Mechanism of pain generation for endometriosis-associated pelvic pain

Arch Gynecol Obstet. 2014 Jan;289(1):13-21. doi: 10.1007/s00404-013-3049-8. Epub 2013 Oct 12.

Abstract

Purpose: Endometriosis-associated pelvic pain appears due to persistent nociceptive stimulation, but the precise mechanisms remain poorly understood.

Methods: A search was conducted to screen and select articles from PubMed.

Main results: Neurotrophins (NTs), a family of neuronal growth factors, are overexpressed in endometriosis and encompass NGF, BDNF and NT-3 and NT-4/5. NT receptors, TrkA and p75NTR, and NT receptor-interacting proteins, MAGE and NDN, were also expressed. NTs and their receptors play a role in the development and maintenance of neural tissues in non-neuronal cell types such as endometriosis. Nerve fibers contain unmyelinated sensory C, myelinated sensory Adelta and adrenergic nerve fibers that innervate abnormal cell growths. An increased release of proinflammatory cytokines from endometriotic lesions is responsible for the excessive sensory innervation and development of chronic pelvic pain.

Conclusions: The preponderance of the inflammatory milieu and subsequent hyperinnervation might be involved in the pathophysiology of pain generation in women with endometriosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Pain / etiology*
  • Chronic Pain / metabolism
  • Endometriosis / complications*
  • Endometriosis / metabolism
  • Endometriosis / pathology
  • Female
  • Humans
  • Nerve Fibers / metabolism
  • Nerve Fibers / pathology
  • Nerve Growth Factors / metabolism*
  • Pelvic Pain / etiology*
  • Pelvic Pain / metabolism
  • Pelvic Pain / pathology

Substances

  • Nerve Growth Factors