Department of Woman and Child Health, University of Padua, Padua, Italy.
Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy.
Reprod Sci. 2016 Apr;23(4):415-28. doi: 10.1177/1933719115584446. Epub 2015 Apr 29.
The aim of the study was to analyze all the available evidence from both in vitro and in vivo studies regarding the efficacy of statin therapy in the treatment of endometriosis, evaluating the potential efficacy, side effects, and contraindications of their administration in humans. We focused on defining the potential benefits that the administration of statins may have on patients affected by endometriosis and the possible adverse effects of such a therapy on ovarian function and fertility profile. According to our article selection criteria, we included in the review in vitro and in vivo studies performed on human or animal models. The systematic review of literature identified 24 eligible articles, 12 of which reported evidence regarding the effects of statins on endometrial/endometriotic cells and 12 regarding their effects on ovarian function and fertility. All articles seem to emphasize the utility of statin administration in the treatment of endometriosis due to their anti-proliferative/proapoptotic effects, their ability to reduce cell viability and migration, and the inhibition of angiogenesis and anti-inflammatory activities. Regarding the potential adverse effects on gonadal activities, steroidogenesis and fertility function, no conclusive data were collected in human models (excluding women affected by polycystic ovary syndrome in which significant decline of androgen levels was reported after statin treatment), while contrasting results were reported by studies conducted in in vitro and in vivo in animal models. Despite evidence supporting statins as the potential therapeutic agent for a targeted conservative treatment of endometriosis, the uncertainties regarding their impact on gonadal function may not define them as an appropriate therapy for all young fertile women.
本研究旨在分析所有关于他汀类药物治疗子宫内膜异位症的体外和体内研究的证据，评估其在人类中的潜在疗效、副作用和禁忌症。我们专注于确定他汀类药物给药可能对子宫内膜异位症患者带来的潜在益处，以及这种治疗对卵巢功能和生育状况可能产生的不良反应。根据我们的文章选择标准，我们纳入了关于人类或动物模型的体外和体内研究。文献的系统评价确定了 24 篇合格文章，其中 12 篇报道了他汀类药物对子宫内膜/子宫内膜异位症细胞的影响，12 篇报道了它们对卵巢功能和生育的影响。所有文章似乎都强调了他汀类药物给药在子宫内膜异位症治疗中的效用，因为它们具有抗增殖/促凋亡作用、降低细胞活力和迁移能力、抑制血管生成和抗炎活性。关于对性腺活动、类固醇生成和生育功能的潜在不良反应，在人类模型中未收集到确凿的数据（多囊卵巢综合征患者除外，他汀类药物治疗后雄激素水平显著下降），而在体外和体内动物模型中进行的研究则报告了相反的结果。尽管有证据支持他汀类药物作为子宫内膜异位症靶向保守治疗的潜在治疗药物，但它们对性腺功能的影响仍存在不确定性，这可能使它们不适合所有年轻生育力旺盛的女性。
