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Semin Immunopathol. 2007 Jun;29(2):193-210.

Neuroendocrine-immune disequilibrium and endometriosis: an interdisciplinary approach.

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Center of Internal Medicine and Dermatology, Division of PsychoNeurolmmunology, Charité, University Medicine Berlin, Berlin, Germany.


Endometriosis, a chronic disease characterized by endometrial tissue located outside the uterine cavity, affects one fourth of young women and is associated with chronic pelvic pain and infertility. However, an in-depth understanding of the pathophysiology and effective treatment strategies of endometriosis is still largely elusive. Inadequate immune and neuroendocrine responses are significantly involved in the pathophysiology of endometriosis, and key findings are summarized in the present review. We discuss here the role of different immune mechanisms particularly adhesion molecules, proteinglycan interactions, and pro-angiogenic mediators in the development and progression of the disease. Finally, we introduce the concept of endometrial dissemination as result of a neuroendocrine-immune disequilibrium in response to high levels of perceived stress caused by cardinal clinical symptoms of endometriosis.

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