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Endometriose

Molekularbiologische Untersuchungsmethoden führen zu neuen Behandlungskonzepten

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Der Gynäkologe Aims and scope

Zusammenfassung

Endometriose ist ein häufiger Grund für unerfüllten Kinderwunsch und chronische Schmerzen. Die Erforschung neuer Therapiekonzepte dient in erster Linie der Verbesserung der Lebensqualität. Es ist denkbar, dass neue, spezifisch wirksame Substanzen auf der Basis molekularbiologischer Forschung in Zukunft dem Therapieziel der Heilung zumindest nahe kommen. Der klassische Weg der Therapie wird bisher häufig kombiniert operativ und medikamentös beschritten. Die Hemmung der Östradiolsynthese galt bislang als wichtigste Therapieoption. Mit selektiven Östradiolrezeptormodulatoren kann zudem die Wirkung des Östradiols deutlich gehemmt werden. Auch selektive Progesteronrezeptormodulatoren sind bei hoher Spezifität antiproliferativ wirksam. Mit der Hemmung von Matrixmetalloproteinasen wird die Implantation endometrioider Herde verhindert. Die Ausbildung neuer Gefäße, die die Proliferation ermöglichen, wird möglicherweise durch antiangiogenetisch wirksame Substanzen verhindert. Eine Hemmung der Synthese und Sekretion von Zytokinen wird mit Hilfe von antiinflammatorischen Substanzen, Antikörpern oder Bindungsproteinen angestrebt.

Abstract

Endometriosis is a common cause for infertility and chronic pain. Investigations for new therapeutic concepts are mainly aimed to achieve better life quality. New specific substances, based on molecular biological investigations, may be helpful to approach the goal of healing patients. The most common therapeutic concept is to combine operative treatment with drug therapy. The main therapeutic option today is to inhibit the estradiol biosynthesis. In addition, selective estradiol receptor modulators may inhibit the effects of estradiol. Also, selective progesterone receptor modulators are acting specifically against the proliferating potential of endometriosis. While inhibiting matrix metalloproteinases, the implantation of endometriotic tissue can be blocked. Sprouting of new vessels, which provides the potential of proliferation, could possibly be blocked by antiangiogenic substances. Using anti-inflammatory drugs, antibodies or binding proteins, the synthesis and secretion of cytokines could be inhibited.

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Authors and Affiliations

  1. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck

    D. Finas, M. Friedrich, D. Diesing, F. Köster, A. Schultze-Mosgau, K. Diedrich &  D. Hornung

  2. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck

    D. Hornung

Authors
  1. D. Finas
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  2. M. Friedrich
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  3. D. Diesing
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  4. F. Köster
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  5. A. Schultze-Mosgau
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  6. K. Diedrich
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  7. D. Hornung
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Correspondence to D. Hornung.

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Finas, D., Friedrich, M., Diesing, D. et al. Endometriose. Gynäkologe 37, 116–122 (2004). https://doi.org/10.1007/s00129-003-1478-3

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  • DOI: https://doi.org/10.1007/s00129-003-1478-3

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