Estrogen production and metabolism in endometriosis.
Aromatase activity is absent in normal endometrium. In contrast, aromatase is expressed aberrantly in endometriosis, which gives rise to strikingly high levels of aromatase activity in this tissue. Both aromatase expression and activity are stimulated by PGE2. This results in local production of estrogen, which induces PGE2 formation and establishes a positive feedback cycle. Another abnormality in endometriosis, that is, deficient 17beta-HSD type 2 expression, impairs the inactivation of estradiol to estrone. These molecular aberrations collectively favor accumulation of increasing quantities of estradiol and PGE2 in endometriosis. The clinical relevance of these findings was exemplified by the successful treatment of an unusually aggressive case of postmenopausal endometriosis using an aromatase inhibitor.
Bulun
Serdar E
SE
Department of Obstetrics and Gynecology, University of Illinois at Chicago, 60612, USA. sbulun@uic.edu
Yang
Sijun
S
Fang
Zhojuan
Z
Gurates
Bilgin
B
Tamura
Mitsutoshi
M
Sebastian
Siby
S
D001141:Aromatase / Q000378:metabolism; D047072:Aromatase Inhibitors; D015232:Dinoprostone / Q000378:metabolism; D004715:Endometriosis / Q000188:drug therapy / Q000201:enzymology / Q000378:metabolism*; D004717:Endometrium / Q000201:enzymology; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D004967:Estrogens / Q000096:biosynthesis* / Q000378:metabolism; D005260:Female; D006801:Humans
D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D004967:Estrogens; D001141:Aromatase; D015232:Dinoprostone