Molecular biology of endometriosis: from aromatase to genomic abnormalities
Abstract
Endometriosis has been initially described as the presence of ectopic endometrial tissue on pelvic organs or in extrapelvic sites; and this has been used as its key pathologic feature ever since. Endometriosis responds to fluctuations in estrogen and progesterone by growth and inflammation, leading to pain aggravated by menses. It was proposed that pelvic endometriosis primarily originate from retrograde menstruation of a critical number of eutopic endometrial cells with stem characteristics. This postulate is supported by the molecular defects found in ectopic endometriotic tissue. Genome-wide differences in CpG methylation between eutopic endometrial and endometriotic stromal cells are present. Defective CpG methylation affecting several genes that encode key transcription factors such as GATA6, steroidogenic factor-1, and estrogen receptor-β in endometriosis gives rise to overproduction of local estrogen and prostaglandins and suppression of progesterone receptor. Progesterone receptor deficiency leads to progesterone resistance, resulting in decreased retinol uptake and retinoic acid production and altered retinoic acid action. These molecular defects collectively give rise to poor cellular differentiation, enhanced survival, and increased inflammation, which are the biological hallmarks of endometriotic tissue.
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Local estrogen production and progesterone resistance were demonstrated in larger endometriosis lesions.
“Local estrogen production (154) and progesterone resistance (155-162) were demonstrated in larger endometriosis lesions (154-163)”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [154]
The biochemical changes in endometriosis lesions are increasingly viewed as a consequence of genetic or epigenetic polymorphism.
“These changes are increasingly viewed as a consequence of genetic or epigenetic polymorphism (154, 188-190).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [154]
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Towards a more biologically informative system of endometriosis classification
Mijatovic, V. (2020) · Human Reproduction · doi:10.1093/humrep/deaa265 · Cited by 3 · see citing works
“In addition, on a biochemical and hormonal level, a large variability is encountered in the inflammatory reaction and aromatase activity as well as progesterone resistance found around macroscopically similar endometriosis lesions (Bulun et al., 2015).”
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Gene Expression in Endometriosis
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Pathogenomics of Endometriosis Development
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“(11,12) Despite being a benign disease, endometriosis exhibits malignant-like behavior owing to its ability to adhere to mesothelial surfaces at ectopic sites, degrade extracellular matrix (ECM) components, and invade the surrounding tissues.”
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A Primer on Clinical Classification and Pathophysiology of Endometriosis
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Endometriosis, Infertility, and Oocyte Quality
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FACTORS OF ENDOMETRIAL RECEPTIVITY DOWN-REGULATION IN GENITAL ENDOMETRIOSIS
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ENDOMETRIC FACTOR OF ENDOMETRIOSIS-ASSOCIATED INFERTILITY
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Molecular biological profile of the endometrium in patients with endometriosis (literature review)
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- Authors
- Monsivais, D., Kakinuma, T., Furukawa, Y., Bernardi, L., Pavone, M., Dyson, M., & Bulun, S.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Bulun, Serdar
- Venue
- Seminars in Reproductive Medicine
- Publisher
- Georg Thieme Verlag KG
- Published
- 2015-06-02
- Volume
- 33
- Issue
- 03
- Pages
- 220-224
- ISSN
- 1526-4564 (ISSN-L)
- 1526-8004
- OpenAlex
- W2225996156
- Cited by
- 112
- References
- 0
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 19 · 2019: 16 · 2018: 20 · 2017: 6 · 2016: 8 · 2015: 2
- FWCI
- 13.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Reproductive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R37HD038691, R03HD082558)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- endometriosis, aromatase, genomic abnormalities, CpG methylation, retrograde menstruation, endometriotic stromal cells, estrogen receptor beta, progesterone receptor, progesterone resistance, retinoic acid, GATA6, steroidogenic factor 1, prostaglandins, inflammation, eutopic endometrium
- MeSH terms
- Aromatase, Cell Survival, Endometriosis, Endometrium, Epithelial Cells, Estrogens, Female, Humans, Receptors, Progesterone, Retinoids, DNA Methylation, Epigenesis, Genetic, PPAR delta, Estrogen Receptor beta, PPAR-beta, Cell Proliferation, Steroidogenic Factor 1
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