The Main Theories on the Pathogenesis of Endometriosis

Abstract

Endometriosis is a complex disease, which is defined by abnormal growth of endometrial tissue outside the uterus. It affects about 10% of women of reproductive age all over the world. Endometriosis causes symptoms that notably worsen patient’s well-being—such as severe pelvic pain, dysfunction of the organs of pelvic cavity, infertility and secondary mental issues. The diagnosis of endometriosis is quite often delayed because of nonspecific manifestations. Since the disease was defined, several different pathogenetic pathways have been considered, including retrograde menstruation, benign metastasis, immune dysregulation, coelomic metaplasia, hormonal disbalance, involvement of stem cells and alterations in epigenetic regulation, but the true pathogenesis of endometriosis remains poorly understood. The knowledge of the exact mechanism of the origin and progression of this disease is significant for the appropriate treatment. Therefore, this review reports the main pathogenetic theories of endometriosis based on current studies.

Profiling N6-methyladenosine (m6A) methylation-related genes in endometriosis towards a diagnostic model

“…Some studies showed that endometriosis patients have elevated neutrophils in their blood and peritoneal uid [47,48]. This may happen because endometriotic tissue makes factors that attract and activate neutrophils [49].…”

Cancer Stem Cells in Pancreatic Ductal Adenocarcinoma

“…Epigenetic changes are alterations of gene expression without changes in DNA sequence. The epigenetic regulation of CSCs occurs via (1) DNA methylation, (2) alterations to the chromatin architecture that are either due to the post-translational modification of histones or the activity of polycomb group proteins, as well as (3) a modified spectrum of microRNAs [ 11 , 105 ].…”

Dyspareunia

“…18 Endometriosis occurs when cells of the endometrium travel outside of the uterus and implant on surfaces of other organs or structures of the pelvic cavity, such as the ovaries, fallopian tubes, uterus, bowel, and bladder, or even outside of the pelvic cavity, such as on or in the abdominal wall. 19 Th e inserted cells proliferate and grow into a web of tissue causing adhesions that connect the organs and tissue of the pelvis, resulting in the pulling, pressure, and tearing sensations experienced by patients. Laparoscopy is the gold standard for diagnosis of endometriosis.…”