Publication: Búsqueda de nuevas opciones terapéuticas para el tratamiento de la endometriosis
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Date
2026-05-25
Authors
García Izquierdo, Mª Laura
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Escuela Internacional de Doctorado
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Martínez-Esparza Alvargonzález, María Concepción
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
La endometriosis es una enfermedad inflamatoria crónica que afecta aproximadamente al diez por ciento de las mujeres en edad reproductiva y se asocia a dolor pélvico persistente e infertilidad, con un impacto significativo en la calidad de vida. Las opciones terapéuticas actuales se basan principalmente en tratamientos hormonales y cirugía, con eficacia variable, riesgo de recurrencia y limitaciones derivadas de efectos secundarios o del deseo gestacional. Estas circunstancias ponen de manifiesto la necesidad de nuevas aproximaciones dirigidas a los mecanismos fisiopatológicos implicados en la enfermedad.
En los últimos años, se ha consolidado la consideración de la endometriosis como una patología inflamatoria compleja en la que la alteración del sistema inmunitario innato desempeña un papel relevante. En particular, los macrófagos peritoneales y su interacción con las células endometriales contribuyen al mantenimiento de un microambiente inflamatorio persistente asociado a la progresión de las lesiones y al dolor.
El objetivo general de esta tesis fue integrar el análisis crítico de la evidencia terapéutica disponible para el tratamiento del dolor asociado a la endometriosis con la evaluación preclínica de estrategias no hormonales basadas en la modulación de la respuesta inflamatoria innata. Para ello, se llevó a cabo una revisión estructurada de las opciones terapéuticas actuales y de las alternativas emergentes, así como estudios experimentales in vitro empleando modelos celulares humanos para analizar la activación funcional de macrófagos y su interacción con células endometriales.
Los resultados obtenidos respaldan la relevancia de los mecanismos inmunológicos en la fisiopatología de la endometriosis y apoyan la exploración de estrategias no hormonales orientadas a la modulación de la inflamación como aproximación terapéutica potencial.
Endometriosis is a chronic inflammatory disease affecting approximately ten percent of women of reproductive age and is associated with persistent pelvic pain and infertility, significantly impairing quality of life. Current therapeutic approaches are mainly based on hormonal treatments and surgery, showing variable efficacy, risk of recurrence and relevant limitations due to side effects or reproductive concerns. These challenges highlight the need for alternative strategies targeting underlying pathophysiological mechanisms. Growing evidence supports the view of endometriosis as a complex inflammatory disorder in which alterations of the innate immune system play a central role. In particular, peritoneal macrophages and their interaction with endometrial cells contribute to the maintenance of a persistent inflammatory microenvironment associated with lesion progression and pain. The main objective of this thesis was to integrate a critical analysis of current therapeutic strategies for endometriosis-associated pain with a preclinical evaluation of non-hormonal approaches based on modulation of the innate inflammatory response. A structured review of existing and emerging treatments was conducted, together with in vitro experimental studies using human cellular models to analyze macrophage activation and their interaction with endometrial cells. The findings support the relevance of immune mechanisms in the pathophysiology of endometriosis and reinforce the rationale for exploring non-hormonal anti-inflammatory strategies as potential therapeutic alternatives.
Endometriosis is a chronic inflammatory disease affecting approximately ten percent of women of reproductive age and is associated with persistent pelvic pain and infertility, significantly impairing quality of life. Current therapeutic approaches are mainly based on hormonal treatments and surgery, showing variable efficacy, risk of recurrence and relevant limitations due to side effects or reproductive concerns. These challenges highlight the need for alternative strategies targeting underlying pathophysiological mechanisms. Growing evidence supports the view of endometriosis as a complex inflammatory disorder in which alterations of the innate immune system play a central role. In particular, peritoneal macrophages and their interaction with endometrial cells contribute to the maintenance of a persistent inflammatory microenvironment associated with lesion progression and pain. The main objective of this thesis was to integrate a critical analysis of current therapeutic strategies for endometriosis-associated pain with a preclinical evaluation of non-hormonal approaches based on modulation of the innate inflammatory response. A structured review of existing and emerging treatments was conducted, together with in vitro experimental studies using human cellular models to analyze macrophage activation and their interaction with endometrial cells. The findings support the relevance of immune mechanisms in the pathophysiology of endometriosis and reinforce the rationale for exploring non-hormonal anti-inflammatory strategies as potential therapeutic alternatives.
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