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Angiogenic factors in endometriosis. Endometriosis is a common gynecological disorder defined by the proliferation of endometrial tissue outside the uterine cavity. The disease affects about 10% of all reproductive-aged women and the prevalence rises to 20%-50% in infertile women. The most widely accepted hypothesis is that endometrial cells are transported from the uterine cavity, then implant at ectopic sites. Retrograde flow of menstrual tissue through the fallopian tubes could cause intra-abdominal endometriosis. The clinical manifestations are pelvic pain and mass, alteration of menses, and infertility. Some women with extensive endometriosis are asymptomatic, whereas some with minimal disease have incapacitating pain. Increased understanding of tumorogenesis has driven increased development of molecules able to regulate angiogenesis, a market likely to reach $2.4 billion by 2006. Although inhibitors of angiogenesis are most commonly being developed for the treatment of cancer, this class of drug also holds considerable promise for sufferers of arthritis and endometriosis. In view of this development, leaders in the field of endometriosis have recently published a state of the art review of angiogenic targets of relevance to this disease. This review notes that endometriotic implants are often surrounded by vascularity, and that extrapelvic endometriosis, while rare, typically occurs in well-vascularized organs. Cytokines, notably, IL-1ß, IL-6 and IL-8, receive particular attention and the involvement of angiogenic growth factors such as IGF, FGF, EGF and ENDO-I is also reviewed. This review may be of particular use to those already involved in angiogenesis research and wishing to expand their interest to cover new disease areas. Link to journal abstract:
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