Department of Biochemistry, Molecular Biology (B) and Immunology, Faculty of Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia and Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain.
Department of Gynaecology and Obstetrics, Hospital General Universitario Santa Lucía, University of Murcia and Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain.
Int J Mol Sci. 2024 Jun 27;25(13):7068. doi: 10.3390/ijms25137068.
Endometriosis is a chronic inflammatory disorder characterized by the abnormal growth of endometrial-like tissue outside the uterine cavity, affecting 10-15% of women of reproductive age. Pain is the most common symptom. Treatment options include surgery, which has limited effectiveness and high recurrence rates, and pharmacotherapy. Hormonal therapies, commonly used for symptom management, can have side effects and contraceptive outcomes, contributing to the infertility associated with endometriosis, with pain and lesions often reappearing after treatment cessation. Among its etiological factors, immunological and inflammatory dysregulation plays a significant role, representing an interesting target for developing new therapeutic strategies. This review critically analyzes recent studies to provide an updated synthesis of ongoing research into potential new pharmacotherapies focusing on lesion progression, pain relief, and improving quality of life. Immunotherapy, natural anti-inflammatory and antioxidant compounds and drug repurposing show promise in addressing the limitations of current treatments by targeting immunological factors, potentially offering non-invasive solutions for managing pain and infertility in endometriosis. Promising results have been obtained from in vitro and animal model studies, but clinical trials are still limited. More effort is needed to translate these findings into clinical practice to effectively reduce disease progression, alleviate pain symptoms and preserve the reproductive capacity, improving patients' overall wellbeing.
子宫内膜异位症是一种慢性炎症性疾病,其特征是子宫内膜样组织在子宫腔外异常生长,影响 10-15%的育龄妇女。疼痛是最常见的症状。治疗选择包括手术,但手术效果有限且复发率高,还有药物治疗。常用于症状管理的激素疗法可能有副作用和避孕效果,这导致与子宫内膜异位症相关的不孕,治疗停止后疼痛和病变常常再次出现。在其病因中,免疫和炎症失调起着重要作用,这为开发新的治疗策略提供了一个有趣的目标。本综述批判性地分析了最近的研究,提供了对潜在新的药物治疗方法的研究进展的综合分析,这些方法侧重于病变进展、缓解疼痛和提高生活质量。免疫疗法、天然抗炎和抗氧化化合物以及药物再利用在针对免疫因素方面显示出希望,可能为管理子宫内膜异位症的疼痛和不孕提供非侵入性的解决方案。在体外和动物模型研究中已经取得了有希望的结果,但临床试验仍然有限。需要进一步努力将这些发现转化为临床实践,以有效减缓疾病进展、减轻疼痛症状并保护生殖能力,从而改善患者的整体健康状况。