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Pathogenesis of Endometriosis: Role of Platelets in Endometriosis

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Endometriosis and Adenomyosis

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Abstract

Endometriosis is often likened to cancer, since endometriotic lesions also exhibit proliferation, apoptosis resistance, invasion, inflammation, angiogenesis, epigenetic aberration, and even cancer-driver mutations. Unlike cancer, however, endometriotic lesions simply do not grow unbridled. In fact, one defining hallmark of endometriotic lesions that sets it apart from cancer cells is cyclic bleeding as in eutopic endometrium. Yet bleeding is a quintessential hallmark of vascular injury and thus tissue injury. Once there is a tissue injury, the evolutionarily conserved tissue repair program would kick in in all organisms. Consequently, endometriotic lesions resemble wounds. Following each bleeding episode, endometriotic lesions go through four, somewhat overlapping, phases of tissue repair: hemostasis, inflammation, proliferation, and remodeling. Among these four phases, platelets are the first responder that participates in tissue repair. It turns out that this repeated tissue injury and repair would elicit several molecular events crucial for lesional progression, eventually leading to lesional fibrosis. Platelets actively participate into these events, promoting the lesional progression and fibrogenesis. In this chapter, the role of platelets in the progression of endometriosis is reviewed, along with therapeutic implication.

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Acknowledgment

This research was supported in part by grant 82071623 from the National Natural Science Foundation of China, an Excellence in Centers of Clinical Medicine grant (2017ZZ01016) from the Science and Technology Commission of Shanghai Municipality, and grant SHDC2020CR2062B from Shanghai Shenkang Center for Hospital Development.

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  1. Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China

    Sun-Wei Guo

  2. Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University, Shanghai, China

    Sun-Wei Guo

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  1. Department of Obstetrics and Gynecology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey

    Engin Oral

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Guo, SW. (2022). Pathogenesis of Endometriosis: Role of Platelets in Endometriosis. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_4

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