Jacques Donnez, M. D. , Ph. D. , Maria Mercedes Binda, Ph. D

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Presentation transcript:

Oxidative stress in the pelvic cavity and its role in the pathogenesis of endometriosis Jacques Donnez, M.D., Ph.D., Maria Mercedes Binda, Ph.D., Olivier Donnez, M.D., Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D. Fertility and Sterility Volume 106, Issue 5, Pages 1011-1017 (October 2016) DOI: 10.1016/j.fertnstert.2016.07.1075 Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Evolution of the Earth's atmospheric oxygen content through time. Fertility and Sterility 2016 106, 1011-1017DOI: (10.1016/j.fertnstert.2016.07.1075) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Hypotheses explaining oxidative stress in the peritoneal cavity of women with endometriosis. Bold type indicates factors that have been studied specifically in relation to pelvic endometriosis. NOS = nitric oxide synthase. Fertility and Sterility 2016 106, 1011-1017DOI: (10.1016/j.fertnstert.2016.07.1075) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Origin of iron overload in the pelvic cavity of endometriosis patients. Erythrocytes are carried into the pelvic cavity by retrograde menstruation and hemorrhaging foci of ectopic endometrium. A proportion of them are phagocytosed by peritoneal macrophages. Metabolism of Hb by HO-1 (HO) releases iron. Macrophages store some iron in the form of ferritin or hemosiderin, and release some that binds to Tf. Macrophages are also able to release ferritin into peritoneal fluid, whereas lysis of erythrocytes releases Hb. Hemoglobin forms a complex with Hp, which is in part secreted by ectopic lesions. The Hb–Hp complex is then endocytosed by macrophages. Increased pelvic iron concentrations result from Tf, ferritin, and Hb accumulation in peritoneal fluid. Transferrin and Hb may be assimilated by ectopic endometrial cells, resulting in the formation of iron deposits (ferritin or hemosiderin) inside lesions. Fertility and Sterility 2016 106, 1011-1017DOI: (10.1016/j.fertnstert.2016.07.1075) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Cells and processes involved in endometriosis development. Iron overload may affect a wide range of cell types, modulating multiple mechanisms involved in endometriosis development. NF-κB = nuclear factor κB. Fertility and Sterility 2016 106, 1011-1017DOI: (10.1016/j.fertnstert.2016.07.1075) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions