Pathogenesis of endometriosis: Interaction between Endocrine and inflammatory pathways

Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back to the 17th century, the etiology of endometriosis remains poorly understood. Classical theories of the histological origins of endometriosis are reviewed below. Clinical presentations are variable, and...

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Published inBest practice & research. Clinical obstetrics & gynaecology Vol. 50; pp. 50 - 60
Main Authors Patel, Bansari G., Lenk, Emily E., Lebovic, Dan I., Shu, Yimin, Yu, Jie, Taylor, Robert N.
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.07.2018
Subjects
Endocrine System - immunology
Endocrine System - physiopathology
Endometriosis
Endometriosis - complications
Endometriosis - immunology
Endometriosis - pathology
Estrogen
Female
GnRH (gonadotropin-releasing hormone)
Humans
Immune System - immunology
Immune System - physiopathology
Infertility, Female - etiology
Inflammation - immunology
Inflammation - physiopathology
Pelvic Pain - etiology
Progesterone
SERM (selective estrogen receptor modulator)
Endometriosis
Progesterone
SERM (selective estrogen receptor modulator)
GnRH (gonadotropin-releasing hormone)
Estrogen
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ISSN1521-6934
1532-1932
1532-1932
DOI10.1016/j.bpobgyn.2018.01.006

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Summary:Despite an estimated prevalence of 11% in women and plausible historical descriptions dating back to the 17th century, the etiology of endometriosis remains poorly understood. Classical theories of the histological origins of endometriosis are reviewed below. Clinical presentations are variable, and signs and symptoms do not correlate well with the extent of disease. In this summary, we have attempted to synthesize the growing evidence that hormonal and immune factors conspire to activate a local inflammatory microenvironment that encourages endometriosis to persist and elaborate mediators of its two cardinal symptoms: pain and infertility. Surprisingly, in the search for novel therapeutics for medical treatment of endometriosis, some compounds appear to have dual pharmacological functions, simultaneously modifying the endocrine and immune system facets of this complex gynecologic syndrome. We predict that these lead drugs will provide more therapeutic choices for patients in the future.
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ISSN:1521-6934
1532-1932
1532-1932
DOI:10.1016/j.bpobgyn.2018.01.006