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Endometrial cell apoptosis impairment associated with hormonal imbalance as a key factor in the development of endometriosis

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Abstract


The review describes the effect of certain hormones and their imbalance on apoptosis of retrogradely refluxed endometrial cells in the abdominal cavity and the effects of estrogen, progesterone, anti-Mullerian hormone, and gonadotropin-releasing hormone on the internal and external apoptotic pathways of various cell populations in endometriotic foci. The nuclear estrogen receptor β (ER-β) is shown to inhibit TNF receptors that trigger the external apoptotic pathway, but the effects of estrogens do not play a key role in the pathogenesis of endometriosis. The role of progesterone and changes in the receptor status towards prevalence of PR-A with a decreased response of endometrial tissue to progesterone and inhibition of apoptosis are described. We discuss the role of the anti-Müllerian hormone and gonadotropin-releasing hormone II (GnRH II) as activators of apoptosis in normal endometrial tissue and in endometriosis. Investigation of endocrine effects on apoptosis of parenchymal and stromal cells of endometriotic foci may provide a theoretical basis for searching for new therapeutic targets in this hormone-dependent pathology.


Roman V. Ukrainets

Smolensk State Medical University

Email: ukrainets.roman@yandex.ru
ORCID iD: 0000-0002-0590-1399
SPIN-code: 1272-2446

Russian Federation, 28, Krupskay street, Smolensk, 214019

resident

Yulia S. Korneva

Smolensk State Medical University; Smolensk Regional Institute of Pathology

Author for correspondence.
Email: ksu1546@yandex.ru
ORCID iD: 0000-0002-8080-904X
SPIN-code: 5169-7740

Russian Federation, 28, Krupskay street, Smolensk, 214019; 27, Gagarina Avenue, Smolensk, 214018

MD, PhD

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Copyright (c) 2019 Ukrainets R.V., Korneva Y.S.

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