Matrix Metalloproteinases and Endometriosis: Their ROle in Disease Pathophysiology and Potential as Therapeutic Targets

Background: The matrix metalloproteinase (MMP) system is a group of enzymes, function to modulate the tissue structure and degrade the extracellular matrix (ECM), a process required in cellular repair, proliferation, apoptosis, and angiogenesis. The role of MMPs in endometriosis pathophysiology has been examined, and it is hypothesized that mis-expression of MMPs in endometrial cells or surrounding tissues is a key factor in promoting the attachment, invasion, and angiogenesis required for establishment of ectopic lesions. Objective: The objective of this review is to update the current state of knowledge on the role of MMPs in the pathophysiology of endometriosis and discuss the potential utility of treatments that may directly or indirectly target their action in endometriosis. Results: In this review we summarize the current state of knowledge on the MMPs and the pathogenesis of endometriosis, discuss the role of the MMPs in endometriosis pathophysiology, summarize current treatments for endometriosis and discuss potential utility of inhibition of MMP action in endometriosis treatment. Conclusion: Based upon the current state of knowledge, therapeutic approaches targeting MMPs may be useful in mitigating the proliferation and the establishment of the lesions but further patientbased studies are clearly needed. Keywords: Endometriosis, matrix metalloproteinase, tissue inhibitor of matrix metalloproteinase, pathophysiology, therapeutic targets, extracellular matrix.