![]() In fact, one study reported estrogen receptors are expressed on mast cells (although the action of estrogen on the mast cell is not described) (Hart, 2015). Estrogen seems to stimulate mast cells to support the inflammatory process (Zhu et al., 2018). Endometriosis is an inflammatory disease, and degranulating mast cells have been found in higher quantities in endometriosis lesions versus normal tissue (Hart, 2015 Indraccolo & Barbieri, 2010). Mast cells are immune system cells that can stimulate inflammation (Graziottin, Skaper, & Fusco, 2014). Our findings indicate that ectopic lesions are the major drivers of systemic inflammation in endometriosis.” ![]() “Endometriotic lesion removal significantly alters the inflammatory profile both locally and systemically in women with endometriosis. Surgical removal of endometriotic lesions alters local and systemic proinflammatory cytokines in endometriosis patients. K., Zhou, J., Nagarkatti, P., Nagarkatti, M., Young, S. This inconsistency could be due to the progesterone resistance typical of endometriosis which may stem from altered progesterone receptor expression 8.” Progestin (progesterone) treatment appears to be successful in most 5, but not all 6, women, and not all progestin formulations are effective in reducing endometriosis-associated pain 7. Progesterone exhibits anti-inflammatory actions, and as such, progesterone analogs have been used to treat endometriosis and its associated symptoms 4. One of the driving factors for the enhanced production of endometriotic lesion cytokines is an altered progesterone responsiveness associated with the disease. Altered cytokine production by both cells of the immune system and the endometriotic lesion tissue has been proposed (discussed below for each of the specified cytokines) to contribute to these elevated cytokine levels. “It has long been acknowledged by both researchers and clinicians that endometriosis is a disease associated with inflammation and elevated cytokine levels 2,3. Recent advances in the understanding of endometriosis: the role of inflammatory mediators in disease pathogenesis and treatment. Sometimes this inflammation can be seen in blood tests, but not always. Inflammation can lead to increased pain, fatigue, and general feelings of unwellness. ![]() Inflammation is influenced by hormones however, hormone receptors are altered in endometriosis lesions, thus changing the way endometriosis responds to hormones (see “ Role of Estrogen Receptor in Endometriosis” and “ Progesterone Resistance“). Inflammation involves a variety of inflammatory factors, such as cytokines, prostaglandins, macrophages, and tumor necrosis factor. Endometriosis is an inflammatory disorder. ![]()
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