Endometriosis is one of the most common causes of chronic pelvic pain and infertility in women in the reproductive age group. Although the existence of this disease has been known for over 100 years our current knowledge of its pathogenesis and the pathophysiology of its related infertility remains unclear. Several reasons contribute to our lack of knowledge, the most critical being the difficulty in carrying out objective long-term studies in women. Thus, we and others have developed a model of this disease in the non-human primate, the baboon (Papio anubis). Intraperitoneal inoculation of autologous menstrual endometrium results in the development of endometriotic lesions with gross morphological characteristics similar to those seen in the human. Multiple factors have been implicated in endometriosis-associated infertility. We have described aberrant levels of factors involved in multiple pathways important in the establishment of pregnancy, in the endometrium of baboons induced with endometriosis. Specifically, we have observed dysregulation of proteins involved in invasion, angiogenesis, methylation, cell growth, immunomodulation, and steroid hormone action. These data suggest that, in an induced model of endometriosis in the baboon, an increased angiogenic capacity, decreased apoptotic potential, progesterone resistance, estrogen hyper-responsiveness, and an inability to respond appropriately to embryonic signals contribute to the reduced fecundity associated with this disease.

译文

子宫内膜异位症是生殖年龄组女性慢性盆腔疼痛和不育的最常见原因之一。尽管已经知道这种疾病的存在已有100多年了,但我们目前对其发病机理及其相关不育症的病理生理学的了解仍不清楚。造成我们缺乏知识的原因有很多,最关键的是难以对女性进行客观的长期研究。因此,我们和其他人在非人类的灵长类狒狒(狒狒)中建立了这种疾病的模型。自体月经子宫内膜的腹膜接种导致子宫内膜异位病变的发展,其形态特征与人类相似。子宫内膜异位症相关的不孕症涉及多种因素。我们已经描述了子宫内膜异位症诱发的狒狒子宫内膜中参与建立重要妊娠的多种途径的因素的异常水平。具体而言,我们已经观察到与侵袭,血管生成,甲基化,细胞生长,免疫调节和类固醇激素作用有关的蛋白质失调。这些数据表明,在狒狒子宫内膜异位症的诱发模型中,血管生成能力增强,凋亡潜能降低,孕酮抵抗,雌激素高反应性以及无法对胚胎信号做出适当反应,导致与该疾病相关的生殖力降低。 。

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