title: Nuclear factor-kappaB: a main regulator of inflammation and cell survival in endometriosis pathophysiology.
abstract: OBJECTIVE
  To update, analyze, and summarize the literature concerning nuclear factor-kappaB (NF-κB) participation in endometriosis pathophysiology.
  
  
  METHODS
  Review.
  
  
  RESULTS
  Nuclear factor-kappaB is physiologically activated in the human endometrium, showing variable activity. A cyclic p65-DNA binding pattern was shown in the endometrium of healthy women. This cyclic pattern was altered in the endometrium of patients with endometriosis. Nuclear factor-kappaB is basally activated in peritoneal endometriotic lesions, showing higher p65 activity in red endometriotic lesions than in black lesions. In vivo and in vitro studies show up-regulation of inflammation and cell proliferation and down-regulation of apoptosis by NF-κB activity. Iron overload has been shown in the pelvic cavity of endometriosis patients, and iron overload and oxidative stress activate NF-κB in macrophages, which have been shown to participate in the endometriosis-associated inflammatory reaction.
  
  
  CONCLUSIONS
  Nuclear factor-kappaB activation dysregulation in the endometrium of endometriosis patients may explain some endometrial biological alterations associated with endometriosis. The scientific evidence strongly suggests that NF-κB activity in endometriotic cells stimulates inflammation and cell proliferation and inhibits apoptosis, favoring the development and maintenance of endometriosis. Iron overload in the pelvic cavity of endometriosis patients could be a main factor enhancing oxidative stress and activating NF-κB in a chronic manner, contributing to endometriosis establishment and growth.
authors: Instituto de Investigaciones Materno Infantil, Departamento de Obstetricia y Ginecología, Hospital Clínico San Borja-Arriarán, Facultad de Medicina, Universidad de Chile, Santiago, Chile. rgonzalezr@med.uchile.cl
authors: Reinaldo
authors: R
authors: González-Ramos
authors: Sylvie
authors: S
authors: Defrère
authors: Luigi
authors: L
authors: Devoto
mesh_terms: D000818:Animals; D017209:Apoptosis; D049109:Cell Proliferation; D002470:Cell Survival; D004715:Endometriosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007501:Iron / Q000378:metabolism; D016328:NF-kappa B / Q000502:physiology*
chemical_list: D016328:NF-kappa B; D007501:Iron