Involvement of Prostaglandins in the Pathophysiology of Endometriosis

F. Gabriela, N. Carla
In: Endometriosis - Basic Concepts and Current Research Trends · 2012 · doi:10.5772/30414 · W1606633525
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Prostaglandins, particularly PGE2, are critical to endometriosis pathophysiology by promoting proliferation, estrogen production, angiogenesis, and immune alterations, and celecoxib's inhibition of COX-2 demonstrated therapeutic potential.

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This chapter reviews the role of prostaglandins in the pathophysiology of endometriosis, highlighting their involvement in inflammation, pain, and lesion progression. It details how elevated levels of specific prostaglandins contribute to the chronic inflammatory environment characteristic of ectopic endometrial tissue. The text also examines the therapeutic potential of targeting these pathways using nonsteroidal anti-inflammatory drugs for symptom management. This paper is centrally about endometriosis — specifically the biochemical mechanisms involving prostaglandins that drive disease pathology and pain.

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Abstract

Prostaglandins are bioactive lipids that possess multiple and diverse functions. In reproductive biology, they are involved in the regulation of ovulation, in endometrial physiology and in the process of menstruation. Furthermore, cyclooxygenases (COX) levels, which are key enzymes for the synthesis of prostaglandins, have been found to be elevated in pathologic, tumoral and inflammatory processes. In endometriosis, prostaglandins are not only implicated in pain, but they are also critical for the establishment as well as for the development of the disease. The high levels of prostaglandin E2 (PGE2) found in the peritoneal fluid from patients with endometriosis, not only favor cellular proliferation by stimulating the activity of aromatase with the consequent estrogen production, but also these estrogens are responsible for enhancing PGE2 synthesis by stimulating COX-2 activity. PGE2 also stimulates angiogenesis and is implicated in the peritoneal immunologic alterations observed in endometriosis. COX-2 inhibitors were and are used in a vast number of preclinical and clinical studies in different types of cancer. In studies conducted both in vitro and in vivo, we have demonstrated that the selective COX-2 inhibitor, celecoxib, was efficient in inhibiting experimental endometriosis. It is important to search for new horizons in endometriosis treatment. Prostaglandins and the enzymes in charge of their synthesis, COXs, represent an attractive target for developing new therapies that attack directly the molecules involved in the causes of this pathology.
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Open access Submitted: 17 March 2011 Published: 09 May 2012 DOI: 10.5772/30414 From the Edited Volume Edited by Koel Chaudhury and Baidyanath Chakravarty Submitted: 17 March 2011 Published: 09 May 2012 © 2012 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Discover 2026 Nobel Laureate Francis Halzen’s chapter on IntechOpen >

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