Novel Therapies Targeting Endometriosis

Abstract

Endometriosis is an often painful disorder in which the endometrial glands and stroma grow outside the uterus. The disease affects women's quality of life and is a common cause of infertility. In this review, we describe promising new developments in the field based on in vitro assays and rodent models, each of which has the potential to be beneficial in the treatment of this disease. We will specifically describe the role of anti-inflammatory drugs, selective estrogen, or progesterone modulators, statins, antiangiogenic agents, and the potential for targeting stem cells as likely methods to hone in and eliminate endometriosis. The most promising of these potential therapies are currently slated for further testing in both rodent and nonhuman primate trials.

Endometriosis and Infertility

“…A wide spectrum of treatment options have been examined including expectant management, medical treatment, surgical treatment, and assisted reproductive technology. Current research is also examining novel promising non-hormonal treatment options for endometriosis such as ICON, VEGF antagonists, and stem cells, which may also prove to increase fecundity by decreasing the extent of ectopic implants or improving the eutopic endometrium (51, 52). …”

“…We recently reviewed several novel medical therapies being tested for the treatment of endometriosis(51). Some are hormonal, such as selective estrogen receptor modulators and selective progesterone receptor modulators, while others target inflammation and angiogenesis such as statins, VEGF receptor antagonists, and immunoconjugate (ICON).…”

“…These include but are not limited to immunoconjugate (ICON), and aromatase inhibitors. ICON targets aberrantly expressed tissue factor on endometriotic endothelium and prompts regression of the established disease, likely by devascularization (51). It has the potential to destroy preexisting implants in a nontoxic, non-hormonal manner, which could subsequently improve fertility rates.…”

Endometriosis

“…Around a third of women, however, will require further surgery for symptoms at five years, compared with 10% of those who undergo hysterectomy with oophorectomy for endometriosis. In younger women (aged [30][31][32][33][34][35][36][37][38][39], however, removal of the ovaries did not significantly improve the surgery-free time and is likely to lead to adverse symptomatic and health consequences associated with surgical menopause. 27 Oestrogen (as HRT) is advised for young (aged under 45) and/or symptomatic women after oophorectomy for endometriosis, but HRT or tibolone can potentially lead to recurrence.…”

Novel agents for the medical treatment of endometriosis

“…Thiazolidinediones (ciglitazone, rosiglitazone, pioglitazone) are a class of antidiabetic drugs that inhibit the expression of various inflammatory molecules in chronic inflammatory diseases [24,36].…”