Anderson George
CRC Scotland & London, Eccleston Square, London, UK.
Biomol Concepts. 2019 Jul 19;10(1):133-149. doi: 10.1515/bmc-2019-0017.
Endometriosis is a common, often painful, condition that has significant implications for a woman's fertility. Classically, endometriosis has been conceptualized as a local estrogen-mediated uterine condition driven by retrograde menstruation. However, recent work suggests that endometriosis may be a systemic condition modulated, if not driven, by prenatal processes. Although a diverse array of factors have been associated with endometriosis pathophysiology, recent data indicate that the low body mass index and decreased adipogenesis may be indicative of an early developmental etiology with alterations in metabolic function crucial to endometriosis pathoetiology. The present article reviews the data on the pathoetiology and pathophysiology of endometriosis, suggesting key roles for alterations in mitochondria functioning across a number of cell types and body systems, including the immune system and gut microbiome. These changes are importantly regulated by decreases in vitamin A and its retinoic acid metabolites as well as increases in mitochondria estrogen receptor-beta and the N-acetylserotonin/melatonin ratio across development. This has treatment and future research implications for this still poorly managed condition, as well as for the association of endometriosis with a number of cancers.
子宫内膜异位症是一种常见且常伴有疼痛的病症，对女性生育能力有重大影响。传统上，子宫内膜异位症被认为是一种由逆行月经驱动的局部雌激素介导的子宫病症。然而，最近的研究表明，子宫内膜异位症可能是一种全身性病症，即使不是由产前过程驱动，也是由其调节的。尽管多种因素与子宫内膜异位症的病理生理学相关，但最近的数据表明，低体重指数和脂肪生成减少可能表明存在早期发育病因，而代谢功能的改变对子宫内膜异位症的发病机制至关重要。本文综述了有关子宫内膜异位症发病机制和病理生理学的数据，表明线粒体功能在多种细胞类型和身体系统（包括免疫系统和肠道微生物群）中的改变起着关键作用。这些变化受到发育过程中维生素A及其视黄酸代谢物减少以及线粒体雌激素受体-β和N-乙酰血清素/褪黑素比值增加的重要调节。这对这种仍管理不善的病症的治疗和未来研究具有启示意义，以及对子宫内膜异位症与多种癌症的关联也有启示意义。
