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Human Reproduction Update, Vol.6, No.5 pp.413-418, 2000
© European Society of Human Reproduction and Embryology 2000; all rights reserved

Molecular basis for treating endometriosis with aromatase inhibitors

Serdar E. Bulun1, Khaled M. Zeitoun2, Kazuto. Takayama3 and Hironobu. Sasano3

1 Departments of Obstetrics and Gynecology and Molecular Genetics, University of Illinois at Chicago, IL 60612, 2 Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 622 W. 168th St, New York, NY 100323702 3 Departments Pathology and Obstetrics and Gynecology, Tohoku University School of Medicine, 2-1 Seiryo Machi, Sendai-Shi 980, Japan

To whom correspondence should be addressed at: Serdar E Bulun, Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 S. Wood St M/C 808, Chicago, IL 60612, USA. Tel: (312) 996-8197; Fax: (312) 996-4238; e-mail: & sbulun{at}uic.edu

Abstract

Although treatment of one unusually aggressive case of postmenopausal endometriosis with an aromatase inhibitor has been strikingly successful, large clinical trials are required to establish whether aromatase inhibitors will have a significant role in the medical management of endometriosis. Introduction of aromatase inhibitors into the treatment of endometriosis underscores the importance of basic research leading to the development of novel strategies in reproductive disorders. It was shown earlier that aromatase activity was not detectable in normal endometrium. Aromatase, however, is expressed inappropriately in endometriosis and stimulated by prostaglandin E2. Aromatase activity gives rise to local biosynthesis of oestrogen, which, in turn, stimulates prostaglandin E2 production, thus establishing a positive feedback cycle. This favours accumulation of oestrogen and prostaglandins in endometriosis, which is an inflammatory disorder dependent on oestrogen for growth.

Key words: aromatase / aromatase inhibitor / endometriosis / endometrium / oestrogen biosynthesis


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