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A systematic review of toll-like receptors in endometriosis

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Abstract

Introduction

The pathogen-associated molecular patterns and the danger-associated molecular patterns are possibly responsible for the activation of the inflammatory process in endometriosis through the activation of toll-like receptors (TLRs).

Objective

The aim of this systematic review was to critically analyze the findings of published articles on TLRs in endometriosis.

Methods

The keywords used were “endometriosis” and “toll-like” and the search was performed in Pubmed, Scielo and Lilacs databases. This study followed the PRISMA guidelines and the risk of bias of articles was conducted by Newcastle–Ottawa scale (NOS).

Results

Overall, the studies analyzed in this review point toward an increased expression of TLRs two, four and nine in women with endometriosis. Among all TLRs, TLR4 was the most cited receptor.

Conclusion

Despite the evidence demonstrating elevated TLR levels in endometriosis, the relationship with the disease is still unclear and needs to be clarified in further studies about innate immune response.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Avenida Albert Einstein, 627, Morumbi, São Paulo, CEP 05652-900, Brazil

    Bruna Cestari de Azevedo, Fernanda Mansur & Sérgio Podgaec

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  1. Bruna Cestari de Azevedo
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  2. Fernanda Mansur
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  3. Sérgio Podgaec
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Contributions

BCA and SP contributed to conception and design of the systematic review. BCA conducted the literature search, title/abstract review, abstracted. BCA and SP conducted the quality-assessed the included studies. FM prepared the Fig. 3, reviewed, and edited the manuscript. BCA and SP contributed to writing and revising the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bruna Cestari de Azevedo.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This is an observational study. The Research Ethics Committee at Hospital Israelita Albert Einstein–CEP/Einstein, has confirmed that no ethical approval is required.

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de Azevedo, B.C., Mansur, F. & Podgaec, S. A systematic review of toll-like receptors in endometriosis. Arch Gynecol Obstet 304, 309–316 (2021). https://doi.org/10.1007/s00404-021-06075-x

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  • DOI: https://doi.org/10.1007/s00404-021-06075-x

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