Should Genetics Now Be Considered the Pre-eminent Etiologic Factor in Endometriosis?
Endometriosis is a common, estrogen-dependent, inflammatory disorder characterized by the growth of endometrial-like tissue at extrauterine locations. Its pathogenesis and mechanisms underlying its pathophysiology are poorly understood, although genetic variation is strongly implicated in these processes. Genetic studies reveal that approximately 50% of risk for endometriosis is due to genetic factors and the other 50% likely owing to environmental factors. As with other complex diseases, genetic variants in the DNA sequence increasing endometriosis risk all have small effects, unlike most single-gene disorders. It is the combinations of these variants adding together that contribute to higher risks for individual women. In addition, recent data on disease lesions demonstrate a high frequency of somatic (likely acquired) mutations, some of which are present in the eutopic endometrium and specifically in the epithelial cell compartment, raising the possibility that abnormal epithelial progenitors in the eutopic endometrium give rise to ectopic disease. Discovery in this field is occurring at a rapid pace, and further definitions of genetic (germline) and environmental (somatic) contributions to the pathogenesis and pathophysiology of this disorder are anticipated soon. These discoveries are expected to increase diagnostic, therapeutic, and preventive strategies to minimize disease and its associated morbidities.
['Montgomery|Grant W|GW|', 'Mortlock|Sally|S|', 'Giudice|Linda C|LC|']
D003937:Diagnosis, Differential D003944:Diagnostic Techniques, Obstetrical and Gynecological D004715:Endometriosis D004717:Endometrium D004967:Estrogens D005260:Female D020022:Genetic Predisposition to Disease D005820:Genetic Testing D006801:Humans D009154:Mutation D010532:Peritoneal Diseases D012307:Risk Factors
Disease model Genetic risk factors Somatic mutations