The role of genetic factors in developing endometrioid lesions

In: Obstetrics, Gynecology and Reproduction · 2023 · vol. 17(4) , pp. 443–454 · doi:10.17749/2313-7347/ob.gyn.rep.2023.434 · W4385644747
article OA: gold CC0 ⤵ 6 in-corpus citations
AI-generated summary by gemini-2.5-flash-lite, 2026-06-08

Genome-wide association studies have identified over 190 loci linked to endometriosis, with only a few polymorphisms consistently replicated across multiple independent studies.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text

This paper reviews existing genetic association data on endometriosis, focusing on genome-wide association study (GWAS) findings for loci linked to developing endometrioid lesions. Across the literature, GWAS have identified over 190 loci associated with endometriosis development, but only a small subset of polymorphisms has been repeatedly reported, including specific variants such as rs1537377 in CDKN2B-AS1, rs71575922 in SYNE1, and rs11674184 in GREB1, as well as multiple loci in GREB1 and WNT4 regions. The authors report that only some loci have been confirmed in replication studies, while more than 95% of GWAS-significant loci have not been validated independently, which they cite as a key limitation and rationale for further genetic studies. This paper is centrally about endometriosis — it reviews genetic factors and replication status of GWAS loci related to endometrioid lesion development.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Here, we analyze the data on genetic factors involved in developing endometriosis available in current publications. To date, the genome-wide associative studies (GWAS) have revealed more than 190 loci associated with endometriosis development, however, only few polymorphisms were associated with this disease identified in two GWAS (rs1537377 CDKN2B-AS1 , rs71575922 SYNE1 , rs11674184 GREB1 , rs1903068 KDR , rs2235529 WNT4 , rs7412010 CDC42 ), and only one rs12700667 TSEN15P3/MIR148A polymorphic locus in four studies. Several polymorphisms located in the region of two genes GREB1 (rs11674184, rs13394619, rs35417544) and WNT4 (rs2235529, rs12037376, rs7521902) are associated with endometriosis in several GWAS. The association of 5 polymorphic loci with endometriosis was confirmed in two or more replication studies: rs13394619 GREB1 , rs7521902 MIR4418/WNT4 , rs1250248 FN1 and rs6542095 CKAP2L/IL1A – in two studies, rs12700667 TSEN15P3/MIR148A – in four studies. At the same time, the relationship between the vast majority of GWAS-significant polymorphic loci (more than 95 %) and endometriosis has not been confirmed in other independent studies, necessitating a need to continue endometriosis-related genetic studies, including those aimed at confirming previously identified associations.
Full text 17,330 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Here, we analyze the data on genetic factors involved in developing endometriosis available in current publications. To date, the genome-wide associative studies (GWAS) have revealed more than 190 loci associated with endometriosis development, however, only few polymorphisms were associated with this disease identified in two GWAS (rs1537377 CDKN2B-AS1, rs71575922 SYNE1, rs11674184 GREB1, rs1903068 KDR, rs2235529 WNT4, rs7412010 CDC42), and only one rs12700667 TSEN15P3/MIR148A polymorphic locus in four studies. Several polymorphisms located in the region of two genes GREB1 (rs11674184, rs13394619, rs35417544) and WNT4 (rs2235529, rs12037376, rs7521902) are associated with endometriosis in several GWAS. The association of 5 polymorphic loci with endometriosis was confirmed in two or more replication studies: rs13394619 GREB1, rs7521902 MIR4418/WNT4, rs1250248 FN1 and rs6542095 CKAP2L/IL1A – in two studies, rs12700667 TSEN15P3/MIR148A – in four studies. At the same time, the relationship between the vast majority of GWAS-significant polymorphic loci (more than 95 %) and endometriosis has not been confirmed in other independent studies, necessitating a need to continue endometriosis-related genetic studies, including those aimed at confirming previously identified associations. About the Authors T. A. PonomarevaRussian Federation Tatiana A. Ponomareva – MD, Postgraduate Student, Department of Medical and Biological Disciplines, Belgorod National Research University; Obstetrician-Gynecologist, Obstetric Department, Belgorod Regional Clinical Hospital of St. Joasaph 85 Pobedy Str., Belgorod 308015 8/9 Nekrasova Str., Belgorod 308000 O. B. Altukhova Russian Federation Oxana B. Altukhova – MD, Dr Med Sci, Associate Professor, Head of the Department of Obstetrics and Gynecology, Belgorod National Research University; Head of Gynecological Department, Belgorod Regional Clinical Hospital of St. Joasaph Scopus Author ID: 57216900558 85 Pobedy Str., Belgorod 308015 8/9 Nekrasova Str., Belgorod 308000 I. V. Ponomarenko Russian Federation Irina V. Ponomarenko – MD, Dr Med Sci, Associate Professor, Department of Medical and Biological Disciplines Scopus Author ID: 57190225823 85 Pobedy Str., Belgorod 308015 M. I. Churnosov Russian Federation Mikhail I. Churnosov – MD, Dr Med Sci, Professor, Head of the Department of Medical and Biological Disciplines Scopus Author ID: 6601948788 85 Pobedy Str., Belgorod 308015

References

1. Laganà A.S., Garzon S., Götte M. et al. The pathogenesis of endometriosis: molecular and cell biology insights. Int J Mol Sci. 2019;20(22):5615. https://doi.org/10.3390/ijms20225615. 2. Wang Y., Nicholes K., Shih I.-M. The origin and pathogenesis of endometriosis. Annual Review of Pathology. 2020;15:71–95. https://doi.org/10.1146/annurev-pathmechdis-012419-032654. 3. Adamyan L.V., Aznaurova Ya.B. Molecular aspects of endometriosis. [Molekulyarnye aspekty patogeneza endometrioza]. Problemy reprodukcii. 2015;21(2):66–77. (In Russ.). https://doi.org/10.17116/repro201521266-77. 4. Gerasimov A.M., Malyshkina A.I., Kuligina M.V. et al. Incidence rate and structure of external genital endometriosis in hospital patients. [Chastota vstrechaemosti i struktura naruzhnogo genital'nogo endometrioza u gospitalizirovannyh bol'nyh]. Ginekologiya. 2021;23(2):184–9. (In Russ.). https://doi.org/10.26442/20795696.2021.2.200783. 5. Begovich E., Solopova A.G., Khlopkova S.V. et al. Quality of life and psychoemotional status in patients with external genital endometriosis. [Kachestvo zhizni i osobennosti psihoemocional'nogo statusa bol'nyh naruzhnym genital'nym endometriozom]. Obstetrics, Gynecology and Reproduction. 2022;16(2):122–33. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.283. 6. Adamyan L.V., Arslanyan K.N., Loginova O.N. et al. Immunologicheskie aspekty endometrioza: obzor literatury. [Immunologicheskie aspekty endometrioza: obzor literatury]. Lechashchij vrach. 2020;(4):37. (In Russ.). https://doi.org/10.26295/OS.2020.29.10.007. 7. Khashchenko E.P., Lobanova A.D., Kulabukhova E.A. Clinical and diagnostic features of various forms of genital endometriosis (adenomyosis, external genital endometriosis, endometrioid cysts) in adolescent girls. [Osobennosti klinicheskoj kartiny i diagnostiki raznyh form genital'nogo endometrioza (adenomioz, naruzhnyj genital'nyj endometrioz, endometrioidnye kisty) u devochek podrostkogo vozrasta]. Reproduktivnoe zdorov'e detej i podrostkov. 2020;16(4):117–30. (In Russ.). https://doi.org/10.33029/1816-2134-2020-16-4-117-130. 8. Igenbaeva E.V., Uzlova T.V., Kurenkov E.L. Anxiety-depressive disorders of patients with external genital endometriosis. [Trevozhno-depressivnye rasstrojstva u pacientok s naruzhnym genital'nym endometriozom]. Kazanskij medicinskij zhurnal. 2017;98(6):910–2. (In Russ.). https://doi.org/10.17750/kmj2017-910. 9. Bouaziz J., Mashiach R., Cohen S. et al. How artificial intelligence can improve our understanding of the genes associated with endometriosis: Natural Language Processing of the PubMed Database. Biomed Res Int. 2018;2018:6217812. https://doi.org/10.1155/2018/6217812. 10. Kennedy S. The genetics of endometriosis. J Reprod Med. 1998;43(3 Suppl):263–8. https://doi.org10.1201/b14235-5. 11. Treloar S.A., O’Connor D.T., O’Connor V.M., Martin N.G. Genetic influences on endometriosis in an Australian twin sample. Fertil Steril. 1999;71(4):701–10. https://doi.org/10.1016/s0015-0282(98)00540-8. 12. Saha R., Pettersson H.J., Svedberg P. et al. Heritability of endometriosis. Fertil Steril. 2015;104(4):947–52. https://doi.org/10.1016/j.fertnstert.2015.06.035. 13. Adachi S., Tajima A., Quan J. et al. Meta-analysis of genome-wide association scans for genetic susceptibility to endometriosis in Japanese population. J Hum Genet. 2010;55(12):816–21. https://doi.org/10.1038/jhg.2010.118. 14. Uno S., Zembutsu H., Hirasawa A. et al. A genome-wide association study identifies genetic variants in the CDKN2BAS locus associated with endometriosis in Japanese. Nat Genet. 2010;42(8):707–10. https://doi.org/10.1038/ng.612. 15. Painter J.N., Anderson C.A., Nyholt D.R. et al. Genome-wide association study identifies a locus at 7p15.2 associated with endometriosis. Nat Genet. 2011;43(1):51–4. https://doi.org/10.1038/ng.731. 16. Nyholt D.R., Low S.-K., Anderson C.A. et al. Genome-wide association meta-analysis identifies new endometriosis risk loci. Nat Genet. 2012;44(12):1355–9. https://doi.org/10.1038/ng.2445. 17. Albertsen H.M., Chettier R., Farrington P., Ward K. Genome-wide association study link novel loci to endometriosis. PLoS One. 2013;8(3):e58257. https://doi.org/10.1371/journal.pone.0058257. 18. Borghese B., Tost J., de Surville M. et al. Identification of susceptibility genes for peritoneal, ovarian, and deep infiltrating endometriosis using a pooled sample-based genome-wide association study. Biomed Res Int. 2015;2015:461024. https://doi.org/10.1155/2015/461024. 19. Wang W., Li Y., Li S. et al. Pooling-based genome-wide association study identifies risk loci in the pathogenesis of ovarian endometrioma in Chinese Han women. Reprod Sci. 2017;24(3):400–6. https://doi.org/10.1177/1933719116657191. 20. Uimari O., Rahmioglu N., Nyholt D.R. et al. Genome-wide genetic analyses highlight mitogenactivated protein kinase (MAPK) signaling in the pathogenesis of endometriosis. Hum Reprod. 2017;32(4):780–93. https://doi.org/10.1093/humrep/dex024. 21. Sapkota Y., Steinthorsdottir V., Morris A.P. et al. Meta-analysis identifies five novel loci associated with endometriosis highlighting key genes involved in hormone metabolism. Nat Commun. 2017;8:15539. https://doi.org/10.1038/ncomms15539. 22. Sobalska-Kwapis M., Smolarz B., Słomka M. et al. New variants near RHOJ and C2, HLADRA region and susceptibility to endometriosis in the Polish population – the genome-wide association study. Eur J Obstet Gynecol Reprod Biol. 2017;217:106–12. https://doi.org/10.1016/j.ejogrb.2017.08.037. 23. Ishigaki K., Akiyama M., Kanai M. et al. Large-scale genome-wide association study in a Japanese population identifies novel susceptibility loci across different diseases. Nat Genet. 2020;52(7):669–79. https://doi.org/10.1038/s41588-020-0640-3. 24. Masuda T., Ogawa K., Kamatani Y. et al. A Mendelian randomization study identified obesity as a causal risk factor of uterine endometrial cancer in Japanese. Cancer Sci. 2020;111(12):4646–51. https://doi.org/10.1111/cas.14667. 25. Chou Y.-C., Chen M.-J., Chen P.-H. et al. Integration of genome-wide association study and expression quantitative trait locus mapping for identification of endometriosis-associated genes. Sci Rep. 2021;11(1):478. https://doi.org/10.1038/s41598-020-79515-4. 26. Jiang L., Zheng Z., Fang H., Yang J. A generalized linear mixed model association tool for biobank-scale data. Nat Genet. 2021;53(11):1616–21. https://doi.org/10.1038/s41588-021-00954-4. 27. Backman J.D., Li A.H., Marcketta A. et al. Exome sequencing and analysis of 454,787 UK Biobank participants. Nature. 2021;599(7886):628–34. https://doi.org/10.1038/s41586-021-04103z. 28. Masuda T., Low S.K., Akiyama M. et al. GWAS of five gynecologic diseases and cross-trait analysis in Japanese. Eur J Hum Genet. 2020;28(1):95–107. https://doi.org/10.1038/s41431-0190495-1. 29. Sakaue S., Kanai M., Tanigawa Y. et al. A cross-population atlas of genetic associations for 220 human phenotypes. Nat Genet. 2021;53(10):1415–24. https://doi.org/10.1038/s41588-021-00931-x. 30. Rahmioglu N., Mortlock S., Ghiasi M. et al. The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nat Genet. 2023;55(3):423–36. https://doi.org/10.1038/s41588-023-01323-z. 31. Chernukha G.E., Pronina V.A. Endometriosis comorbidity and its clinical significance. [Komorbidnost' endometrioza i ee klinicheskoe znachenie]. Akusherstvo i ginekologiya. 2023;(1):27–34. (In Russ.). https://doi.org/10.18565/aig.2022.252. 32. Koller D., Pathak G.A., Wendt F.R. et al. Epidemiologic and genetic associations of endometriosis with depression, anxiety, and eating disorders. JAMA Netw Open. 2023;6(1):e2251214. https://doi.org/10.1001/jamanetworkopen.2022.51214. 33. Fan Y.H., Leong P.Y., Chiou J.Y. et al. Association between endometriosis and risk of systemic lupus erythematosus. Sci Rep. 2021;11(1):532. https://doi.org/10.1038/s41598-020-79954-z. 34. Chao Y.H., Liu C.H., Pan Y. et al. Association between endometriosis and subsequent risk of Sjögren's syndrome: A Nationwide Population-Based Cohort Study. Front Immunol. 2022;13:845944. https://doi.org10.3389/fimmu.2022.845944. 35. Painter J.N., O'Mara T.A., Morris A.P. et al. Genetic overlap between endometriosis and endometrial cancer: evidence from cross-disease genetic correlation and GWAS meta-analyses. Cancer Med. 2018;7(5):1978–87. https://doi.org/10.1002/cam4.1445. 36. Gallagher C.S., Mäkinen N., Harris H.R. et al. Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis. Nat Commun. 2019;10(1):4857. https://doi.org/10.1038/s41467-019-12536-4. 37. Adewuyi E.O., Sapkota Y.; International Endogene Consortium Iec, andMe Research Team, International Headache Genetics Consortium Ihgc, Auta A. et al. Shared molecular genetic mechanisms underlie endometriosis and migraine comorbidity. Genes (Basel). 2020;11(3):268. https://doi.org/10.3390/genes11030268. 38. Adewuyi E.O., Mehta D., Sapkota Y.; International Endogene Consortium; 23andMe Research Team, Auta A. et al. Genetic analysis of endometriosis and depression identifies shared loci and implicates causal links with gastric mucosa abnormality. Hum Genet. 2021;140(3):529–52. https://doi.org/10.1007/s00439-020-02223-6. 39. Adewuyi E.O., Mehta D.; International Endogene Consortium (IEC); 23andMe Research Team, Nyholt D.R. Genetic overlap analysis of endometriosis and asthma identifies shared loci implicating sex hormones and thyroid signalling pathways. Hum Reprod. 2022;37(2):366–83. https://doi.org/10.1093/humrep/deab254. 40. Radzinsky V.E., Altuchova O.B. Molecular-genetic determinants of infertility in genital endometriosis. [Molekulyarno-geneticheskie determinanty besplodiya pri genital'nom endometrioze]. Research Results in Biomedicine. 2018;4(3):28–37. (In Russ.). https://doi.org/10.18413/2313-8955-2018-4-3-0-3. 41. Golovchenko I., Aizikovich B., Golovchenko O. et al. Sex hormone candidate gene polymorphisms are associated with endometriosis. Int J Mol Sci. 2022;23(22):13691. https://doi.org/10.3390/ijms232213691. 42. Golovchenko I.O. Genetic determinants of sex hormone levels in endometriosis patients. [Geneticheskie determinanty urovnya polovyh gormonov u bol'nyh endometriozom]. Research Results in Biomedicine. 2023;9(1):5–21. (In Russ.). https://doi.org/10.18413/2658-6533-2023-9-10-1. 43. Andreev A.E., Kleimenova T.S., Drobintseva A.O. et al. Signal molecules involved in the formation of new nerve endings in endometriosis (review). [Signal'nye molekuly, vovlechennye v obrazovanie novyh nervnyh okonchanij pri endometrioze (obzor)]. Research Results in Biomedicine. 2019;5(1):94–107. (In Russ.). https://doi.org/10.18413/2313-8955-2019-5-1-0-7. 44. Ponomarenko I.V., Polonikov A.V., Verzilina I.N. et al. Molecular-genetic determinants of the development of endometriosis. [Molekulyarno-geneticheskie determinanty razvitiya endometrioza]. Voprosy ginekologii, akusherstva i perinatologii. 2019;18(1):82–6. (In Russ.). https://doi.org/10.20953/1726-1678-2019-1-82-86. 45. Ponomarenko I.V., Polonikov A.V., Churnosov M.I. Molecular mechanisms of and risk factors for endometriosis. [Molekulyarnye mekhanizmy i faktory riska razvitiya endometrioza]. Akusherstvo i ginekologiya. 2019;(3):26–31. https://doi.org/10.18565/aig.2019.3.26-31. 46. Christofolini D.M., Mafra F.A., Catto M.C. et al. New candidate genes associated to endometriosis. Gynecol Endocrinol. 2019;35(1):62–5. https://doi.org/10.1080/09513590.2018.1499090. 47. Zhang Z., Ruan L., Lu M., Yao X. Analysis of key candidate genes and pathways of endometriosis pathophysiology by a genomics-bioinformatics approach. Gynecol Endocrinol. 2019;35(7):576–81. https://doi.org/10.1080/09513590.2019.1576609. 48. Pagliardini L., Gentilini D., Vigano' P. et al. An Italian association study and meta-analysis with previous GWAS confirm WNT4, CDKN2BAS and FN1 as the first identified susceptibility loci for endometriosis. J Med Genet. 2013;50(1):43–6. https://doi.org/10.1136/jmedgenet-2012-101257. 49. Pagliardini L., Gentilini D., Sanchez A.M. et al. Replication and meta-analysis of previous genome-wide association studies confirm vezatin as the locus with the strongest evidence for association with endometriosis. Hum Reprod. 2015;30(4):987–93. https://doi.org/10.1093/humrep/dev022. 50. Sundqvist J., Xu H., Vodolazkaia A. et al. Replication of endometriosis-associated singlenucleotide polymorphisms from genome-wide association studies in a Caucasian population. Hum Reprod. 2013;28(3):835–9. https://doi.org/10.1093/humrep/des457. 51. Sapkota Y., Fassbender A., Bowdler L. et al. Independent replication and meta-analysis for endometriosis risk loci. Twin Res Hum Genet. 2015;18(5):518–25. https://doi.org/10.1017/thg.2015.61. 52. Sapkota Y., Low S.K., Attia J. et al. Association between endometriosis and the interleukin 1A (IL1A) locus. Hum Reprod. 2015;30(1):239–48. https://doi.org/10.1093/humrep/deu267. 53. Mafra F., Catto M., Bianco B. et al. Association of WNT4 polymorphisms with endometriosis in infertile patients. J Assist Reprod Genet. 2015;32(9):1359–64. https://doi.org/10.1007/s10815015-0523-1. 54. Wu Z., Yuan M., Li Y. et al. Analysis of WNT4 polymorphism in Chinese Han women with endometriosis. Reprod Biomed Online. 2015;30(4):415–20. https://doi.org/10.1016/j.rbmo.2014.12.010. 55. Li Y., Hao N., Wang Y.X., Kang S. Association of endometriosis-associated genetic polymorphisms from genome-wide association studies with ovarian endometriosis in a Chinese population. Reprod Sci. 2017;24(1):109–13. https://doi.org/10.1177/193371911665075. 56. Sundqvist J., Xu H., Vodolazkaia A. et al. Replication of endometriosis-associated singlenucleotide polymorphisms from genome-wide association studies in a Caucasian population. Hum Reprod (Oxford, England). 2013;28(3):835–9. https://doi.org/10.1093/humrep/des457. 57. Osiński M., Mostowska A., Wirstlein P. et al. The assessment of GWAS – identified polymorphisms associated with infertility risk in Polish women with endometriosis. Ginekol Pol. 2018;89(6):304–10. https://doi.org/10.5603/GP.a2018.0052. 58. Viana P.C.S., Mendes A.C.D.M., Delgado L.F. et al. Association between single nucleotide polymorphisms and endometriosis in a Brazilian Population. Rev Bras Ginecol Obstet. 2020;42(3):146–51. https://doi.org10.1055/s-0040-1708460. Review For citations: Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I. The role of genetic factors in developing endometrioid lesions. Obstetrics, Gynecology and Reproduction. 2023;17(4):443-454. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.434 JATS XML This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

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 (56)

Cited by (7)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK