Aromatase and endometriosis


Bulun S., Fang Z., Imir G., Gurates B., Tamura M., Yilmaz B., ...More

SEMINARS IN REPRODUCTIVE MEDICINE, vol.22, no.1, pp.45-50, 2004 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 22 Issue: 1
  • Publication Date: 2004
  • Doi Number: 10.1016/j.fertnstert.2003.11.027
  • Journal Name: SEMINARS IN REPRODUCTIVE MEDICINE
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.45-50
  • Keywords: aromatase, aromatase inhibitor, endometriosis, endometrium, estrogen biosynthesis, pelvic pain, POLYMERASE CHAIN-REACTION, P450 CYP19 GENE, CYTOCHROME-P450 TRANSCRIPTS, ESTROGEN BIOSYNTHESIS, PROXIMAL PROMOTER, STROMAL CELLS, EXPRESSION, WOMEN, ANDROSTENEDIONE, AROMATIZATION

Abstract

Aromatase P450 (P450arom) is the key enzyme for biosynthesis of estrogen, which is an essential hormone for the establishment and growth of endometriosis. There is no detectable aromatase enzyme activity in normal endometrium; therefore, estrogen is not locally produced in endometrium. Endometriosis tissue, however, contains very high levels of aromatase enzyme, which leads to production of significant quantities of estrogen. Moreover, one of the best-known mediators of inflammation and pain, prostaglandin E-2, strikingly induces aromatase enzyme activity and formation of local estrogen in this tissue. Additionally, estrogen itself stimulates cyclo-oxygenase-2 and therefore increases the formation of prostaglandin E2 in endometriosis. We were able to target this positive feedback cycle in endometriosis using aromatase inhibitors. In fact, pilot trials showed that aromatase inhibitors could decrease pelvic pain associated with endometriosis.