Health Worlds

TreatmentAnonymous Original Site Updated: January 27, 2008
Introduction:
Known to live in different endometrial disorder (endometriosis) is an estrogen-dependent disease, we treat the central dogma of the past is to decrease estrogen production and reduce or increase the role of male hormones, the ectopic growth endometrial "inactivation." From the earliest of estrogen and progesterone combined therapy and progesterone alone to danazol, the PR cause false menopause, by inhibiting ovulation so that estrogen levels drop, and the current use of GnRH-a cause of drug-induced ovarian removal, uterus Drug treatment of endometriosis in the continuous improvement of existing drugs are still a variety of different levels of adverse reactions. The ideal drug is to be able to reduce the symptoms of dysmenorrhea, endometriosis to improve infertility status of potential patients but does not inhibit ovulation, and the small side. Now at home and abroad endometriosis and experimental clinical medicine Advances in drug research are summarized below.
A gonadotropin-releasing hormone agonist (GnRH-a) plus add back therapy GnRH-a is a synthetic GnRH agonists. GnRH-a long-term continuous application of large doses of pituitary down-regulation have a significant role in suppression of pituitary function, then inhibition of ovulation, which led to a series of menopausal changes. Currently GnRH-a short term effect of Endometriosis pretty sure that the reverse was added after the additi


on of sex hormones and the effect of GnRH-a alone quite, but perimenopausal symptoms, significantly reduced bone loss and other side effects. Because it is uncertain GnRH-a withdrawal 6 months of bone can fully recover, the provisions of the U.S. Food and Drug Administration the drug alone when used in the treatment of endometriosis can only be used for 6 months. To reduce the adverse reactions commonly used anti-added treatments are: norethindrone, 2.5 mg / d; Premarin, 0,625 mg / a, and medroxyprogesterone acetate, 2.5 mg / d; Livial , 1.25 ~ 2.5 mg / a, the current recommended dosage is 1.25 mg / a. Large amounts of data that, GnRH-a treatment compared the efficacy of endometriosis Danazol is good, side effects of Danazol was less than the light.
2 GnRH antagonists GnRH antagonists block GnRH receptors by competitive and produce rapid and lasting effects of pituitary down regulation after administration of plasma levels of FSH and LH decrease within hours, no application of GnRH-a after the initial "spark" (flare up) effect, and by the GnRH antagonist pre-treatment, the pituitary remains of its response to GnRH. GnRH antagonists of this pharmacological mechanism for ovarian stimulation and treatment of hormone-dependent diseases provides a new way, this approach depends on the GnRH antagonist and the role of endogenous GnRH balance. Kupker other with Cetrotide 3-llg 1 week, sharing 8 weeks, showing symptoms of endometriosis were relieved the severity of degradation, and no obvious side effects, estrogen levels can be maintained at 50 re / ha level. GnRH antagonists play a role in the treatment of endometriosis with low estrogen status without the occurrence of side effects, no anti-added treatment, is expected to be a substitute for GnRH agonists.
3 Mifepristone, also known as RU486, a progesterone antagonist, blocking progesterone receptors play a physiological role of progesterone, and the hypothalamic-pituitary-ovarian uterus have a role; long-term continuous treatment can inhibit ovarian function, causing amenorrhea lead to endometrial and ectopic endometrial atrophy, 9o late era for the treatment of endometriosis, and its light side is effective and is a quite promising method of treatment. But the exact mechanisms are not yet very clear, some scholars believe that the down-regulation by RU486 may be on endometrial estrogen and progesterone receptors. However, such L2J Sidell said: RU486 treatment mechanism of endometriosis is as an antioxidant, inhibit Nfk (a nuclear transcription factor) activity, NfkappaB can affect the secretion of several inflammatory factors, such as MCP-1. GM-CSF, CSF-1 and some other adhesion factors. Usual dose of mifepristone is 50 mg / a consecutive 6 months treatment, symptoms disappeared during the treatment about 50%, efficacy and GnRHa with danazol is similar, but 50% of patients remain at physiological levels of estrogen. RU486 can occur when large doses are not the typical hot flashes, nausea, vomiting, dizziness, fatigue and so on. For optimum dose of the drug and whether long-term adverse consequences for further clinical trials and observation. Easy to relapse after stop taking the drug is its biggest drawbacks.
4 aromatase inhibitor (aromatase inhibitors) in normal endometrial tissue, aromatase activity was not measured, and in the ectopic endometrial tissue, there was abnormal expression, and this expression may be prostaglandin E2 (PGE2) activated, resulting in ectopic endometrial tissue of local estrogen production, and PGE2-mediated formation of ectopic endometrial tissue from the enhancement effect, the theory of an aromatase inhibitor used in endometriosis provides a theoretical basis for treatment. Yano, etc., and Kudoh, etc. with drozole hydrochloride (an aromatase inhibitor) in the treatment of endometriosis model rats, found that migration reduces the volume of endometriotic cyst in a dose-dependent, this is an aromatase inhibitor therapy endometriosis provides an experimental basis. There are also case reports of clinical use of aromatase inhibitors in the treatment of endometriosis patients can eliminate pain and almost completely remove the ectopic lesions, showing the aromatase inhibitors as new drugs for the treatment of endometriosis application. The current theory is that: eutopic endometriosis abnormal expression of aromatase, EM can be used as indicators of the initial screening, postmenopausal women with aromatase inhibitors to treat EM.
5 Other non-hormonal drugs during the treatment of hormone drugs can effectively control, although lesions of endometriosis, but not pregnancy, and the high relapse rate after treatment, so some non-hormonal drug application has been carried out in clinical and laboratory .
5.1 COX (cyclooxygenase) inhibitors of COX is an enzyme protein involved in the synthesis of PGE2 and PGF2, in uterine glandular epithelial cells and vascular epithelium were expressed, showed low expression of proliferation and secretion of the expression of high cyclical changes while living in different endometrial there are also highly expressed. 2OO4 in Dogan and other L4jCOX ~ 2 inhibitor rofecoxib (3 mg / kg) treatment of experimental rat model of endometriosis, medication for 3 weeks, compared with leuprolide, was found in histological Luo Celebrex and non-leuprolide suppression of ectopic endometrial growth and to promote shrinkage of both the role, and to decrease serum levels of epidermal growth factor.
5.2 leukotriene leukotriene receptor antagonist is the inflammation or the body under high-sensitivity one of the factors exist in 1990, some scholars have found that patients with adenomyosis of leukotrienes in peritoneal fluid were significantly higher than that leukotrienes may be involved in the pathophysiology of endometriosis process. Dysmenorrhea women endometrium and smooth muscle cells of leukotriene factor, leukotriene patients with endometriosis was significantly increased. Abu and put forward a leukotriene receptor antagonist can be used for dysmenorrhea and endometriosis patients. Ihara applications such as leukotriene receptor antagonist treatment of rat model of endometriosis was found to inhibit leukotriene receptor antagonist interstitial ectopic endometrial hyperplasia, accelerated apoptosis of fibroblasts and collagen fibers degeneration.
5.3 TWP TWP GSC has immunosuppressive effects, can inhibit the body's humoral and cellular immunity, cellular immunity to correct defects in 111, the normal ratio of 111 and inhibit the production of auto-immune globulin, TWP also direct anti-inflammatory effect. 2OO2 such as L7 in Xiao TWP treatment with New Zealand white rabbits with experimental model of endometriosis, can be found TWP immune suppression and endocrine system regulating the treatment of endometriosis to achieve the purpose.
5.4 IFN Interferon is a class of immune modulation as a factor, can activate the body's various cytokines, phagocytic cells and NK cells from the immune system, positive regulation. In 1999, Ingelmo JM applications such as IFN treatment of rat model of endometriosis was found significantly reduced lesions. 2OOO years, Fateen B and other one-time placement within the peritoneal IFN (/ a 2b (dose and was positively correlated with the classification EMs) in treatment of EM patients and found that clinical symptoms, reduce the grade of endometriosis, the lesions reduced, CA125 decreased and pregnancy after treatment increased. Shawky Z.A. Nishida, etc., etc., and found that in vitro, IFN can inhibit the ectopic endometrial DNA synthesis of different living cells, inhibit cell proliferation and promote apoptosis. These are tips interference Su IFN (/ a 2b can be used to live in different endometrial disease treatment.
5.5 methotrexate methotrexate is mainly used in clinical cancer treatment. Mesogius such reports in the ultrasound guided drainage of ectopic endometrial cysts, followed by injection of 30mg methotrexate treatment without anesthesia. Studies have shown that topical application of methotrexate is safe and effective, can act directly on endometriotic cells. However, limitations of this indication, mainly for endometriosis. In addition, scholars pointed out that the TNF inhibitors, matrix metalloproteinase inhibitors and natural progesterone receptor modulators may also become the treatment of endometriosis of the ideal drug, but has yet to see the clinical reports. In short, as the pathophysiology of endometriosis research progress in development of more and more drugs are used in clinical practice and experiments, to find a better efficacy, minimal side effects of drugs is our ultimate goal. Related Content Dan Curcuma Fukang decoction treatment of endometriosis is more secure than Shenqi danazol tablets and other treatment of endometriosis than in the United States through Sanjie analgesic capsule endometriosis surgery Analgesic efficacy of 92.3% after the capsule and the Sanjie PRNewswire compare the treatment of endometriosis treatment of endometriosis: Results capsule combined consumption of red gold gestrinone Tags: endometriosis in different disease treatment Tell Friend Favorites Close Window Date: endometriosis (endometriosis) with infertility treatment


Friends Links:Automation Control Blog
Automation Products Order Numbers