[Frontiers in Bioscience E1, 415-428, June 1, 2009]

Insights into endometriosis-associated endometrial dysfunctions: a review

Patrick Kibangou Bondza, Rodolphe Maheux, Ali Akoum

Unite d'Endocrinologie de la Reproduction, Centre de Recherche, Hopital Saint-Francois d'Assise, Centre Hospitalier Universitaire de Quebec (CHUQ), Faculte de Medecine, Universite Laval. 10, rue de l'Espinay, local D0-711, Quebec, G1L 3L5 Canada


1. Abstract
2. Introduction
3. Summary Genetic basis of endometriosis
4. Hormonal dysfunctions in eutopic endometrium of women with endometriosis
5. Immuno-inflammatory changes in eutopic endometrium of women with endometriosis
5.1. Monocyte chemoattractant protein-1 (MCP-1)
5.2. Interleukin-1 (IL-1)
5.3. Prostaglandins (PGs)
6. Abnormal gene expression, protein production from eutopic and ectopic endometrium of women with endometriosis
6.1. Matrix metalloproteinases (MMPs)
6.2. Angiogenesis
6.3. Apoptosis
6.4. CA-125
7. Role of oxidative stress in the eutopic endometrium from women with endometriosis
8. Gene dysfunctions in the eutopic endometrium of women with endometriosis-related infertility
8.1. Integrins and NOS/NO
8.2. HOX genes
8.3. EMX2
8.4. Leukemia inhibitory factor (LIF)
9. Conclusion
10. References


Endometriosis is defined as the presence of ectopic endometrial-like tissue outside the uterus cavity. This disease, afflicting women during their reproductive age, is mainly associated with pelvic pain and infertility. Sampson's theory which supports the ability of endometrial fragments from retrograde menstruations to slough through fallopian tubes and reach peritoneal environment has been recognized as the most plausible explanation for endometriosis during many years. However, further studies provided evidence that fundamental abnormal changes may occur within the eutopic endometrium of women with endometriosis compared to that of women without endometriosis. These dysfunctions included genetic predisposition, genes aberrantly expressed such as matrix metalloproteinases, Hox genes, integrins, anti-apoptotic genes Bcl-2, but also steroid hormones, immuno-inflammatory factors and angiogenesis. This review aims at summarizing and emphasizing a non exhaustive panel of biochemical and molecular factors abnormally expressed in the eutopic endometrium and related to the pathogenesis of endometriosis.