Systems genetics view of endometriosis: a common complex disorder
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This study investigated endometriosis as a complex disorder through a systems genetics approach to identify underlying genetic contributions.
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Abstract
Endometriosis is a condition in which cells derived from the endometrium grow outside the uterus, e.g. in the peritoneum (external genital endometriosis). As these cells are under the influence of female hormones, major symptoms of endometriosis are pain, especially during the cycle, and infertility. Numerous hypotheses for the formation of endometriosis can be found in the literature, but there is growing evidence of serious genetic contributions to endometriosis susceptibility. The involvement of genes, steroid hormone metabolism, immunological reactions, receptor formation, inflammation, proliferation, apoptosis, intercellular adhesion, cell invasion and angiogenesis as well as genes regulating the activity of aforementioned enzymes have been suggested. Some more recently suggested candidate genes picked up in genome-wide association studies are involved in oncogenesis, metaplasia of endometrium cells and pathways of embryonic development of the female reproductive system. However, gene mutations proven to be causative for endometriosis have not been identified so far, even though the abnormal expression of candidate genes for endometriosis could be provoked by different epigenetic modifications including DNA methylation, heterochromatization or introduction of regulatory miRNA. We hypothesize that endometriosis is induced by a combination of abnormal genetic and/or epigenetic mutations: the latter pave the way for pathological changes which become irreversible, and according to the "epigenetic landscape" theory, this proceeds to the typical clinical manifestations. Two stages in the endometriosis pathway are suggested: (1) induction of primary endometrial cells toward endometriosis, and (2) implantation and progression of these cells into endometriosis lesions. The model favors endometriosis as an outgrowth of primary cells different in their origin, canalization of pathological processes, manifestation diversity provoked by unique genetic background and epigenetic influences, which result in many different clinical forms of the disease.
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- Endometriosis and Infertility: Gynecological Examination Practical Guide 2025
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- Deep Infiltrating Endometriosis in Adolescence: Early Diagnosis and Possible Prevention of Disease Progression 2024
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- Molecular Basis of Endometriosis and Endometrial Cancer: Current Knowledge and Future Perspectives 2021
- MiR-182 inhibits proliferation, migration, invasion and inflammation of endometrial stromal cells through deactivation of NF-κB signaling pathway in endometriosis 2021
- The Genetic-Epigenetic Pathophysiology of Endometriosis: A Surgeon’s View 2020
- Bioinformatic analysis reveals the importance of epithelial-mesenchymal transition in the development of endometriosis 2020
- Epithelial-mesenchimal transition and its relationship with leaky gut syndrome as possible step in pathogenesis of endometriosis 2020
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