Aberrant invasion of nervous fibers in endometriosis: the role of estrogens

Burlev V.A.

doi:https://doi.org/10.17116/repro202026021104

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Abstract:

Endometriosis is a complex and heterogeneous disease with unknown etiology. Estrogens, innervation and dysregulation of macrophages are important factors affecting the pathogenesis of pain associated with endometriosis. The aim of the review is to show the role of estrogen in the interaction between macrophages and nerve fibers by polarizing macrophages as a potentially valuable therapeutic target for the treatment of pain in endometriosis. The PubMed database was searched using relevant keywords to identify studies on the role of estrogen in aberrant invasion of nerve fibers in endometriosis. The coexistence of macrophages and nerve fibers induces innovative neuroimmune communications under the influence of estrogens. Persistent stimulation of nerve fiber nociceptors by inflammatory cytokines from macrophages aggravates neuroinflammation by releasing inflammatory neurotransmitters. This neuroimmune interaction, regulated by estrogens, sensitizes peripheral nerves, leading to neuropathic pain in endometriosis. Estrogens can promote the secretion of chemokines from peripheral nerves, enhancing the recruitment and polarization of macrophages in the tissues of the eutopic and ectopic endometrium. Macrophages play a role in activating multiple nerve growth factors that mediate neurogenesis imbalance depending on estrogen.

Keywords:

endometriosis

estrogens

macrophages

nerve fibers

neuroinflammation

Authors:

Burlev V.A.

Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova, Moskva

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References:

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