Progesterone receptor ligands for the treatment of endometriosis

被引:2
作者
Clemenza, Sara [1 ]
Capezzuoli, Tommaso [1 ]
Eren, Ecem [2 ]
Garcia, Jose M. Garcia [1 ]
Vannuccini, Silvia [1 ]
Petraglia, Felice [1 ,3 ]
机构
[1] Univ Florence, Careggi Univ Hosp, Mario Serio Obstet & Gynecolodgy Dept Expt, Clin & Biomed Sci, Florence, Italy
[2] Bakirkoy Dr Sadi Konuk Educ & Res Hosp, Dept Obstet & Gynecol, Istanbul, Turkiye
[3] Univ Florence, Dept Expt Clin & Biomed Sci Obstet & Gynaecol, Viale Morgagni 44, I-50134 Florence, Italy
关键词
Endometriosis; Progestins; Dienogest; Norethisterone acetate; Medroxyprogesterone acetate; Levonorg-estrel; DEPOT-MEDROXYPROGESTERONE ACETATE; QUALITY-OF-LIFE; PELVIC PAIN; INTRAUTERINE SYSTEM; RECTOVAGINAL ENDOMETRIOSIS; NORETHINDRONE ACETATE; ULIPRISTAL ACETATE; PR-B; DIENOGEST; WOMEN;
D O I
10.23736/S2724-606X.22.05157-0
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Estrogen dependence and progesterone resistance play a crucial role in the origin and development of endometriosis. Therefore, hormonal therapies are currently the most effective treatment. Progestins are considered the first-line ap-proach, especially for a long-term management. Progestins are synthetic compounds that mimic the effects of progester-one by binding progesterone receptors. Continuous use of progestins leads to the suppression of ovarian steroidogenesis with anovulation and low serum levels of ovarian steroids, causing endometrial pseudodecidualization. Moreover, they act by interfering on several endometriosis pathogenetic pathways, decreasing inflammation, provoking apoptosis in endometriotic cells, stimulating atrophy or regression of endometrial lesions, inhibiting angiogenesis, and decreasing expression of metalloproteinases, thus diminishing the invasiveness of endometriotic implants. Progestins are effective for pain relief and improvement of the quality of life (QoL). The side effects are limited, and the compounds are available in different formulations and routes of administration and represent, in most cases, an inexpensive treatment option. Di-enogest, Medroxyprogesterone acetate and Norethisterone acetate are the labeled progestins for endometriosis, but other progestins, such as Dyhidrogesterone, Levonorgestrel and Desogestrel, have been shown to be effective in the treatment of endometriosis-associated pain. The present review aims to describe the available and emerging evidences on proges-tins used for the treatment of endometriosis.
引用
收藏
页码:288 / 297
页数:10
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