Endometriosis — insights into a multifaceted entity

Abstract

Firstly described at the end of nineteenth century, endometriosis remains an enigmatic disease, from etio-pathogenesis to specific markers of diagnosis and its ability to associate with malignancies. Our review has been designed from a historical perspective and steps up to an updated understanding of the disease, facilitated by relatively recent molecular and genetic progresses. Although the histopathological diagnosis is relatively simple, the therapy is difficult or ineffective. Experimental models have been extremely useful as they reproduce the human disease and allow the testing of different potential modulators or treatment options. Due to molecular resemblance to carcinogenesis, applications of anti-cancer agents are currently under scrutiny. The desired goal of an efficient therapy against symptomatic disease, along with associated infertility and malignancies, needs a deeper insight into the complex mechanisms involved in endometriosis initiation, development, and progres-sion. Current trends in genomic and proteomic approaches are useful for a more accurate classification and for the identification of new therapeutic targets.

Matrix metalloproteinases-2, -7 and tissue metalloproteinase inhibitor-1 expression in human endometrium

“…The TIMP-1 expression in the endometrium was not dependent neither on estradiol nor progesterone concentration. The lack of hormonal dependence was shown in other in vitro studies [40,43]. The results of our study indicate that TIMP-1 may be important for maintaining endometrial stability and prevent tissue breakdown during the menstrual cycle.…”

Endometriosis and Cancer: Exploring the Role of Macrophages

“…Akin to endometriosis, tumor growth may depend on estrogens which exert mitogenic action and facilitate the expression of antiapoptotic proteins [ 91 ]. In both endometriosis and cancer, invasion involves MMP family proteins; for instance, MMP9 participates in both the implantation of ectopic endometrium in endometriosis and the invasion of tumor cells and metastasis in cancer [ 92 , 93 ]. Endometriosis has been associated with decreased expression of cyclin-dependent kinase inhibitor 1B (p27Kip1) in epithelial and stromal cells of endometrium [ 94 ].…”

“…Decreased expression of p27Kip1 observed in certain cancers has been associated with poor prognosis [ 94 ]. Another common feature of endometriosis and cancer is suppressed apoptosis; accordingly, the inhibited expression of proapoptotic proteins and increased expression of antiapoptotic Bcl-2 family proteins are typical for both [ 93 , 95 ].…”

“…Similar to cancers, endometriosis has a strong genetic component, which refers to both the inherited predisposition and accumulation/selection of pathogenic somatic variants. Similar to tumors, endometrioid heterotopias tend to reprogram their microenvironments to support their growth ( Table 2 ) [ 21 , 93 ].…”

Clinical Characteristics of Patients With External Genital Endometriosis

“…Наружный генитальный эндометриоз значительно снижает репродуктивное здоровье и качество жизни миллионов женщин. По разным данным, патологию диагностируют у 30-50 % женщин детородного возраста с бесплодием [1][2][3]. Несмотря на достижения современной медицины, нет общей точки зрения о патогенезе эн-дометриоза, который характеризуется персистентной эстрогензависимой активностью, тазовой болью и некоторыми идентичными опухолевому процессу фундаментальными проявлениями [4][5][6].…”