Aromataseinhibitoren zur Therapie der Endometriose?

Zusammenfassung Ein 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. Abstract The 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. 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Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Wülfing, P., Kiesel, L. Aromataseinhibitoren zur Therapie der Endometriose?. Gynäkologe 38, 326–332 (2005). https://doi.org/10.1007/s00129-005-1668-2 Issue date: DOI: https://doi.org/10.1007/s00129-005-1668-2