Molecular-cellular aspects of the development of inflammatory reaction and fibrosis in endometriosis

Aim. An extensive analysis of scientific studies devoted to the metabolic activity of the neuromodulators kisspeptin and oxytocin, their involvement in the development of endothelial dysfunction and inflammation in endometriosis. Key points. The causes and conditions of endometriosis development are multifactorial and manifest themselves through disturbances in the local immune response and steroidogenesis, leading to a vicious cycle of disease development and progression associated with the development of inflammation, leading to fibrosis, severe pain, and infertility. The specific molecular and cellular metabolism of neuropeptides in peripheral tissues and their direct impact on the vascular wall can have a vasomotor effect due to their direct action on the vascular endothelium, triggering the development of reactive fibrosis in endometriosis. Conclusion. The analyzed studies indicate a probable local synergistic effect of the neuropeptides in the development of peritoneal endothelial dysfunction, the induction of an inflammatory response, and the development of reactive fibrosis based on the differential distribution of signaling pathways and the multidirectional involvement of cascade reactions. The lack of a single, typical expression pattern for several genes, which is characteristic of endometriosis, is also noted, demonstrating the heterogeneity of this disease and the need to develop a molecular classification of this common pathology. Keywords: endometriosis, oxytocin, kisspeptin, endometrium, endothelium, peritoneum, expression, vasomotor effect