Skip to main content

Table 1 Molecular pathways of endometriosis

From: Extrapelvic endometriosis: a rare entity or an under diagnosed condition?

Past theories

 

Von Recklinghausen (1885)

Embryonic mesonephric elements

Grunwald (1942)

Fetal cells of Muller resources can be converted into endometrial cells

Metaplasia theory (Meyers 1903)

Metaplasia of the peritoneal serosa cuff differentiation of mesothelial cells of the peritoneum

Theory of dispersion and transplantation (Halban, Sampson)

Dispersion of endometrial cells through lymphatic vessels and hematogenous spread

Theory of induction (Merril)

Combination of the previous theories

Modern theories combine

 

Estrogens

Estrogen dependent

Genetics

Hereditary (10q26, 7p15.2)

Transplantation

Direct spread

Immune system

Incapability of the immune system

Context

Environmental factors

Congenital defect

Atretic hymen

Ectopic endometrial implantation via retrograde menses

 

Cellular level

Development of monoclonal tissue with characteristics of malignant behavior

Molecular level

Enzymes of the extracellular matrix act to endometriosis or in normal endometrium of women with endometriosis

MMP-9/TIMP-1

Stamatowicz et al.

MMP-9/TIMP-3

Chung et al.

MMP-5 type membranes increase

Gaetje et al.

MMP-3/uPA

Ramon et al.

VEGF/MMP-3/uPA

Gillabert –Estelles et al.

VEGF/MMP-2/CD44/Ki67

Kim et al.

PAI/TIMP-1

Gillabert –Estelles et al.

IL-1/MMP-1

Hudelist et al.