Department of Obstetrics and Gynecology, Dong-A University, College of Medicine, Busan, Republic of Korea.
Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA.
J Mol Endocrinol. 2018 Apr;60(3):R97-R113. doi: 10.1530/JME-17-0227. Epub 2018 Jan 12.
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It affects approximately 5-10% of women of reproductive age. Endometriosis is associated with dysmenorrhea, dyspareunia and, often, severe pelvic pain. In addition to pain, women with endometriosis often experience infertility. Defining the molecular etiology of endometriosis is a significant challenge for improving the quality of women's lives. Unfortunately, the pathophysiology of endometriosis is not well understood. Here, we summarize the potential causative factors of endometriosis in the following three categories: (1) dysregulation of immune cells in the peritoneal fluid and endometriotic lesions; (2) alteration of apoptotic signaling in retrograde menstrual tissue and cytotoxic T cells involved in endometriosis progression and (3) dysregulation of oxidative stress. Determining the molecular etiology of these dysregulated cellular signaling pathways should provide crucial clues for understanding initiation and progression of endometriosis. Moreover, improved understanding should suggest new molecular therapeutic targets that could improve the specificity of endometriosis treatments and reduce the side effects associated with current approaches.
子宫内膜异位症是指子宫内膜组织出现在子宫腔以外的部位。它影响了大约 5-10%的育龄妇女。子宫内膜异位症与痛经、性交痛以及经常出现的严重盆腔痛有关。除了疼痛，患有子宫内膜异位症的女性通常还会不孕。明确子宫内膜异位症的分子病因是提高女性生活质量的一个重大挑战。不幸的是，子宫内膜异位症的病理生理学还不是很清楚。在这里，我们总结了以下三个方面的子宫内膜异位症的潜在病因：（1）腹腔液和子宫内膜异位病灶中免疫细胞的失调；（2）逆行月经组织中细胞凋亡信号的改变以及涉及子宫内膜异位症进展的细胞毒性 T 细胞；（3）氧化应激的失调。确定这些失调的细胞信号通路的分子病因应该为理解子宫内膜异位症的发生和进展提供关键线索。此外，更好的理解应该提示新的分子治疗靶点，这可以提高子宫内膜异位症治疗的特异性，并减少与现有方法相关的副作用。
