Peritoneal endometriosis is an inflammatory disease

Jacques Donnez
In: Frontiers in Bioscience · 2012 · vol. E4(1) , pp. 23–40 · doi:10.2741/e358 · W4213343843
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper explores the roles of iron, nuclear factor-kappa B, and prostaglandins in peritoneal endometriosis pathogenesis, emphasizing peritoneal macrophages and inflammation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper is a review exploring evidence from patient biopsies plus in vitro and in vivo studies that peritoneal endometriosis is a chronic inflammatory disease marked by increased peritoneal macrophages and their secreted products. It summarizes how peritoneal oxidative stress—driven by reactive oxygen species formed after retrograde menstruation-associated pro-oxidants like heme and iron—can contribute to cellular damage and proinflammatory gene expression via nuclear factor-kappa B activation, which also regulates prostaglandin biosynthetic enzymes linked to higher peritoneal prostaglandin concentrations. The review emphasizes the key role of macrophages and examines potential molecular interactions among iron, NF-kappa B, and prostaglandins, while acknowledging that the conclusions are based on heterogeneous “available data collected” across study types. This paper is centrally about endometriosis — specifically peritoneal endometriosis as an inflammatory disease involving macrophages, oxidative stress, NF-κB, and prostaglandins.

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Abstract

Peritoneal endometriosis is a chronic inflammatory disease characterized by increased numbers of peritoneal macrophages and their secreted products. Inflammation plays a major role in pain and infertility associated with endometriosis, but is also extensively involved in the molecular processes that lead to peritoneal lesion development. Peritoneal oxidative stress is currently thought to be a major constituent of the endometriosisassociated inflammatory response. Excessive production of reactive oxygen species, secondary to peritoneal influx of pro-oxidants such as heme and iron during retrograde menstruation, may induce cellular damage and increased proinflammatory gene expression through nuclear factorkappa B activation. In particular, prostaglandin biosynthetic enzyme expression is regulated by this transcriptional factor, and increased peritoneal prostaglandin concentrations have been demonstrated in endometriosis. In the light of available data collected from patient biopsies, as well as in vitro and in vivo studies, the respective involvement and potential molecular interactions of iron, nuclear factor-kappa B and prostaglandins in the pathogenesis of endometriosis are explored and discussed. The key role of peritoneal macrophages is emphasized and potential therapeutic targets are examined.
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Abstract

Peritoneal endometriosis is a chronic inflammatory disease characterized by increased numbers of peritoneal macrophages and their secreted products. Inflammation plays a major role in pain and infertility associated with endometriosis, but is also extensively involved in the molecular processes that lead to peritoneal lesion development. Peritoneal oxidative stress is currently thought to be a major constituent of the endometriosisassociated inflammatory response. Excessive production of reactive oxygen species, secondary to peritoneal influx of pro-oxidants such as heme and iron during retrograde menstruation, may induce cellular damage and increased proinflammatory gene expression through nuclear factorkappa B activation. In particular, prostaglandin biosynthetic enzyme expression is regulated by this transcriptional factor, and increased peritoneal prostaglandin concentrations have been demonstrated in endometriosis. In the light of available data collected from patient biopsies, as well as in vitro and in vivo studies, the respective involvement and potential molecular interactions of iron, nuclear factor-kappa B and prostaglandins in the pathogenesis of endometriosis are explored and discussed. The key role of peritoneal macrophages is emphasized and potential therapeutic targets are examined.

Keywords

- Peritoneal endometriosis - Inflammation - Oxidative Stress - iron - NF-kappa B - Prostaglandins - Macrophages - Medical Treatment - Review

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endometriosisinfertility

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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.

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