Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 13;84(6):555-563.
doi: 10.1055/a-2306-8759. eCollection 2024 Jun.

The Hallmarks of Endometriosis

Iason Psilopatis  1 , Stefanie Burghaus  1 , Katharina Au  1 , Louisa Hofbeck  1 , Lisa Windischbauer  1 , Laura Lotz  1 , Matthias W Beckmann  1
Affiliations

The Hallmarks of Endometriosis

Iason Psilopatis et al. Geburtshilfe Frauenheilkd. .

Abstract
in English, German

A heuristic tool called "the hallmarks of cancer" helps to reduce the enormous complexity of cancer phenotypes and genotypes to a preliminary set of guiding principles. Other aspects of cancer have surfaced as possible improvements in our understanding of the disease's mechanisms. Endometriosis is a gynecological disease condition negatively impacting the quality of life of many women. To date, there is no curative treatment for endometriosis. Therapy is aimed at treating the symptoms using hormone therapy, pain therapy and complementary therapy. Chronic pain and overlapping pain syndromes and illnesses can also be treated with multimodal pain therapy and psychosomatic therapy. Endometriosis is, however, a chronic and complex entity which, in this regard, resembles cancer. The present work investigates the hallmarks of endometriosis with a view to summarizing the current research status and paving new ways for future research projects.

Ein heuristisches Werkzeug, „Markenzeichen von Krebs“ genannt, wird eingesetzt, um die große Komplexität der Phänotypen und Genotypen von Krebszellen zu vereinfachen und in einer vorläufigen Reihe von Leitprinzipien zusammenzufassen. Andere Aspekte von Krebserkrankungen sind in jüngster Zeit auch als potenzielle Ansätze zur Verbesserung des Verständnisses von Krebserkrankungsmechanismen in Erscheinung getretten. Die Endometriose ist eine gynäkologische Erkrankung, welche die Lebensqualität vieler Frauen stark beeinträchtigt. Es gibt bisher keine kurative Behandlung dafür. Die aktuellen Therapien fokussieren darauf, Symptome anhand von Hormontherapie, Schmerztherapie sowie komplementären Therapien zu lindern. Chronische Schmerzen und überlappende Schmerzsyndrome und Erkrankungen können mithilfe multimodaler Schmerztherapien und psychosomatischer Therapien behandelt werden. Aber die Endometriose ist eine chronische und komplexe Entität, die Ähnlichkeiten mit Krebs aufweist. Diese Arbeit untersucht die Kennzeichen von Endometriose mit dem Ziel, den aktuellen Forschungsstand zusammenzufassen und neue Wege für künftige Forschungsprojekte zu ebnen.

Keywords: endometriosis; epigenetics; genetics; molecular; pathway; signaling.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Deep infiltrating endometriosis-Intraoperative laparoscopic views (Patient collective-Department of Gynecology, University Hospital of Erlangen).
Fig. 2
Fig. 2
Diagnostic approaches based on the four major endometriotic entities.
Fig. 3
Fig. 3
Hallmarks of endometriosis and their potential targets for therapy. Captions in blue: completed clinical trials. Captions in green: ongoing clinical trials. Captions in black: experimental models in vitro/in vivo. Abbreviations: ADAM17 = A Disintegrin and Metalloprotease 17; COX-2 = Cyclooxygenase 2; E2 = Estrogen 2; EPAC1 = Exchange Protein Directly Activated by cAMP 1; ERK = Extracellular Signal-regulated Kinase; FAK = Focal Adhesion Kinase; FGFR2 = Fibroblast Growth Factor Receptor 2; GPR30 = G Protein-coupled Receptor 30; HIF = Hypoxia-inducible Factor; LXA4 = Lipoxin A4; MAPK = Mitogen-activated Protein Kinase; METTL3 = Methyltransferase-like 3; miR = micro RNA; MMP = Matrix Metallopeptidase; NF-κB = Nuclear Factor kappa B; NGF = Nerve growth factor; NLRP3 = NLR Family Pyrin Domain Containing 3; NO = Nitric Oxide; PGE2 = Prostaglandin E2; PKA = Protein Kinase A; PI3K/Akt/mTOR = Phosphatidylinositol 3-kinase/Protein Kinase B/mammalian Target of Rapamycin; PPAR = Peroxisome Proliferator-activated Receptor; PrPC = Cellular Prion Protein; Rap1 = Ras-associated Protein-1; ROCK = Rho-associated Protein Kinase; S1P = Sphingosine-1-Phosphate; SERCA = Sarcoplasmic/endoplasmic Reticulum Ca2+-ATPase; SF = Steroidogenic Factor; SHH = Sonic Hedgehog; SHP-1 = Src Homology Region 2 Domain-containing Phosphatase-1; sICAM-1 = soluble form of intercellular adhesion molecule-1; SMAD = Suppressor of Mothers against Decapentaplegic; SRC = Steroid Receptor Coactivator; TGF = Transforming Growth Factor; TIMP = Tissue Inhibitor of MMP; TNF = Tumor Necrosis Factor; VEGFR = Vascular Endothelial Growth Factor Receptor; ZEB1 = Zinc Finger E-Box Binding Homeobox 1
Fig. 4
Fig. 4
Risk factors and associated conditions with endometriosis .
See this image and copyright information in PMC

References

    1. Mechsner S. Endometrioseschmerz beherrschen. Schmerz. 2021;35:159–171. doi: 10.1007/s00482-021-00543-8. - DOI - PubMed
    1. Burghaus S, Beckmann MW. Endometriose – gynäkologische Diagnostik und Therapie. Schmerz. 2021;35:172–178. doi: 10.1007/s00482-021-00541-w. - DOI - PubMed
    1. D’Alterio MN, D’Ancona G, Raslan M et al.Management Challenges of Deep Infiltrating Endometriosis. Int J Fertil Steril. 2021;15:88–94. doi: 10.22074/IJFS.2020.134689. - DOI - PMC - PubMed
    1. Schliep KC, Chen Z, Stanford JB et al.Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study. BJOG. 2017;124:220–229. doi: 10.1111/1471-0528.13711. - DOI - PMC - PubMed
    1. Keckstein J, Saridogan E, Ulrich UA et al.The #Enzian classification: A comprehensive non-invasive and surgical description system for endometriosis. Acta Obstet Gynecol Scand. 2021;100:1165–1175. doi: 10.1111/aogs.14099. - DOI - PubMed