{"paper_id":"177d36a3-242f-4359-8572-f756b43b536e","body_text":"Zusammenfassung\nEin Großteil der medikamentösen Behandlungsmöglichkeiten der Endometriose basiert auf dem Konzept, durch den Einsatz von z. B. GnRH-Analoga oder Gestagenen einen relativen Östrogenmangel im Gewebe zu erzielen. Da diese Therapien jedoch unbefriedigend und mit nicht unerheblichen Nebenwirkungen assoziiert sind, werden gezieltere Ansätze der Endometriosebehandlung wie z. B. der Einsatz von Aromataseinhibitoren erforscht. Die Aromatase P450 ist das Schlüsselenzym für die Östrogenbiosynthese. Während im eutopen Endometrium keine Aromataseaktivität nachweisbar ist, wird die Aromatase im Endometriosegewebe überexprimiert, was wiederum zu einer lokal gesteigerten Östrogensynthese mit vermehrter Zellproliferation, Angiogenese und Apoptoseresistenz führt. Ferner ist bekannt, dass Prostaglandin E2 eine Induktion der Aromataseaktivität und somit eine vermehrte Östrogensynthese in Endometrioseherden bewirkt. Im Sinne eines positiven Feedbackmechanismus stimuliert Östrogen die Cyclooxygenase-2 und dadurch wiederum die Bildung von Prostaglandin E2. Erste Studien konnten zeigen, dass dieser Kreislauf durch Aromataseinhibitoren durchbrochen und eine Schmerzlinderung bei Endometriosepatientinnen erzielt werden kann.\nAbstract\nThe medical treatment of endometriosis has long centred upon producing a hypoestrogenic state by use of GnRH analogues or progestins. Since these regimens are of limited value and have been associated with high incidence of side effects, current research is focused upon medications targeting specific aspects of the development and maintenance of endometriosis. An obvious therapeutic target would be the aromatase. Aromatase is the key enzyme for estrogen biosynthesis. It is not detectable in normal endometrium, however, in endometriosis aromatase is aberrantly expressed resulting in local production of estrogen with increased cell proliferation, angiogenesis and impaired apoptosis. Also, aromatase expression is stimulated by prostaglandin E2 thereby also leading to an increased estrogen synthesis in endometriotic tissue. As a positive feedback cycle, estrogen stimulates cyclooxygenase-2 expression which induces formation of prostaglandin E2. Preliminary studies demonstrated that this vicious circle can be disrupted by aromatase inhibitors leading to regression and pain relief in patients with endometriosis.\nSimilar content being viewed by others\nLiteratur\nAckerman GE, Smith ME, Mendelson CR, MacDonald PC, Simpson ER (1981) Aromatization of androstenedione by human adipose tissue stromal cells in monolayer culture. 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J Clin Endocrinol Metab 83: 4474–4480\nInteressenkonflikt:\nDer korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nWülfing, P., Kiesel, L. Aromataseinhibitoren zur Therapie der Endometriose?. Gynäkologe 38, 326–332 (2005). https://doi.org/10.1007/s00129-005-1668-2\nIssue date:\nDOI: https://doi.org/10.1007/s00129-005-1668-2","source_license":"CC0","license_restricted":false}