Novel therapies targeting endometriosis

Abstract

Endometriosis is an often painful disorder in which the endometrial glands and stroma grow outside the uterus. The disease affects women's quality of life and is a common cause of infertility. In this review, we describe promising new developments in the field based on in vitro assays and rodent models, each of which has the potential to be beneficial in the treatment of this disease. We will specifically describe the role of anti-inflammatory drugs, selective estrogen, or progesterone modulators, statins, antiangiogenic agents, and the potential for targeting stem cells as likely methods to hone in and eliminate endometriosis. The most promising of these potential therapies are currently slated for further testing in both rodent and nonhuman primate trials.

Figure 1.

Inhibition of HMG-CoRA by statins. Statins are competitive inhibitors of HMG-CoAR, a rate-limiting step of the mevalonate pathway. By competing with the reductase, statins are believed to decrease oxidative stress, apoptosis, invasiveness, and angiogenesis. 3- HMG-CoAR indicates hydroxy-3-methylglutaryl-coenzyme A reductase.

Figure 2.

Novel therapies targeting endometriosis. The inflammation caused by endometriosis is shown by red arrows, indicating stem cells, estrogens, and/or low progesterone response, and as yet, unknown causes; whereas the novel therapies are shown by blue arrows and their potential mechanism of action described. SERM indicates selective estrogen receptor modulator; SPRM, selective progesterone receptor modulator; P, progesterone; ICON, immunoconjugate molecule.