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ACTA REVIEWS

Endometriosis-associated nerve fibers and pain

&
Pages 968-975 | Received 05 Mar 2009, Published online: 01 Sep 2009
 

Abstract

The assessment and diagnosis of endometriosis remain elusive targets. Patient and medical-related factors add to delays in the detection and treatment. Recently, investigators have revealed specific nerve fibers present in endometriotic tissue, with existing parallels between density and pain severity. The aim of this review is to compile a comprehensive review of existing literature on endometriosis-related nerve fiber detection, and the effects of medical therapy on these neural fibers. We performed a systematic literature-based review using Medline and PubMed of nerve fibers detected in eutopic endometrium, endometriotic lesions, and the peritoneum. Various arrangements of significant medical terms and phrases consisting of endometriosis, pelvic pain, nerve fiber detection/density in endometriosis, and diagnoses methodology, including treatment and detection were applied in the search. Subsequent references used were cross-matched with existing sources to compile all additional similar reports. Similar nerve fibers were detected within lesions, endometrium, and myometrium, though at varying degrees of density. Hormonal therapy is widely used to treat endometriosis and was shown to be related to a reduction in fiber density. A direct result of specific nerve fiber detection within eutopic endometrial layers points to the use of a minimally invasive endometrial biopsy technique in reducing delay in diagnosis and subsequent possible preservation of fertility.

Abbreviations
Ach=

acetylcholine

CGRP=

calcitonin gene-related peptide

HT=

hormone treated

NGF=

nerve growth factor

NGFRp75=

nerve growth factor receptor p75

NF=

neurofilament

NHT=

no hormone treatment

NPY=

neuropeptide Y

NT=

neurotensin

PGP9.5=

protein gene product 9.5

SP=

substance P

TGF-B1=

transforming growth factor B1

TH=

tyrosine hydroxylase

VAChT=

vesicular acetylcholine transporter

VMAT=

vesicular monoamine transporter

VIP=

vasoactive intestinal polypeptide

Abbreviations
Ach=

acetylcholine

CGRP=

calcitonin gene-related peptide

HT=

hormone treated

NGF=

nerve growth factor

NGFRp75=

nerve growth factor receptor p75

NF=

neurofilament

NHT=

no hormone treatment

NPY=

neuropeptide Y

NT=

neurotensin

PGP9.5=

protein gene product 9.5

SP=

substance P

TGF-B1=

transforming growth factor B1

TH=

tyrosine hydroxylase

VAChT=

vesicular acetylcholine transporter

VMAT=

vesicular monoamine transporter

VIP=

vasoactive intestinal polypeptide

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