Pergialiotis Vasilios, Frountzas Maximos, Fasoulakis Zacharias, Daskalakis George, Chrisochoidi Mairi, Kontzoglou Konstantinos, Perrea Despoina N
First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, GRC.
First Propaedeutic Department of Surgery, Hippocration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, GRC.
Cureus. 2022 Feb 25;14(2):e22616. doi: 10.7759/cureus.22616. eCollection 2022 Feb.
Endometriosis is a disease that affects a significant proportion of women and its infiltrative pattern is entirely dependent on the vascular supply of lesions. Several factors seem to trigger the process of angiogenesis in endometriotic lesions. During the last years, peroxisome proliferator-activated receptors (PPARs), a group of nuclear proteins that regulate gene transcription and that seem to regulate energy consumption and expenditure, have been also implicated in the pathophysiology of angiogenesis. Their ability to regulate the course of cancer and improve the survival rates of patients has been extensively studied and seems to be partially dependent on alteration of the vascular supply of malignant lesions. Research in the field of endometriosis is scarce in the international literature and mainly focused on PPAR-gamma. However, indirect evidence suggests that PPAR-alpha (PPAR-α) may also regulate the vascular supply of endometriotic lesions as well. Specifically, PPAR-α agonists seem to downregulate angiogenesis by increasing the expression of several anti-angiogenic molecules, including thrombospondin-1 (TSP-1) and gypenoside 140 (gp140), as well as factors that are involved in the mitogen-activated protein kinase cascade. In the present article, we summarize existing indirect and direct evidence that indicates the existence of an association between the expression of PPAR-α and endometriosis to help future research in this field.
子宫内膜异位症是一种影响相当一部分女性的疾病，其浸润模式完全取决于病变的血管供应。有几个因素似乎会触发子宫内膜异位症病变中的血管生成过程。在过去几年中，过氧化物酶体增殖物激活受体（PPARs），这一组调节基因转录且似乎调节能量消耗和支出的核蛋白，也被认为与血管生成的病理生理学有关。它们调节癌症进程和提高患者生存率的能力已得到广泛研究，并且似乎部分依赖于恶性病变血管供应的改变。国际文献中关于子宫内膜异位症领域的研究较少，且主要集中在PPAR-γ。然而，间接证据表明PPAR-α也可能调节子宫内膜异位症病变的血管供应。具体而言，PPAR-α激动剂似乎通过增加几种抗血管生成分子的表达来下调血管生成，这些分子包括血小板反应蛋白-1（TSP-1）和绞股蓝皂苷140（gp140），以及参与丝裂原活化蛋白激酶级联反应的因子。在本文中，我们总结了现有的间接和直接证据，这些证据表明PPAR-α的表达与子宫内膜异位症之间存在关联，以助力该领域未来的研究。
