Association of endometriosis with cardiovascular disease: Genetic aspects (Review)

Abstract

Cardiovascular disease (CVD) comprises a broad spectrum of pathological conditions that affect the heart or blood vessels, including sequelae that arise from damaged vasculature in other organs of the body, such as the brain, kidneys or eyes. Atherosclerosis is a chronic inflammatory disease of the arterial intima and is the primary cause of coronary artery disease, peripheral vascular disease, heart attack, stroke and renal pathology. It represents a leading cause of mortality worldwide and the loss of human productivity that is marked by an altered immune response. Endometriosis is a heritable, heterogeneous, common gynecological condition influenced by multiple genetic, epigenetic and environmental factors, affecting up to 10% of the female population of childbearing age, causing pain and infertility; it is characterized by the ectopic growth of endometrial tissue outside the uterine cavity. Of note, epidemiological data obtained thus far have suggested a link between endometriosis and the risk of developing CVD. The similarities observed in specific molecular and cellular pathways of endometriosis and CVD may be partially explained by a shared genetic background. The present review presents and discusses the shared genetic factors which have been reported to be associated with the development of both disorders.

Angiogenesis signaling in endometriosis: Molecules, diagnosis and treatment (Review)

“…Previous studies have suggested that enhanced concentration of neutrophils in the peritoneal fluid of patients with EM may be the result of elevated concentrations of potent neutrophil chemokines, such as IL-8, in plasma and peritoneal fluid ( 28 , 29 ). Moreover, neutrophils secrete cytokines such as VEGF and IL-8 and −17 to promote the proliferation and invasion of endometriotic cells and angiogenesis ( 30 ).…”

Association of endometriosis with Sjögren's syndrome: Genetic insights (Review)

“…Endometriosis is a highly complex disease with numerous genetic, epigenetic and environmental factors interacting with each other, thus contributing to its pathogenesis ( 15 ). The identification and functional analysis of the numerous genetic factors involved in the development of endometriosis have notably contributed to the better understanding of the biological processes and molecular mechanisms leading to the disease, as presented in detail in recent studies by our research group ( 27 , 30 , 32 ). In brief, the strong genetic predisposition of the disease was documented firstly in monozygotic twin-based and family studies ( 37 , 38 ), followed by linkage analysis, various candidate and gene association, genome wide association studies (GWAS), meta-analyses and next-generation sequencing studies ( 39 - 53 ).…”

“…Immune dysregulation leading to chronic inflammatory response in the ectopic endometrium aggravates a number of abnormalities in the cell-mediated as well as the humoral immune systems of patients ( 30 ). Furthermore, other studies suggested the association of endometriosis with both antibody self-reactivity and chronic local inflammation ( 11 , 23 , 27 , 30 ), caused by a variety of inflammatory factors such as cytokines, macrophages and prostaglandins, thus characterizing this disorder as an autoimmune one ( 74 ). In this framework, extensive research has been conducted to understand the influence of autoimmunity in endometriosis, aiming to gain better insight of the pathogenetic mechanisms leading to this condition ( 30 ).…”

“…Advances in the past years have shown that female patients with endometriosis are at higher risk of developing chronic diseases as systemic comorbidities, such as cancer ( 25 ), cardiovascular diseases ( 26 , 27 ), asthma ( 25 ), hypothyroidism ( 25 ) and psychiatric disorders ( 28 ). Most importantly, epidemiological studies demonstrated that patients with endometriosis were associated with an increased risk of developing a number of autoimmune diseases compared with unaffected controls due to notable changes in immune-related parameters.…”

Genetic factors involved in the co‑occurrence of endometriosis with ankylosing spondylitis (Review)

“…Women with endometriosis are at a high risk of developing several other chronic diseases, including cancer ( 12 ), endocrine disorders (hypothyroidism) ( 12 ), cardiovascular disorders ( 13 , 14 ) and, mainly, a number of autoimmune diseases including RA, multiple sclerosis, scleroderma, systemic lupus erythematosus, ulcerative colitis, Crohn's disease, Sjögren's syndrome, coeliac disease and autoimmune thyroid disorder ( 15 , 16 ). Notably, recent findings have suggested that endometriosis can increase the susceptibility for AS in these women ( 17 ).…”