A systematic review of toll-like receptors in endometriosis

• Published in: Archives of gynecology and obstetrics Vol. 304; no. 2; pp. 309 - 316
• Main Authors: de Azevedo, Bruna Cestari, Mansur, Fernanda, Podgaec, Sérgio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2021; Springer Nature B.V
• Subjects: Bias; Endocrinology; Endometriosis; Endometrium; Gynecology; Human Genetics; Immunology; Inflammation; Medicine; Medicine & Public Health; Obstetrics; Obstetrics/Perinatology/Midwifery; Pathogenesis; Pathogens; Review; Systematic review; Endometriosis; Toll-like receptor
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-021-06075-x

Introduction
The pathogen-associated molecular patterns and the danger-associated molecular patterns are possibly responsible for the activation of the inflammatory process in endometriosis through the activation of toll-like receptors (TLRs).
Objective
The aim of this systematic review was to critically analyze the findings of published articles on TLRs in endometriosis.
Methods
The keywords used were “endometriosis” and “toll-like” and the search was performed in Pubmed, Scielo and Lilacs databases. This study followed the PRISMA guidelines and the risk of bias of articles was conducted by Newcastle–Ottawa scale (NOS).
Results
Overall, the studies analyzed in this review point toward an increased expression of TLRs two, four and nine in women with endometriosis. Among all TLRs, TLR4 was the most cited receptor.
Conclusion
Despite the evidence demonstrating elevated TLR levels in endometriosis, the relationship with the disease is still unclear and needs to be clarified in further studies about innate immune response.