Review

Nuclear Factor-B (NF-B): An Unsuspected Major Culprit in the Pathogenesis of Endometriosis That Is Still at Large?
Sun-Wei Guo

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisc., USA

Address of Corresponding Author

Gynecol Obstet Invest 2007;63:71-97 (DOI: 10.1159/000096047)

  Key Words

• Apoptosis
• Angiogenesis
• Cytokine, endometriosis
• Inflammation
• Invasion
• NF-B
• Pathogenesis
• Pelvic pain
• Progesterone receptor
• Proliferation

  Abstract

Endometriosis, defined as the ectopic presence of endometrial glandular and stromal cells outside the uterine cavity, is a common benign gynecological disorder with an enigmatic pathogenesis. Many genes and gene products have been reported to be altered in endometriosis, yet some of them may not be major culprits but merely unwitting accomplices or even innocent bystanders. Therefore, the identification and apprehension of major culprits in the pathogenesis of endometriosis are crucial to the understanding of the pathogenesis and would help to develop better therapeutics for endometriosis. Although so far NF-B only has left few traces of incriminating fingerprints, several lines of investigation suggest that NF-B, a pivotal pro-inflammatory transcription factor, could promote and maintain endometriosis. Various inflammatory agents, growth factors, and oxidative stress activate NF-B. NF-B proteins themselves and proteins regulated by them have been linked to cellular transformation, proliferation, apoptosis, angiogenesis, and invasion. Interestingly, all existing and nearly all investigational medications for endometriosis appear to act through suppression of NF-B activation. In endometriotic cells, NF-B appears to be constitutively activated, and suppression of NF-B activity by NF-B inhibitors or proteasome inhibitors suppresses proliferation in vitro. Viewing NF-B as a major culprit, an autoregulatory loop model can be postulated, which is consistent with existing data and, more importantly, can explain several puzzling phenomena that are otherwise difficult to interpret based on prevailing theories. This view has immediate and important implications for novel ways to treat endometriosis. Further research is warranted to precisely delineate the roles of NF-B in the pathogenesis of endometriosis and to indict and convict its aiders and abettors.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Sun-Wei Guo, PhD
Department of Pediatrics, Medical College of Wisconsin
8701 Watertown Plank Road, MS 756
Milwaukee, WI 53226-0509 (USA)
Tel. +1 414 456 4992, Fax +1 414 456 6663, E-Mail swguo@mcw.edu

  Article Information

Acknowledgement of financial support: The Children's Research Institute, Milwaukee, Wisc.

Published online: October 4, 2006
Number of Print Pages : 27
Number of Figures : 8, Number of Tables : 1, Number of References : 419