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Mechanism of pain generation for endometriosis-associated pelvic pain

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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.

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Acknowledgments

The present review was supported by grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan to the Department of Obstetrics and Gynecology, Nara Medical University (to H.K.).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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  1. Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Hiroshi Kobayashi, Yuki Yamada, Sachiko Morioka, Emiko Niiro, Aiko Shigemitsu & Fuminori Ito

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  1. Hiroshi Kobayashi
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Correspondence to Hiroshi Kobayashi.

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Kobayashi, H., Yamada, Y., Morioka, S. et al. Mechanism of pain generation for endometriosis-associated pelvic pain. Arch Gynecol Obstet 289, 13–21 (2014). https://doi.org/10.1007/s00404-013-3049-8

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