Basic mechanisms of vascularization in endometriosis and their clinical implications

AbstractBACKGROUNDVascularization is a major hallmark in the pathogenesis of endometriosis. An increasing number of studies suggests that multiple mechanisms contribute to the vascularization of endometriotic lesions, including angiogenesis, vasculogenesis and inosculation.OBJECTIVE AND RATIONALEIn this review, we provide an overview of the basic mechanisms of vascularization in endometriosis and give special emphasis on their future clinical implications in the diagnosis and therapy of the disease.SEARCH METHODSLiterature searches were performed in PubMed for English articles with the key words ‘endometriosis’, ‘endometriotic lesions’, ‘angiogenesis’, ‘vascularization’, ‘vasculogenesis’, ‘endothelial progenitor cells’ and ‘inosculation’. The searches included both animal and human studies. No restriction was set for the publication date.OUTCOMESThe engraftment of endometriotic lesions is typically associated with angiogenesis, i.e. the formation of new blood vessels from pre-existing ones. This angiogenic process underlies the complex regulation by angiogenic growth factors and hormones, which activate intracellular pathways and associated signaling molecules. In addition, circulating endothelial progenitor cells (EPCs) are mobilized from the bone marrow and recruited into endometriotic lesions, where they are incorporated into the endothelium of newly developing microvessels, referred to as vasculogenesis. Finally, preformed microvessels in shed ...
Source: Human Reproduction Update - Category: OBGYN Source Type: research