Cited by 88Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementReproductive Biology and Fertility

Hypoxia: The force of endometriosis

Wu, Meng‐Hsing, Hsiao, Kuei‐Yang, Tsai, Shaw‐Jenq·2019·Journal of Obstetrics and Gynaecology Research

Abstract

Aim: Summarize recent findings of how hypoxia regulates numerous important processes to facilitate the implantation, proliferation and progression of ectopic endometriotic lesions. Methods: Most up‐to‐date evidences about how hypoxia contributes to the disease pathogenesis of endometriosis and potential therapeutic approaches were collected by conducting a comprehensive search of medical literature electronic databases. Quality of data was analyzed by experienced experts including gynecologist and basic scientists. Results: Uterus is a highly vascularized organ, which makes endometrial cells constantly expose to high concentration of oxygen. When endometrial tissues shed off from the eutopic uterus and retrograde to the peritoneal cavity, they face severe hypoxic stress. Even with successful implantation to ovaries or peritoneum, the hypoxic stress remains as a critical issue because endometrial cells are used to live in the well‐oxygenated environment. Under the hypoxia condition, cells undergo epigenetic modulation and evolve several survival processes including steroidogenesis, angiogenesis, inflammation and metabolic switch. The complex gene regulatory network driven by hypoxia ensures endometriotic cells can survive under the hostile peritoneal microenvironment. Conclusion: Hypoxia plays critical roles in promoting pathological processes to facilitate the development of endometriosis. Targeting hypoxia‐mediated gene network represents an alternative approach for the treatment of endometriosis.

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Crossref · 10.1111/jog.13900

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Authors
Wu, M., Hsiao, K., & Tsai, S.
Affiliations
  • National Cheng Kung University (TW)
  • National Chung Hsing University (TW)
Corresponding author
Tsai, Shaw‐Jenq
Venue
Journal of Obstetrics and Gynaecology Research
Publisher
Wiley
Published
2019-01-07
Volume
45
Issue
3
Pages
532-541
ISSN
  • 1341-8076 (ISSN-L)
  • 1447-0756
OpenAlex
W2909794175
Cited by
88
References
102
Citations by year
2026: 12 · 2025: 9 · 2024: 14 · 2023: 7 · 2022: 8 · 2021: 21 · 2020: 17
FWCI
1.62
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of obstetrics and gynaecology research (publishedVersion)
  • PubMed (publishedVersion)
  • NCHU Institutional Repository CRIS (submittedVersion)
Funders
Ministry of Science and Technology, Taiwan (MOST 106‐2320‐B‐006‐072‐MY3)
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 › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Keywords
endometriosis, hypoxia, endometriosis pathogenesis, peritoneal microenvironment, epigenetic regulation, angiogenesis, inflammation, metabolic switch, steroidogenesis, endometriosis treatment
MeSH terms
Hypoxia, Endometriosis, Endometrium, Female, Humans, Neovascularization, Pathologic

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