Abstract
Endometriosis is a common gynecological disorder affecting mostly women of reproductive age. Its presenting symptoms include dysmenorrhea, chronic pelvic pain and infertility. There is a pressing need to develop more efficacious therapeutics, preferably with improved safety and cost profiles. Unfortunately, thus far the drug development progress has been frustratingly slow. In this article, published data in support of the notion that endometriosis is an epigenetic disease are reviewed. The desirable properties of histone deacetylase inhibitors as therapeutics for treating endometriosis are enumerated, and the obstacles in evaluating histone deacetylases in clinical trials are listed. It is argued that, from the drug discovery standpoint, repurposing of valproic acid is justifiable. Finally, the areas in need of further research are exposed.
Acknowledgements
The authors thank four anonymous reviewers for their insightful and helpful comments on an earlier version of this manuscript. The authors also thank Edward Parker for helpful editorial comments.
Financial & competing interests disclosure
This work was supported by grant 81070470 (XS Liu) from the National Science Foundation of China, grants 09PJD015 and 10410700200 from the Shanghai Science and Technology Commission (S-W Guo), and grant 09-11 from the State Key Laboratory of Medical Neurobiology of Fudan University (S-W Guo). Financial support was obtained from the Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases and from the Key Specialty Project of the Ministry of Health, China. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.