Endometriosis: novel etiopathogenetic concepts and clinical perspectives.
OBJECTIVE
To discuss current ideas about therapy for endometriosis derived from new observations generated by using molecular biology techniques and in vivo animal models of disease.


METHODS
The MEDLINE database was reviewed for English-language articles on new drugs that affect the endocrine or immunologic system, the possibility that endometriosis has multiple forms, and the association of endometriosis with cancer. Specific attention was given to in vivo studies in animals or humans.


CONCLUSIONS
Among the novel potential candidate drugs, aromatase inhibitors and raloxifene should be considered for treatment of postmenopausal women with endometriosis. Notable observations have emerged from studies of immunomodulators and antiinflammatory agents in animal models of disease. These findings must be confirmed in women. The histogenesis of ovarian endometriomas is still unclear, thus limiting new experimental approaches to this form of disease. Given the low but established risk for malignant transformation of endometriosis, efforts should be directed toward identification of susceptibility loci for the disease and its potential transformation into cancer.
Vignali
Mario
M
IRCCS Istituto Auxologico Italiano, Milan, Italy. mario.vignali@inimi.it
Infantino
Mirco
M
Matrone
Roberta
R
Chiodo
Ilda
I
Somigliana
Edgardo
E
Busacca
Mauro
M
Viganò
Paola
P
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D047072:Aromatase Inhibitors; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D016239:MEDLINE; D010048:Ovarian Cysts / Q000188:drug therapy / Q000209:etiology; D010049:Ovarian Diseases / Q000188:drug therapy / Q000209:etiology; D010051:Ovarian Neoplasms / Q000209:etiology / Q000235:genetics; D017698:Postmenopause; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D012002:Rectal Diseases / Q000188:drug therapy / Q000209:etiology; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014623:Vaginal Diseases / Q000188:drug therapy / Q000209:etiology
D000276:Adjuvants, Immunologic; D000893:Anti-Inflammatory Agents; D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride