Pathogenesis of Endometriosis: Roles of Retinoids and Inflammatory Pathways

• Type of Material: Article
• Authors: Robert N. Taylor, Wake Forest University; Maureen A. Kane, University of Maryland; Neil Sidell, Emory University
• Language: English
• Date: 2015-07-01
• Publisher: Georg Thieme Verlag
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 by Thieme Medical Publishers, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1055/s-0035-1554920
• Title of Journal or Parent Work: Seminars in Reproductive Medicine
• ISSN: 1526-8004
• Volume: 33
• Issue: 4
• Start Page: 246
• End Page: 256
• Grant/Funding Information: This work was supported by Eunice Kennedy Shriver/ National Institute of Child Health grants U01HD66439 (N. S., R. N. T.), R01HD55379 (N. S.), U54HD55787 (R. N. T.), R01HD077260 (M. A. K.), the National Institute of Allergy and Infectious Diseases contract HHSN272202000046C (M. A. K.), and the University of Maryland School of Pharmacy Mass Spectrometry Center SOP1841-IQB2014 (M. A. K.).
• Keywords: Obstetrics & Gynecology; metaplasia; COMMON VARIABLE IMMUNODEFICIENCY; PROGESTERONE RESISTANCE; retinoic acid; PERITONEAL-FLUID; ESTROGEN RECEPTOR-BETA; Life Sciences & Biomedicine; STROMAL CELLS; BINDING-PROTEIN; retrograde menstruation; IN-VITRO; MATRIX-METALLOPROTEINASE EXPRESSION; MONOCYTE CHEMOTACTIC PROTEIN-1; chemokine; Reproductive Biology; cytokine; GAMMA PPAR-GAMMA; Science & Technology
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Pathology; Health Sciences, Pharmacology

Abstract

Endometriosis is a nonmalignant, but potentially metastatic, gynecological condition manifested by the extrauterine growth of inflammatory endometrial implants. Ten percent of reproductive-age women are affected and commonly suffer pelvic pain and/or infertility. The theories of endometriosis histogenesis remain controversial, but retrograde menstruation and metaplasia each infer mechanisms that explain the immune cell responses observed around the ectopic lesions. Recent findings from our laboratories and others suggest that retinoic acid metabolism and action are fundamentally flawed in endometriotic tissues and even generically in women with endometriosis. The focus of our ongoing research is to develop medical therapies as adjuvants or alternatives to the surgical excision of these lesions. On the basis of concepts put forward in this review, we predict that the pharmacological actions and anticipated low side-effect profiles of retinoid supplementation might provide a new treatment option for the long-term management of this chronic and debilitating gynecological disease.