MicroRNAs in Endometriosis: Insights into Inflammation and Progesterone Resistance

Abstract

Endometriosis, a non-malignant gynecological disorder influenced by estrogen, involves the growth of endometrial tissue outside the uterus. Its development includes processes such as inflammation, progesterone resistance, angiogenesis, and cell proliferation. Epigenetic factors, particularly the dysregulation of microRNAs (miRNAs), have emerged as key factors in these mechanisms in endometriosis. This review aims to unveil the intricate molecular processes that control inflammation, progesterone resistance, and miRNA functions in endometriosis. In addition, it provides a comprehensive overview of the current understanding regarding the involvement of miRNAs in the inflammatory aspects of this condition. This synthesis encompasses research investigating the molecular underpinnings of inflammation, along with the biogenesis and roles of miRNAs in endometriosis. Furthermore, it examines human studies and functional analyses to establish the intricate connection between miRNAs, inflammation, and progesterone resistance in the context of endometriosis. The results highlight the significant impact of dysregulated miRNAs on the inflammatory pathways and hormonal imbalances characteristic of endometriosis. Consequently, miRNAs hold promise as potential non-invasive biomarkers and targeted therapeutic agents aimed at addressing inflammation and enhancing the response to progesterone treatment in individuals with endometriosis.

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

“…Results of several studies remain controversial and even contradictory due to the irreproducible nature of the studies ( 12 , 100 ). At present, no single or groups of miRNA biomarkers has sufficient specificity and sensitivity in the diagnosis of EM ( 101 ).…”

“…This indicates that angiogenesis is a key link in the pathogenesis of EM, which represents a potential target for development of future diagnostic and therapeutic strategies. Recent study of angiogenic mechanisms in EM has revealed the importance and potential role of angiogenesis-related pathways and markers of EM for diagnosis and treatment ( 9 – 12 ). That has provided a new direction for the discovery of novel targets of anti-angiogenic action and therapy and novel lines of thought and strategies for clinical treatment of EM.…”

The uterine secretome initiates growth of gynecologic tissues in ectopic locations

“…Studies evaluating gene expression in embryo implantation, endometriosis and ovarian cancer [10,40,41,63] have all found altered expression of LIF, and other genetic and epigenetic changes, such as CD44 and miR 99a-5p [42,43], supporting our hypothesis that the uterine secretome is important in all these processes. miRNA which has been reported in both endometriosis and uterine secretory exosomes, such as miR-302a and let-7b-5p are examples of epigenetic changes [64,65] that will be further investigated. EM has been shown to have elevated LIF in the peritoneal fluid [9,10].…”

Reproductive Immunology and Pregnancy 3.0

“…Thus, a significant role of stem cell-based dysfunction in the formation of initial endometrial lesions is suspected. There is increasing evidence that the role of epigenetic mechanisms and processes in endometriosis has been underestimated [5,[10][11][12]. This conclusion is based on the fact that heritable phenotype changes that do not interfere with the DNA sequence are common triggers for hormonal, immunological, and inflammatory disorders, which play a key role in the formation of endometriotic foci [7].…”