Endometriosis: the ultimate hormonal disease.
Estrogen is an extremely potent mitogen for endometrium and endometriosis. Progesterone, on the other hand, inhibits the mitogenic action of estrogen on endometrium and enhances differentiation. These antiproliferative and differentiative effects of progesterone are less pronounced on endometriosis tissue compared with endometrium. Thus, endometriosis is, at least in part, resistant to progesterone action. The product of a single gene named aromatase synthesizes estrogen. The potent estrogen estradiol is metabolized and thus inactivated by an enzyme termed 17beta-hydroxysteroid dehydrogenase (HSD) type 2 that is normally induced by progesterone in endometrium. Progesterone action is mediated by its receptor subtypes progesterone receptor (PR)-A and PR-B. We found a number of abnormalities in the expression of aromatase, 17beta-HSD type 2, and the PR-B/PR-A ratio in endometriosis tissue. These abnormalities and their functional consequences are discussed in this review article.
Gurates
Bilgin
B
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 S. Wood Street, M/C 808, Chicago, IL 60612, USA.
Bulun
Serdar E
SE
D015067:17-Hydroxysteroid Dehydrogenases / Q000378:metabolism; D000818:Animals; D001141:Aromatase / Q000378:metabolism; D047072:Aromatase Inhibitors; D004351:Drug Resistance; D004715:Endometriosis / Q000188:drug therapy / Q000503:physiopathology*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004958:Estradiol / Q000378:metabolism; D004967:Estrogens / Q000378:metabolism; D005260:Female; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D011374:Progesterone / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D004967:Estrogens; D006728:Hormones; D007527:Isoenzymes; D011980:Receptors, Progesterone; C101118:progesterone receptor A; C097314:progesterone receptor B; D011374:Progesterone; D004958:Estradiol; D015067:17-Hydroxysteroid Dehydrogenases; C044256:3 (or 17)-beta-hydroxysteroid dehydrogenase; D001141:Aromatase