Vanhie Arne, Tomassetti Carla, Peeraer Karen, Meuleman Christel, D'Hooghe Thomas
a Leuven University Endometriosis Center of Expertise, Leuven University Fertility Center, Department of Obstetrics and Gynecology , UZ Gasthuisberg , Leuven , Belgium.
b Department of Gynecology and Obstetrics, Faculty of Medicine , Leuven University , Leuven , Belgium.
Expert Opin Ther Targets. 2016;20(5):593-600. doi: 10.1517/14728222.2016.1118461. Epub 2015 Dec 19.
Endometriosis is an estrogen-dependent disease that results in pelvic pain and infertility. Its treatment is often frustrating due to limited medical treatment options, complex surgical treatment and high recurrence rates. Despite the advances in our understanding of the pathogenesis over the last decades and the consequent novel therapeutic strategies, no new drugs have been introduced in daily clinical practice.
In the first part we present an overview of the pathogenesis of endometriosis. In the second part we discuss how new insights have led to the development of novel nonhormonal strategies for the treatment of endometriosis, focusing on anti-inflammatory and anti-angiogenic agents. In the third part we describe the problems encountered in the translation from experimental drugs to routine medicine for the treatment of endometriosis.
Despite the multitude of agents that have been tested in preclinical trials, only few drugs have passed to the stage of clinical testing and none have been introduced into clinical practice. It is our opinion that the major challenges in the translation from novel agents for endometriosis is due to the use of inadequate rodent models and a lack of standardization in the design and reporting of preclinical endometriosis models.
子宫内膜异位症是一种雌激素依赖性疾病，可导致盆腔疼痛和不孕。由于药物治疗选择有限、手术治疗复杂且复发率高，其治疗往往令人沮丧。尽管在过去几十年里我们对发病机制的理解取得了进展，并由此产生了新的治疗策略，但日常临床实践中尚未引入新的药物。
在第一部分，我们概述了子宫内膜异位症的发病机制。在第二部分，我们讨论了新的见解如何促成了治疗子宫内膜异位症的新型非激素策略的发展，重点是抗炎和抗血管生成药物。在第三部分，我们描述了从实验药物转化为治疗子宫内膜异位症的常规药物过程中遇到的问题。
尽管在临床前试验中测试了众多药物，但只有少数药物进入了临床试验阶段，且没有一种药物被引入临床实践。我们认为，将新型药物用于子宫内膜异位症治疗的转化过程中的主要挑战，是由于使用了不充分的啮齿动物模型，以及临床前子宫内膜异位症模型的设计和报告缺乏标准化。
