Insights into iron and nuclear\n\t\t\t\t factor-kappa B (NF-κB) involvement in chronic\n\t\t\t\t inflammatory processes in peritoneal endometriosis

Endometriosis is a chronic pelvic\n\t\t\t\t inflammatory process. Local inflammation is known to\n\t\t\t\t play a role in pain and infertility associated with the\n\t\t\t\t disease, and may be extensively involved in molecular\n\t\t\t\t and cellular processes leading to endometriosis\n\t\t\t\t development. In this review, we focus on two\n\t\t\t\t inflammatory mediators clearly implicated in the\n\t\t\t\t pathogenesis of endometriosis, iron and NF-κB, and\n\t\t\t\t their potential association. Iron is essential for all living\n\t\t\t\t organisms, but excess iron results in toxicity and is\n\t\t\t\t linked to pathological disorders. In endometriosis\n\t\t\t\t patients, iron overload has been demonstrated in the\n\t\t\t\t different compartments of the peritoneal cavity\n\t\t\t\t (peritoneal fluid, endometriotic lesions, peritoneum and\n\t\t\t\t macrophages). This iron overload affects numerous\n\t\t\t\t mechanisms involved in endometriosis development.\n\t\t\t\t Moreover, iron can generate free radical species able to\n\t\t\t\t react with a wide range of cellular constituents, inducing\n\t\t\t\t cellular damage. Overproduction of reactive oxygen\n\t\t\t\t species also impairs cellular function by altering gene\n\t\t\t\t expression via regulation of redox-sensitive transcription\n\t\t\t\t factors such as NF-κB, which is clearly implicated in\n\t\t\t\t endometriosis. Indeed, NF-κB is activated in\n\t\t\t\t endometriotic lesions and peritoneal macrophages of\n\t\t\t\t endometriosis patients, which stimulates synthesis of\n\t\t\t\t proinflammatory cytokines, generating a positive\n\t\t\t\t feedback loop in the NF-κB pathway. NF-κB-mediated\n\t\t\t\t gene transcription promotes a variety of processes,\n\t\t\t\t including endometriotic lesion establishment,\n\t\t\t\t maintenance and development. In conclusion, iron and NF-κB appear to be linked and both are clearly involved\n\t\t\t\t in endometriosis development, making these pathways\n\t\t\t\t an attractive target for future treatment and prevention of\n\t\t\t\t this disease.