Endometriosis and Oxidative Stress

Can Oxidative Stress Cause Endometriosis?

Key Points

Highlight:

• Reactive oxygen species (ROS) have an important role in modulating many physiological functions in reproduction as well as in conditions such as endometriosis and infertility.

Importance :

• The etiology of endometriosis is still unclear.
• It is widely accepted that oxidative stress may be implicated in the pathophysiology of endometriosis.

What's done here:

• This is a literature review to explore and clarify the different roles of oxidative stress and to define the role of oxidative stress in the development of endometriosis.

Data:

• Women with endometriosis have an increased level of iron which can generate ROS.
• Women with endometriosis present increased oxidative stress markers in serum, peritoneal fluid, follicular fluid and ovarian/endometrial tissue.
• Oxidative stress affects fertility in women with endometriosis in either natural or assisted conception.
• ROS may regulate epigenetic processes such as DNA methylation, histone methylation, and histone acetylation.
• Persistent upregulation of antioxidants may result in restoration of cell survival and subsequent malignant transformation.

Lay Summary

The etiology of endometriosis is still unclear. However, it is now widely accepted that oxidative stress, defined as an imbalance between reactive oxygen species (ROS) and antioxidants, may be implicated in the pathophysiology of endometriosis causing a general inflammatory response in the peritoneal cavity.  Scuterio G et al. from the University of Ferrara, Italy, made a systematic review of the literature recently published in the journal "Oxidative Medicine and Cellular Longevity". This study explores the functions of oxidative stress and its role in the development of endometriosis.

First, the increased level of iron, which can generate ROS, have been found in the peritoneal fluid of women with endometriosis. Also, the affected women present increased oxidative stress markers in serum, peritoneal fluid, follicular fluid, ovarian cortex and endometrial tissue. Especially, detoxification enzyme such as glutathione peroxidase is highly expressed in endometriotic cells, suggesting a higher level of oxidative stress. ROS might affect a variety of physiologic functions such as oocyte maturation, ovulation, implantation and luteal maintenance in pregnancy. Therefore, Oxidative stress affects fertility in women with endometriosis in either natural or assisted conception. Persistent ROS may contribute to the development of endometriosis-associated cancer by regulating epigenetic processes or upregulating antioxidants. These changes may evoke restoration of cell survival and subsequent malignant transformation.

Various lines of evidence support the role of oxidative stress in the development and progression of endometriosis. This observation may open the way to evaluation of therapeutic approaches targeting oxidative imbalance.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29057034