González-Ramos R, Van Langendonckt A, Defrère S, Lousse JC, Colette S, Devoto L, Donnez J. Involvement of the nuclear factor-κB pathway in the pathogenesis of endometriosis.
Fertil Steril 2010;
94:1985-94. [PMID:
20188363 DOI:
10.1016/j.fertnstert.2010.01.013]
[Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 01/05/2010] [Accepted: 01/08/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE
To evaluate the role of nuclear factor-κB (NF-κB) in the pathogenesis of endometriosis.
DESIGN
A literature search was conducted in PubMed to identify all relevant citations.
RESULT(S)
Our findings highlight the important role of NF-κB in the pathophysiology of endometriosis. In vitro and in vivo studies show that NF-κB-mediated gene transcription promotes inflammation, invasion, angiogenesis, and cell proliferation and inhibits apoptosis of endometriotic cells. Constitutive activation of NF-κB has been demonstrated in endometriotic lesions and peritoneal macrophages of endometriosis patients. Agents blocking NF-κB are effective inhibitors of endometriosis development and some drugs with known NF-κB inhibitory properties have proved efficient at reducing endometriosis-associated symptoms in women. Iron overload activates NF-κB in macrophages. NF-κB activation in macrophages and ectopic endometrial cells stimulates synthesis of proinflammatory cytokines, generating a positive feedback loop in the NF-κB pathway and promoting endometriotic lesion establishment, maintenance and development.
CONCLUSION(S)
NF-κB transcriptional activity modulates key cell processes contributing to the initiation and progression of endometriosis. Because endometriosis is a multifactorial disease, inhibiting NF-κB appears to be a promising strategy for future therapies targeting different cell functions involved in endometriosis development, such as cell adhesion, invasion, angiogenesis, inflammation, proliferation, and apoptosis. Upcoming research will elucidate these hypotheses.
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