title: Targeting oxidative stress to treat endometriosis.
abstract: BACKGROUND
  Endometriosis affects 10% of women of reproductive age. It is defined as the presence of implanted active endometrial tissue outside the uterine cavity. The exact pathophysiology of endometriosis is still uncertain, although several optional etiological theories have been suggested. Being so common, a novel treatment for endometriosis is widely quested. Recent studies addressing the pathological characteristics of endometriosis have revealed a vicious cycle in which oxidative stress (OS) is generated, which in turn facilitates the implantation of the ectopic endometrium. At the same time, the generation of high amounts of reactive oxygen species further triggers a state of OS.
  
  
  METHODS
  The author examined the evidence associating OS and endometriosis. After establishing an association, a search for antioxidant agents that were investigated specifically on endometriosis patients are described including Vitamins C and E, melatonin, resveratrol, xanthohumol and epigallocatechin-3-gallate. A significant effect of all the reviewed antioxidants on endometriosis is reported.
  
  
  CONCLUSIONS
  Aiming for the reduction of OS as the treatment goal for endometriosis looks promising. However, since most of the studies are either in vitro or are animal based, further studies on human subjects are deemed necessary to elucidate the impact of OS reduction on patients with endometriosis.
authors.affiliation: a 1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland , OH, USA.|b 2 Ben-Gurion University of the Negev, Faculty of Health Sciences, Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics & Gynecology , Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Harlev
authors.affiliation: a 1 American Center for Reproductive Medicine, Cleveland Clinic, Cleveland , OH, USA.
authors.forename: Sajal
authors.initials: S
authors.lastname: Gupta
authors.affiliation: c 3 American Center for Reproductive Medicine, Cleveland Clinic , Mail Code: X-11, 10681 Carnegie Avenue, Cleveland, OH 44195, USA +1 216 444 9485 ; +1 216 445 6049; agarwaa@ccf.org.
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D004715:Endometriosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D058990:Molecular Targeted Therapy; D018384:Oxidative Stress / Q000187:drug effects*; D017382:Reactive Oxygen Species / Q000378:metabolism
chemical_list: D000975:Antioxidants; D017382:Reactive Oxygen Species
keywords: anti-angiogenesis treatment; anti-inflammatory; anti-oxidants; endometriosis pathophysiology; endometriosis treatment; oxidative stress; reactive oxygen species.