Endometriosis Pathoetiology and Pathophysiology: Roles of Vitamin A, Estrogen, Immunity, Adipocytes, Gut Microbiome and Melatonergic Pathway on Mitochondria Regulation

George Anderson
Biomolecular concepts · 2019 · vol. 10(1) , pp. 133–149 · doi:10.1515/bmc-2019-0017 · PMID:31339848 · W2963361530
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This review explores how vitamin A, estrogen, immunity, adipocytes, gut microbiome, and the melatonergic pathway influence mitochondrial regulation in the pathoetiology and pathophysiology of endometriosis.

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Abstract

Endometriosis is a common, often painful, condition that has significant implications for a woman's fertility. Classically, endometriosis has been conceptualized as a local estrogen-mediated uterine condition driven by retrograde menstruation. However, recent work suggests that endometriosis may be a systemic condition modulated, if not driven, by prenatal processes. Although a diverse array of factors have been associated with endometriosis pathophysiology, recent data indicate that the low body mass index and decreased adipogenesis may be indicative of an early developmental etiology with alterations in metabolic function crucial to endometriosis pathoetiology. The present article reviews the data on the pathoetiology and pathophysiology of endometriosis, suggesting key roles for alterations in mitochondria functioning across a number of cell types and body systems, including the immune system and gut microbiome. These changes are importantly regulated by decreases in vitamin A and its retinoic acid metabolites as well as increases in mitochondria estrogen receptor-beta and the N-acetylserotonin/melatonin ratio across development. This has treatment and future research implications for this still poorly managed condition, as well as for the association of endometriosis with a number of cancers.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Estrogens Gastrointestinal Microbiome Immunity, Innate Mitochondria Vitamin A Adipocytes Adipocytes Endometriosis Estrogens Female Humans Melatonin Melatonin Mitochondria Vitamin A

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (100)

Cited by (33)

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