Cited by 156Endometriosis Research and TreatmentEstrogen and related hormone effectsEndometrial and Cervical Cancer Treatments

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Estrogen metabolism and action in endometriosis

Rižner, Tea Lanišnik·2009·Molecular and Cellular Endocrinology

DOI 10.1016/j.mce.2009.03.022

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Abstract

Endometriosis is a complex estrogen-dependent disease that is defined as the presence of endometrial glands and stroma outside the uterine cavity. The etiology of endometriosis is multifactorial and includes complex interactions of genetic, immunological, hormonal and environmental factors. Many theories have been proposed, but no single theory can explain all aspects of endometriosis, suggesting that endometriosis is a heterogeneous disease. This review presents the current theories on the pathogenesis of endometriosis, followed by an overview on estrogen metabolism in normal endometrium and diseased endometrium of endometriosis patients. The potential role of aberrant expression of individual estrogen-metabolizing enzymes is discussed, and a model mechanism for increased formation of estradiol is presented separately for different types of endometriosis. The disturbed expression of estrogen receptors in endometriosis is detailed, and the estrogen biosynthetic enzymes and receptors are discussed as novel therapeutic targets for the treatment of endometriosis.

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BackgroundInfluential
Identification and Analysis of Potential Autophagy-Related Biomarkers in Endometriosis by WGCNA
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Background
Vanillin prevents the growth of endometriotic lesions through anti-inflammatory and antioxidant pathways in a mouse model
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“Aberrant levels of several estrogen-metabolizing enzymes have been demonstrated in ectopic endometrium (24).”
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KISS1/KISS1R expression in eutopic and ectopic endometrium of women suffering from endometriosis.
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Brassica Bioactives Could Ameliorate the Chronic Inflammatory Condition of Endometriosis
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“In contrast, some ectopic and eutopic endometrial stromal cells in women with endometriosis exhibit progesterone resistance (Attia et al., 2000; Bulun et al., 2006; Rizner, 2009).”
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Copper homeostasis and cuproptosis in gynecological disorders: Pathogenic insights and therapeutic implications
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The mixture of non-persistent endocrine-disrupting chemicals in relation to endometriosis
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“…biosynthesis, is more highly expressed in endometriotic tissues than in the endometrium (Huhtinen et al., 2012), and estrogen, produced by the abnormally elevated aromatase, promotes the growth of endometriotic tissue (Bulun, 2009; Rizner, 2009; Huhtinen et al., 2012; Colette et al., 2013).”
Background
Metalloestrogen cadmium stimulates proliferation of stromal cells derived from the eutopic endometrium of women with endometriosis
Silva, N., Tennekoon, K. H., Senanayake, H. M., & Samarakoon, S. R. (2013) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2013.10.015 · Cited by 14
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Background
Activin A Stimulates Aromatase via the ALK4-Smad Pathway in Endometriosis
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Effects of progestins on local estradiol biosynthesis and action in the Z-12 endometriotic epithelial cell line
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Research progress of dydrogesterone in the treatment of endometriosis
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Models Including Serum CA-125, BMI, Cyst Pathology, Dysmenorrhea or Dyspareunia for Diagnosis of Endometriosis
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Self-citation
Progesterone's role in deep infiltrating endometriosis: Progesterone receptor and estrogen metabolism enzymes expression and physiological changes in primary endometrial stromal cell culture
Kamergorodsky, G., Invitti, A. L., D’Amora, P., Parreira, R. M., Kopelman, A., Bonetti, T. C., Girão, M. J. B. C., & Schor, E. (2020) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2020.110743 · Cited by 12
Comparative G-Protein-Coupled Estrogen Receptor (GPER) Systems in Diabetic and Cancer Conditions: A Review
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SULFATION PATHWAYS: Contribution of intracrine oestrogens to the aetiology of endometriosis
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Progestin effects on expression of AKR1C1–AKR1C3, SRD5A1 and PGR in the Z-12 endometriotic epithelial cell line
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Self-citation
Effects of TSLP on obstetrical and gynecological diseases
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“Estrogen can be synthesized locally in the endometriotic lesions (Rizner 2009).”
Background
A Preliminary Investigation of the Roles of Endometrial Cells in Endometriosis Development via In Vitro and In Vivo Analyses
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“Its levels are elevated in the menstrual blood of women with endometriosis [112,113], suggesting that estrogen is formed locally in the endometrium of patients with endometriosis [114].”
Background
Endometriosis and autoimmunity: a large-scale case-control study of endometriosis and 10 distinct autoimmune diseases
Aziz, M., Beaton, M., Aziz, M. A., Opoku-Anane, J., & Elhadad, N. (2025) · npj Women s Health · doi:10.1038/s44294-025-00086-8 · Cited by 11
“DefectsinT cell and regulatory cellfunctioning, aswellasabnormal levelsofprostaglandins,cytokines,andin ﬂ ammatoryproductshaveallbeen observed among patients with endometriosis 24,25,27 as well as patients with several autoimmune conditions 32,33 .”

Authors: Rižner, T. L.
Affiliations: University of Ljubljana (SI)
Corresponding author: Rižner, Tea Lanišnik
ORCID: Rižner, Tea Lanišnik
Venue: Molecular and Cellular Endocrinology
Publisher: Elsevier BV
Published: 2009-08
Volume: 307
Issue: 1-2
Pages: 8-18
ISSN: 0303-7207 (ISSN-L)
DOI: 10.1016/j.mce.2009.03.022
OpenAlex: W2163825655
Semantic Scholar: c603753d7a96016b2da52a05cc0370ed18a55340
Cited by: 153
References: 120
Citations by year: 2026: 5 · 2025: 10 · 2024: 13 · 2023: 8 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 10 · 2018: 9 · 2017: 9 · 2016: 13 · 2015: 9 · 2014: 9 · 2013: 8 · 2012: 11
FWCI: 1.46
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Molecular and Cellular Endocrinology (publishedVersion)
PubMed (publishedVersion)
Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords: endometriosis, estrogen metabolism, estradiol synthesis, estrogen receptor, endometrium, endometriosis pathogenesis, therapeutic target
MeSH terms: Endometriosis, Endometrium, Estrogens, Female, Humans, Receptors, Estrogen

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Estrogen metabolism and action in endometriosis

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