Semin Reprod Med 2015; 33(04): 246-256
DOI: 10.1055/s-0035-1554920
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pathogenesis of Endometriosis: Roles of Retinoids and Inflammatory Pathways

Robert N. Taylor
1   Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina
,
Maureen A. Kane
2   Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland
,
Neil Sidell
3   Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
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Publication History

Publication Date:
01 July 2015 (online)

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Abstract

Endometriosis is a nonmalignant, but potentially metastatic, gynecological condition manifested by the extrauterine growth of inflammatory endometrial implants. Ten percent of reproductive-age women are affected and commonly suffer pelvic pain and/or infertility. The theories of endometriosis histogenesis remain controversial, but retrograde menstruation and metaplasia each infer mechanisms that explain the immune cell responses observed around the ectopic lesions. Recent findings from our laboratories and others suggest that retinoic acid metabolism and action are fundamentally flawed in endometriotic tissues and even generically in women with endometriosis. The focus of our ongoing research is to develop medical therapies as adjuvants or alternatives to the surgical excision of these lesions. On the basis of concepts put forward in this review, we predict that the pharmacological actions and anticipated low side-effect profiles of retinoid supplementation might provide a new treatment option for the long-term management of this chronic and debilitating gynecological disease.