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Pain in Endometriosis
Frontiers in Cellular Neuroscience ( IF 4.2 ) Pub Date : 2020-09-15 , DOI: 10.3389/fncel.2020.590823
Jessica Maddern 1, 2 , Luke Grundy 1, 2 , Joel Castro 1, 2 , Stuart M Brierley 1, 2, 3
Affiliation  

Endometriosis is a chronic and debilitating condition affecting ∼10% of women. Endometriosis is characterized by infertility and chronic pelvic pain, yet treatment options remain limited. In many respects this is related to an underlying lack of knowledge of the etiology and mechanisms contributing to endometriosis-induced pain. Whilst many studies focus on retrograde menstruation, and the formation and development of lesions in the pathogenesis of endometriosis, the mechanisms underlying the associated pain remain poorly described. Here we review the recent clinical and experimental evidence of the mechanisms contributing to chronic pain in endometriosis. This includes the roles of inflammation, neurogenic inflammation, neuroangiogenesis, peripheral sensitization and central sensitization. As endometriosis patients are also known to have co-morbidities such as irritable bowel syndrome and overactive bladder syndrome, we highlight how common nerve pathways innervating the colon, bladder and female reproductive tract can contribute to co-morbidity via cross-organ sensitization.



中文翻译:

子宫内膜异位症的疼痛

子宫内膜异位症是一种慢性且使人衰弱的疾病,影响约 10% 的女性。子宫内膜异位症的特点是不孕和慢性盆腔疼痛,但治疗选择仍然有限。在许多方面,这与对子宫内膜异位症引起的疼痛的病因和机制缺乏了解有关。虽然许多研究集中于月经逆行以及子宫内膜异位症发病机制中病变的形成和发展,但相关疼痛的机制仍知之甚少。在这里,我们回顾了子宫内膜异位症慢性疼痛机制的最新临床和实验证据。这包括炎症、神经源性炎症、神经血管生成、外周敏化和中枢敏化的作用。由于子宫内膜异位症患者还患有肠易激综合征和膀胱过度活动症候群等合并症,因此我们强调支配结肠、膀胱和女性生殖道的常见神经通路如何通过跨器官致敏导致合并症。

更新日期:2020-10-06
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