بررسی جامع ابعاد ژنتیکی و اپی‌ژنتیکی اندومتریوز، راهکارهای نوین درمان

نوع مقاله : مقاله مروری

نویسندگان

1 استادیار، گروه زیست‌شناسی سلولی مولکولی و میکروبیولوژی، دانشکده‌ی علوم و فناوری‌های زیستی، دانشگاه اصفهان، اصفهان، ایران

2 دانشجو، گروه زیست‌شناسی سلولی مولکولی و میکروبیولوژی، دانشکده‌ی علوم و فناوری‌های زیستی، دانشگاه اصفهان، اصفهان، ایران

3 استاد، گروه زنان و زایمان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان. اصفهان، ایران

10.48305/jims.v43.i835.1337

چکیده

مقاله مروری




مقدمه: اندومتریوز، یک بیماری خوش‌خیم با علت ژنتیکی نامشخص است و درمان کلاسیک آن کارآمدی لازم را ندارند.
روش‌ها: مقالات مرتبط با ابعاد ژنتیکی و اپی‌ژنتیکی اندومتریوز استخراج شدند. نظریات مرتبط با بروز اندومتریوز مورد واکاوی قرار گرفتند. امیدهای درمان با تکیه بر دو جنبه ژنتیک و اپی‌ژنتیک اندومترویز بررسی شدند.
یافته‌ها: قاعدگی بازگشتی، متاپلازی کولومیک، جنین‌زایی ناقص، اندومتریوز متاستاتیک و مهاجرت سلول‌های بنیادی اندومتر به عنوان علت‌های بروز اندومتریوز مطرح هستند. مطالعات گسترده‌ی ژنوم، فاکتورهای مرتبط با افزایش خطر ابتلا به اندومتریوز را معرفی کردند. تغییرات اپی‌ژنتیک شامل کاهش متیلاسیون پروموتور COX2 می‌تواند از طریق افزایش تولیداستروژن، بر تعداد و عملکرد نوتروفیل‌ها اثر بگذارد و موجب توسعه‌ی اندومتریوز شود. دو مولفه مهم برای شروع و پیشرفت اندومتریوز، فرار ضایعات اندومتریوز از سیستم ایمنی و مقادیر بالای سایتوکاین‌های التهابی هستند. گزینه‌های درمانی نوین اندومتریوز شامل مهارکننده‌های آروماتاز می‌باشند و ترکیب این داروها با ژستاژن‌ها، داروهای ضدبارداری خوراکی یا آگونیست‌های هورمون آزادکننده گنادوتروپین، علاوه بر موثر بودن، باعث کاهش درد، کاهش اندازه‌ی ضایعه خارج رحم و بهبود کیفیت زندگی بیماران می‌شود. مهارکننده‌های هیستون داستیلاز از تکثیر سلول‌های استرومای اندومتریوز جلوگیری می‌کنند و اثرات جانبی بسیار ضعیفی بر سلول‌های استرومای طبیعی دارند.
نتیجه‌گیری: ژنتیک و اپی‌ژنتیک نقش مهمی در بروز اندومتریوز دارند و روش‌های درمان مبتنی بر داروهای تعدیل‌کننده‌ی اپی ژنوم، امیدهای درمانی جدیدی هستند و نسبت به روش‌های درمان سنتی، کارآیی بهتری نشان می‌دهند.

تازه های تحقیق

سید مرتضی جوادی راد: PubMed ,Google Scholar 

یلدا ریاحی: Google Scholar 

فریبا بهنام فر: PubMed ,Google Scholar 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comprehensive Review of Genetic and Epigenetic Dimensions of Endometriosis, New Treatment Strategies

نویسندگان [English]

  • Seyed Morteza Javadi Rad 1
  • Yalda Riahi 2
  • Fariba Behnamfar 3
1 Assistant Professor, Department of Cell and Molecular Biology and Microbiology, School of Biological Science and Technology, University of Isfahan, Isfahan, Iran
2 Student, Department of Cell and Molecular Biology and Microbiology, School of Biological Science and Technology, University of Isfahan, Isfahan, Iran
3 Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Endometriosis is a benign condition with an unidentified genetic cause, and conventional therapeutic methods are ineffective.
Methods: Articles pertaining to the genetic and epigenetic dimensions of endometriosis were extracted. Theories concerning the etiology of endometriosis were examined. Therapeutic prospects were evaluated considering both genetic and epigenetic factors of endometriosis.
Findings: Retrograde menstruation, coelomic metaplasia, embryonic rest, metastatic endometriosis, and endometrial stem cell recruitment are regarded as etiological factors of endometriosis. Genome-wide investigations have found variables linked to an elevated incidence of endometriosis. Epigenetic modifications, such as diminished COX2 promoter methylation, can influence the quantity and functionality of neutrophils by elevating estrogen synthesis, hence contributing to the onset of endometriosis. Two critical factors in the onset and advancement of endometriosis are the evasion of endometriotic lesions from the immune response and elevated concentrations of inflammatory cytokines. Novel therapeutic alternatives for endometriosis encompass aromatase inhibitors, and their combination with gestagens, oral contraceptives, or gonadotropin-releasing hormone agonists not only demonstrates efficacy but also alleviates pain, diminishes the size of ectopic lesions, and enhances patients' quality of life. Histone deacetylase inhibitors limit the growth of endometriotic stromal cells while exhibiting little negative effects on normal stromal cells.
Conclusion: Genetics and epigenetics significantly influence the development of endometriosis, and therapeutic approaches utilizing epigenome-modulating agents present promising new options, demonstrating superior efficacy compared to conventional treatments.

کلیدواژه‌ها [English]

  • Endometriosis
  • Genetics
  • Epigenetics
  • Treatment

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مجله دانشکده پزشکی اصفهان
دوره 43، شماره 835
هفته 3، آذر
آذر و دی 1404
صفحه 1337-1353

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  • تاریخ دریافت: 26 فروردین 1404
  • تاریخ پذیرش: 16 آذر 1404

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