title: Role of inflammation and aromatase expression in the eutopic endometrium and its relationship with the development of endometriosis.
abstract: Epigenetic changes favoring the transcription of the aromatase gene in the endometrium allow endometrial cells to survive in ectopic locations by producing estrogens that spare them from destruction through activated macrophages. Local estrogen production hastens prostaglandin synthesis by stimulating COX-2 activity, thus creating a self-perpetuating sequence of augmented estrogen formation and enhanced inflammation. Repetitive retrograde menstruation reintroduces aromatase-positive endometrial cells endowed with the capacity to implant and invade the peritoneum. In order to control endometriosis, an effective medication must inhibit aromatase, block COX-2, decrease fibrosis and induce amenorrhea. Within this framework, progestins, either alone or in the form of oral contraceptives, appear as first-line treatment for endometriosis owing to their capacity to block enzymes such as aromatase and COX-2.
authors.affiliation: Centro de Pesquisas e Assistência em Reprodução Humana (CEPARH) & Instituto da Mulher, Rua Caetano Moura, 35, 40210-341 Salvador, Bahia, Brazil. ceparh@uol.com.br
authors.forename: Hugo
authors.initials: H
authors.lastname: Maia
authors.forename: Clarice
authors.initials: C
authors.lastname: Haddad
authors.forename: Genevieve
authors.initials: G
authors.lastname: Coelho
authors.forename: Julio
authors.initials: J
authors.lastname: Casoy
mesh_terms: D001141:Aromatase / Q000378:metabolism*; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D004717:Endometrium / Q000378:metabolism*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007249:Inflammation / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D016387:Women's Health
chemical_list: D047072:Aromatase Inhibitors; D004965:Estrogen Antagonists; D001141:Aromatase