Endometriosis and the Fallopian Tubes: Theories of Origin and Clinical Implications

Christopher J. Hill, M Fakhreldin, Alison Maclean, Lucy Dobson, Lewis Nancarrow, Alice Bradfield, Fiona Choi, Diandra Daley, Nicola Tempest, Dharani K Hapangama
Journal of clinical medicine · 2020 · vol. 9(6) , pp. 1905 · doi:10.3390/jcm9061905 · PMID:32570847 · PMC7355596 · W3035942147
review OA: gold CC0 ⤵ 40 in-corpus citations
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This review examines the role of the fallopian tubes in the origin, pathogenesis, and clinical consequences of endometriosis, and their potential link to ovarian epithelial cancers.

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Abstract

Endometriosis is a common, oestrogen driven chronic condition, where endometrium-like epithelial and stromal cells exist in ectopic sites. At present, no curative treatments are available and the existing evidence for disease progression is conflicting. The pathogenesis is still unknown and evidently complex, as mechanisms of initiation may depend on the anatomical distribution of endometriotic lesions. However, amongst the numerous theories and plethora of mechanisms, contributions of the fallopian tubes (FT) to endometriosis are rarely discussed. The FT are implicated in all endometriosis associated symptomatology and clinical consequences; they may contribute to the origin of endometriotic tissue, determine the sites for ectopic lesion establishment and act as conduits for the spread of proinflammatory media. Here, we examine the available evidence for the contribution of the human FT to the origin, pathogenesis and symptoms/clinical consequences of endometriosis. We also examine the broader topic linking endometriosis and the FT epithelium to the genesis of ovarian epithelial cancers. Further studies elucidating the distinct functional and phenotypical characteristics of FT mucosa may allow the development of novel treatment strategies for endometriosis that are potentially curative.

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Condition tags

endometriosis

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