Abstract
Endometriosis is a frequent and chronic inflammatory disease with impacts on reproduction, health and quality of life. This disorder is highly estrogen-dependent and the purpose of hormonal treatments is to decrease the endogenous ovarian production of estrogens. High estrogen production is a consistently observed endocrine feature of endometriosis. mRNA and protein levels of estrogen receptors (ER) are different between a normal healthy endometrium and ectopic/eutopic endometrial lesions: endometriotic stromal cells express extraordinarily higher ERβ and significantly lower ERα levels compared with endometrial stromal cells. Aberrant epigenetic regulation such as DNA methylation in endometriotic cells is associated with the pathogenesis and development of endometriosis. Although there is a large body of data regarding ERs in endometriosis, our understanding of the roles of ERα and ERβ in the pathogenesis of endometriosis remains incomplete. The goal of this review is to provide an overview of the links between endometriosis, ERs and the recent advances of treatment strategies based on ERs modulation. We will also attempt to summarize the current understanding of the molecular and cellular mechanisms of action of ERs and how this could pave the way to new therapeutic strategies.
Highlights
Endometriosis is one of the most frequently encountered benign gynecological diseases, known to occur in 6–10% of women of reproductive age [1,2]
-mRNA (34-fold) and protein levels of ERβ were higher in endometriotic stromal cells due to hypomethylation of a CpG island whereas level of ERα was lower in paired endometriotic versus endometrial stromal cells
High estrogen production is a consistently observed feature of endometriosis and this review highlighted the fact that estrogen and its receptors play a key role in the pathophysiology of endometriosis
Summary
Endometriosis is one of the most frequently encountered benign gynecological diseases, known to occur in 6–10% of women of reproductive age [1,2]. It is an estrogen-dependent gynecological condition, defined as the presence and growth of endometrial-like tissue outside the uterine cavity [3]. Three forms of endometriosis were classified according to their location: ovarian endometrioma (OMA), superficial peritoneal lesions (SUP) and deep subperitoneal infiltrating endometriosis (DIE) [4]. 2 of 17 2 of 18 SUP (2) Ovary OMA (1) Uterus Ad (4) DIE (3) Bladder Rectum Cranial
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