New insights into the pathophysiology of endometriosis: from chronic inflammation to danger signal

Abstract

In conclusion, a circulus vitiosus of both the oxidative stress pathway and the TLR pathways is generated when the process becomes chronic (danger signal spiral).

CA-125 concentration in serum and peritoneal fluid in patients with endometriosis – preliminary results

“…The diagnostic accuracy of each marker alone was either similar or worse than that of CA-125. The concentrations of various cytokines, growth and angiogenic factors, metalloproteinases, peptides, subpopulations of leukocytes and expression of various genes were examined in endo metriosis [17][18][19]. Nowadays researchers are trying to develop a statistical model based on three or four serum biomarkers which could have enough statistical power to diagnose endometriosis without the necessity of laparoscopy.…”

Protease-Activated Receptor–Stimulated Interleukin-6 Expression in Endometriosis-Like Lesions in an Experimental Mouse Model of Endometriosis

“…PAR is expressed in uterine endometrial stromal cells (23,24) and PAR activation has been shown to stimulate the production of matrix metalloproteinase (MMP)-1/2, VEGF, and IL-8 (41). One of the potential contributing factors in the progression of endometriosis is neutrophil elastase, which has been implicated in the inflammatory response in endometriotic tissues (42) and can activate PAR1/2 (21). Thus, bleeding may cause PAR1/2 activation through elastase activation.…”

Pathogenesis of endometriosis: The role of initial infection and subsequent sterile inflammation (Review)

“…TLR-mediated inflammation possibly occurs through the exogenous PAMPs as well as the endogenous danger-associated molecular pattern (DAMP) ligands (2). Nucleotide oligomerization domain-like receptors (NLRs) and, to a lesser degree, the retinoic acid-inducible gene I-like receptors are intracellular sensors (16).…”

“…In addition to their response to various exogenous PAMPs, TLRs recognize a wide range of endogenous DAMPs, including high-mobility group box protein 1 (HMGB1), heat shock protein 70 (HSP70), adenosine-5'-triphosphate (ATP), DNA, urate crystals, asbestos, silica, aluminum hydroxide, S100, neutrophil elastase, amyloid-β and soluble extracellular matrix components, such as biglycan, hyaluronan, versican, fibrinogen, heparan sulfate fragments and fibronectin extra domain A (2,26,27). Intracellular contents released from damaged cells into the extracellular space serve as DAMPs or alarmins that trigger inflammation (Fig.…”

“…Sampson's theory of retrograde menstruation hypothesizes that the mechanical transfer, invasive implantation and ectopic growth of endometrial tissues causes endometriosis and it remains the most widely accepted causal theory. However, no single theory is able to completely explain the origin and all aspects of this disorder (2). The mechanisms responsible for the initial development and subsequent progression of endometriosis are not clear.…”