20","author":"Cosgrove","year":"2014","journal-title":"Nat. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1182\/blood-2010-09-304402","article-title":"Expression of p16INK4a prevents cancer and promotes aging in lymphocytes","volume":"117","author":"Liu","year":"2011","journal-title":"Blood"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/nature13193","article-title":"The role of senescent cells in ageing","volume":"509","year":"2014","journal-title":"Nature"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"64665","DOI":"10.18632\/oncotarget.11660","article-title":"Stromal p16 expression is significantly increased in malignant ovarian neoplasms","volume":"4","author":"Yoon","year":"2016","journal-title":"Oncotarget"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00428-012-1276-1","article-title":"Stromal p16 expression differentiates endometrial polyp from endometrial hyperplasia","volume":"461","author":"Moritani","year":"2012","journal-title":"Virchows Arch."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4826","DOI":"10.18632\/oncotarget.13594","article-title":"Stromal p16 expression is significantly increased in endometrial carcinoma","volume":"8","author":"Yoon","year":"2017","journal-title":"Oncotarget"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1080\/09513590.2018.1480709","article-title":"Correlation between replicative senescence of endometrial gland epithelial cells in shedding and non-shedding endometria and endometriosis cyst during menstruation","volume":"34","author":"Yu","year":"2018","journal-title":"Gynecol Endocrinol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1007\/s10815-021-02182-5","article-title":"Decreased number of p16-positive senescent cells in human endometrium as a marker of miscarriage","volume":"38","author":"Parvanov","year":"2021","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_50","first-page":"166","article-title":"Implications of telomeres and telomerase in endometrial pathology","volume":"23","author":"Hapangama","year":"2017","journal-title":"Hum. Reprod. Update"},{"key":"ref_51","first-page":"1213","article-title":"Introduction of p16INK4a inhibits telomerase activity through transcriptional suppression of human telomerase reverse transcriptase expression in human gliomas","volume":"24","author":"Saito","year":"2004","journal-title":"Int. J. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.cell.2013.01.009","article-title":"LBR and lamin A\/C sequentially tether peripheral heterochromatin and inversely regulate differentiation","volume":"152","author":"Solovei","year":"2013","journal-title":"Cell"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1101\/gad.223834.113","article-title":"Lamin B1 depletion in senescent cells triggers large-scale changes in gene expression and the chromatin landscape","volume":"27","author":"Shah","year":"2013","journal-title":"Genes Dev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"283","DOI":"10.4161\/nucl.25808","article-title":"The contrasting roles of lamin B1 in cellular aging and human disease","volume":"4","author":"Dreesen","year":"2013","journal-title":"Nucleus"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1083\/jcb.201206121","article-title":"Lamin B1 fluctuations have differential effects on cellular proliferation and senescence","volume":"200","author":"Dreesen","year":"2013","journal-title":"J. Cell Biol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"111927","DOI":"10.1016\/j.yexcr.2020.111927","article-title":"The role of lamin B receptor in the regulation of senescence-associated secretory phenotype (SASP)","volume":"390","author":"En","year":"2020","journal-title":"Exp. Cell Res."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Dalle Pezze, P., Nelson, G., Otten, E.G., Korolchuk, V.I., Kirkwood, T.B.L., von Zglinicki, T., and Shanley, D.P. (2014). Dynamic Modelling of Pathways to Cellular Senescence Reveals Strategies for Targeted Interventions. PLoS Comput. Biol., 10.","DOI":"10.1371\/journal.pcbi.1003728"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1093\/biolre\/ioaa183","article-title":"In vitro models of the human endometrium: Evolution and application for women\u2019s health","volume":"104","author":"Fitzgerald","year":"2021","journal-title":"Biol. Reprod."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/humupd\/dmv038","article-title":"Menstrual physiology: Implications for endometrial pathology and beyond","volume":"21","author":"Maybin","year":"2015","journal-title":"Hum. Reprod. Update"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.fertnstert.2015.11.047","article-title":"Surgical removal of endometriotic lesions alters local and systemic proinflammatory cytokines in endometriosis patients","volume":"105","author":"Monsanto","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jri.2018.08.002","article-title":"Annexin A1, FPR2\/ALX, and inflammatory cytokine expression in peritoneal endometriosis","volume":"129","author":"Volpato","year":"2018","journal-title":"J. Reprod. Immunol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fimmu.2019.02021","article-title":"Interleukin-1\/-33 signaling pathways as therapeutic targets for endometriosis","volume":"10","author":"Kato","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.cyto.2017.07.022","article-title":"IL-33-matured dendritic cells promote Th17 cell responses via IL-1\u03b2 and IL-6","volume":"99","author":"Park","year":"2017","journal-title":"Cytokine"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/path.2527","article-title":"Do we see what we think we see? The complexities of morphological assessment","volume":"218","author":"Hamilton","year":"2009","journal-title":"J. Pathol."},{"key":"ref_65","first-page":"641","article-title":"Clasificaci\u00f3n y nomenclatura de las alteraciones menstruales","volume":"75","author":"Enciso","year":"2007","journal-title":"Ginecol. Obstet. Mex."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1177\/0192623311419163","article-title":"The use of immunohistochemistry for biomarker assessment\u2014Can itcompete with other technologies?","volume":"39","author":"Dunstan","year":"2011","journal-title":"Toxicol. Pathol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5229","DOI":"10.1210\/jc.2002-020429","article-title":"Mifepristone-induced vaginal bleeding is associated with increased immunostaining for cyclooxygenase-2 and decrease in prostaglandin dehydrogenase in luteal phase endometrium","volume":"87","author":"Hapangama","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_68","first-page":"711","article-title":"Endometriosis is associated with aberrant endometrial expression of telomerase and increased telomere length","volume":"63","author":"Hapangama","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/molehr\/4.4.407","article-title":"Progesterone receptor subtype B is differentially regulated in human endometrial stroma","volume":"4","author":"Wang","year":"1998","journal-title":"Mol. Hum. Reprod."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Faraway, J.J. (2016). Extending the Linear Model with R: Generalized Linear, Mixed Effects and Nonparametric Regression Models, CRC Press.","DOI":"10.1201\/9781315382722"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/5\/2476\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:25:55Z","timestamp":1760135155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/5\/2476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,24]]},"references-count":70,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijms23052476"],"URL":"https:\/\/doi.org\/10.3390\/ijms23052476","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,24]]}}}