LAUSR

Endometriosis is a benign gynecological disease that affects about 10% women of reproductive age. Patients with endometriosis suffer from long-term coexistence with dysmenorrhea, dyspareunia, and even infertility, which severely reduces life quality. So far, surgical removal and hormonal medication are the major treatment options; however, high recurrence and severe adverse effects after surgery and hormone treatment, respectively hamper the therapeutic efficacy. Since the etiology of endometriosis is enigmatic, the mechanisms involved in the pathogenesis remains largely unclarified. Hypoxia is a kind of cellular stress that drives the expression of a specific group of genes mainly through the effect of hypoxia inducible factors (HIFs). A growing body of evidence demonstrated that hypoxia plays critical roles in modulating the pathological conditions in endometriosis, such as increasing adhesion ability, causing dysregulation of estrogen biosynthesis, aberrant production of proinflammatory cytokines, and suppression of immune functions. In this review, we summarize the findings of most recent studies in exploring the underlying mechanisms of hypoxia involved in endometriosis. Potential therapeutic options of targeting HIF and downstream effectors will also be discussed.