Aromatase inhibitors: the next generation of therapeutics for endometriosis?
Aromatase inhibitors: the next generation of therapeutics for endometriosis?
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DOI：
10.1016/j.fertnstert.2005.09.064
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发表时间：
2006-05-01
影响因子：
6.7
通讯作者：
Bulun, Serdar E.
中科院分区：
文献类型：
--
作者：
Attar, Erkut;Bulun, Serdar E.
目标与设计：综述芳香化酶抑制剂（AIs）在子宫内膜异位症治疗中的作用。结论：子宫内膜异位症是一种常见的雌激素依赖性疾病，可导致严重的并发症，包括盆腔疼痛、多次手术和不孕。大约只有一半患有子宫内膜异位症的女性从现有的药物或手术治疗中获得疼痛缓解。医学治疗通常针对抑制雌激素作用或其从卵巢的产生，并且不解决在卵巢病变中通过芳香酶的局部雌激素生物合成。一个单一的基因编码芳香酶，这是雌激素生物合成途径中的最后一个酶，它的抑制有效地消除雌激素的产生。最近引入的高度特异性的AI成功地治疗了盆腔疼痛，并显着缩小了病变大小。在绝经前妇女中，单独使用AI可能会诱导卵巢卵泡发生，因此AI与炔雌醇、复方口服避孕药或GnRH类似物联合使用。AI与口服避孕药或维生素A联合给药的副作用是非常良性的。我们在此回顾已发表的使用人工授精治疗子宫内膜异位症的临床证据。
Objective and Design: To review the role of aromatase inhibitors (AIs) in the treatment of endometriosis.Conclusion(s): Endometriosis is a common estrogen-dependent disorder that can result ill substantial morbidity, including pelvic pain, multiple operations, and infertility. Approximately only half of women with endometriosis get pain relief from existing medical or surgical treatments. Medical treatments usually are directed at inhibiting estrogen action or its production from the ovaries and do not address local estrogen biosynthesis by the aromatase enzyme in endometriotic lesions. A single gene encodes aromatase, which is the final enzyme in the estrogen biosynthesis pathway, and its inhibition effectively eliminates estrogen production. The recently introduced highly specific AIs have Successfully treated pelvic pain and significantly reduced the lesion size. In premenopausal women, an AI alone may induce ovarian folliculogenesis, and thus AIs are combined with a progestin, a combination oral contraceptive, or a GnRH analogue. The side-effect profile of AIs administered in combination with an oral contraceptive or a progestin is remarkably benign. We review herein the published clinical evidence for the use of AIs in the treatment of endometriosis.