RESHAPING PURPOSE - USE OF METFORMIN IN ENDOMETRIOSIS AN APPROACH TO RECENT LITERATURE

摘要

ENDOMETRIOSIS CAN BE CLASSICALLY DEFINED AS THE PRESENCE OF A FUNCTIONAL ENDOMETRIAL LAYER WITH ENDOMETRIAL GLANDS OUTSIDE THE UTERINE CAVITY, INDUCING A CHRONIC, INFLAMMATORY REACTION, LINKED TO CHRONIC PELVIC PAIN AS WELL AS FERTILITY ISSUES. A LARGE AMOUNT OF LITERATURE SURVEYS AS WELL AS CURRENT STUDIES RECKON ENDOMETRIOSIS AS THE RESULT OF A DEFECTIVE IMMUNOSURVEILLANCE CASCADE IN FERTILE WOMEN, SUGGESTING THAT THE CONSTANT PERITONEAL INFLAMMATORY ENVIRONMENT STIMULATES PROGRESS AS WELL AS MAINTENANCE OF THE DISEASE. THEREFORE, NOVEL THERAPEUTICAL APPROACHES ARE NEEDED IN ORDER TO TARGET DIFFERENT PATHOGENIC SPECTRUMS. METFORMIN, A WIDELY USED BIGUANIDE IMPROVING INSULIN SENSITIVITY IN DIABETES, CAN ALSO PROVIDE BOTH ANTIINFLAMMATORY PROPERTIES AS WELL AS A MODULATORY EFFECT ON OVARIAN STEROID PRODUCTION, TWO ACTIONS THAT HAVE BEEN SUGGESTED TO OFFER NEW PERSPECTIVES IN ENDOMETRIOSIS THERAPY. MANAGING ENDOMETRIOSIS REQUIRES TARGETING A COMPLEX NETWORK OF LOCALLY PRODUCED CYTOKINES MODULATING THE GROWTH AND INFLAMMATORY BEHAVIOR OF ECTOPIC ENDOMETRIAL IMPLANTS. THEREFORE, WHAT WE DEFINE AS THE MAIN OBJECTIVES OF THIS LITERATURE REVIEW BECOME AS FOLLOWING: TO ASSESS WHETHER METFORMIN MAY BE EFFECTIVE AS A NOVEL APPROACH FOR ENDOMETRIOSIS, DOSE-DEPENDENTLY OR NOT, AS WELL AS TO EVALUATE THE EFFECTS OF THIS AGENT ON INFLAMMATORY RESPONSES, ESTRADIOL PRODUCTION AND NEVERTHELESS ENDOMETRIOTIC STROMAL CELLS PROLIFERATION IN BOTH IN VITRO AND IN VIVO CONDITIONS.