Please wait a minute...
J Zhejiang Univ (Med Sci)  2018, Vol. 47 Issue (4): 413-418    DOI: 10.3785/j.issn.1008-9292.2018.08.14
Research progress on roles of vitamin D in endometriosis
ZHANG Lifeng(),ZHANG Xinmei*()
Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
Download: HTML( 13 )   PDF(939KB)
Export: BibTeX | EndNote (RIS)      


In addition to regulating calcium and phosphorus metabolism to maintain strong bones, vitamin D also has immune regulating and anti-inflammatory effects. Moreover, it is related to chronic inflammatory diseases, autoimmune diseases and cancer. Many studies indicate the roles of vitamin D in the development and progression of endometriosis including the effects on modulation of immune responses, inflammation reactions, cell proliferation and apoptosis, angiogenesis, adhesion and invasion. Vitamin D supplementation can relieve pain and improve endometrial receptivity associated with endometriosis and play a preventive and therapeutic role. This paper summarizes the roles of vitamin D in endometriosis.

Key wordsEndometriosis      Vitamin D      Immunocompetence      Review     
Received: 20 June 2018      Published: 04 December 2018
CLC:  R711.71  
Corresponding Authors: ZHANG Xinmei     E-mail:;
Cite this article:

ZHANG Lifeng,ZHANG Xinmei. Research progress on roles of vitamin D in endometriosis. J Zhejiang Univ (Med Sci), 2018, 47(4): 413-418.

URL:     OR



关键词: 子宫内膜异位症,  维生素D,  免疫活性,  综述 
[1]   BURNEY R O , GIUDICE L C . Pathogenesis and pathophysiology of endometriosis[J]. Fertil Steril, 2012, 98 (3): 511- 519
doi: 10.1016/j.fertnstert.2012.06.029
[2]   LIPS P . Vitamin D physiology[J]. Prog Biophys Mol Biol, 2006, 92 (1): 4- 8
[3]   HAUSSLER M R , WHITFIELD G K , KANEKO I et al. Molecular mechanisms of vitamin D action[J]. Calcif Tissue Int, 2013, 92 (2): 77- 98
doi: 10.1007/s00223-012-9619-0
[4]   BATTAULT S , WHITING S J , PELTIER S L et al. Vitamin D metabolism, functions and needs:from science to health claims[J]. Eur J Nutr, 2013, 52 (2): 429- 441
[5]   ZARNANI A H , SHAHBAZI M , SALEK-MOGHADDAM A et al. Vitamin D3 receptor is expressed in the endometrium of cycling mice throughout the estrous cycle[J]. Fertil Steril, 2010, 93 (8): 2738- 2743
doi: 10.1016/j.fertnstert.2009.09.045
[6]   AGIC A , XU H , ALTGASSEN C et al. Relative expression of 1, 25-dihydroxyvitamin D3 receptor, vitamin D 1 alpha-hydroxylase, vitamin D 24-hydroxylase, and vitamin D 25-hydroxylase in endometriosis and gynecologic cancers[J]. Reprod Sci, 2007, 14 (5): 486- 497
doi: 10.1177/1933719107304565
[7]   VAN ETTEN E , STOFFELS K , GYSEMANS C et al. Regulation of vitamin D homeostasis:implications for the immune system[J]. Nutr Rev, 2008, 66 (10 Suppl 2): S125- S134
[8]   FASERL K, GOLDERER G, KREMSER L, et al. Polymorphism in vitamin D-binding protein as a genetic risk factor in the pathogenesis of endometriosis[J/OL]. J Clin Endocrinol Metab, 2011, 96(1): E233-E241.
[9]   HWANG J H , WANG T , LEE K S et al. Vitamin D binding protein plays an important role in the progression of endometriosis[J]. Int J Mol Med, 2013, 32 (6): 1394- 1400
doi: 10.3892/ijmm.2013.1506
[10]   ZHANG X L , GUO Y F , SONG Z X et al. Vitamin D prevents podocyte injury via regulation of macrophage M1/M2 phenotype in diabetic nephropathy rats[J]. Endocrinology, 2014, 155 (12): 4939- 4950
doi: 10.1210/en.2014-1020
[11]   ZHANG X , ZHOU M , GUO Y et al. 1, 25-dihydroxyvitamin D3 promotes high glucose-induced M1 macrophage switching to M2 via the VDR-PPAR signaling pathway[J]. Biomed Res Int, 2015, 2015 14
[12]   SLOKA S , SILVA C , WANG J et al. Predominance of Th2 polarization by vitamin D through a STAT6-dependent mechanism[J]. J Neuroinflammation, 2011, 8 56
doi: 10.1186/1742-2094-8-56
[13]   LI W N , WU M H , TSAI S J . Critical factors involved in chronic inflammation in the pathophysiology of endometriosis[J]. Adaptive Medicine, 2018, 10 (1): 1- 9
doi: 10.4247/AM.2018.ABI197
[14]   KRISHNAN A V , FELDMAN D . Mechanisms of the anti-cancer and anti-inflammatory actions of vitamin D[J]. Annu Rev Pharmacol Toxicol, 2011, 51 311- 336
doi: 10.1146/annurev-pharmtox-010510-100611
[15]   AKYOL A , SIMSEK M , ILHAN R et al. Efficacies of vitamin D and omega-3 polyunsaturated fatty acids on experimental endometriosis[J]. Taiwan J Obstet Gynecol, 2016, 55 (6): 835- 839
doi: 10.1016/j.tjog.2015.06.018
[16]   MIYASHITA M , KOGA K , IZUMI G et al. Effects of 1, 25-dihydroxy vitamin D-3 on endometriosis[J]. J Clin Endocrinol Metab, 2016, 101 (6): 2371- 2379
doi: 10.1210/jc.2016-1515
[17]   TANIGUCHI F , UEGAKI T , NAKAMURA K et al. Inhibition of IAP (inhibitor of apoptosis) proteins represses inflammatory status via nuclear factor-kappa B pathway in murine endometriosis lesions[J]. Am J Reprod Immunol, 2018, 79 (1): 7
[18]   GONZALEZ-RAMOS R , VAN LANGENDONCKT A , DEFRERE S et al. Agents blocking the nuclear factor-kappaB pathway are effective inhibitors of endometriosis in an in vivo experimental model[J]. Gynecol Obstet Invest, 2008, 65 (3): 174- 186
doi: 10.1159/000111148
[19]   LI F , AMBROSINI G , CHU E Y et al. Control of apoptosis and mitotic spindle checkpoint by survivin[J]. Nature, 1998, 396 (6711): 580- 584
doi: 10.1038/25141
[20]   LONDERO A P , CALCAGNO A , GRASSI T et al. Survivin, MMP-2, MT1-MMP, and TIMP-2:their impact on survival, implantation, and proliferation of endometriotic tissues[J]. Virchows Archiv, 2012, 461 (5): 589- 599
doi: 10.1007/s00428-012-1301-4
[21]   MORMILE R , VITTORI G . Vitamin D intake and endometriosis:the good and the bad[J]. Eur J Obstet Gynecol Reprod Biol, 2014, 177 152- 153
doi: 10.1016/j.ejogrb.2014.02.023
[22]   DANASTAS K , MILLER E J , HEY-CUNNINGHAM A J et al. Expression of vascular endothelial growth factor A isoforms is dysregulated in women with endometriosis[J]. Reprod Fertil Dev, 2018, 30 (4): 651- 657
doi: 10.1071/RD17184
[23]   YILDIRIM B , GULER T , AKBULUT M et al. 1-alpha, 25-dihydroxyvitamin D3 regresses endometriotic implants in rats by inhibiting neovascularization and altering regulation of matrix metalloproteinase[J]. Postgrad Med, 2014, 126 (1): 104- 110
doi: 10.3810/pgm.2014.01.2730
[24]   INGLES S A , WU L , LIU B T et al. Differential gene expression by 1, 25(OH)2D3 in an endometriosis stromal cell line[J]. J Steroid Biochem Mol Biol, 2017, 173 223- 227
doi: 10.1016/j.jsbmb.2017.01.011
[25]   GREAVES E , COLLINS F , ESNAL-ZUFIAURRE A et al. Estrogen receptor (ER) agonists differentially regulate neuroangiogenesis in peritoneal endometriosis via the repellent factor SLIT3[J]. Endocrinology, 2014, 155 (10): 4015- 4026
doi: 10.1210/en.2014-1086
[26]   LIU H P , WANG J Y , WANG H Y et al. The plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 are elevated in patients with endometriosis[J]. Ann Clin Biochem, 2016, 53 (5): 599- 605
doi: 10.1177/0004563215626458
[27]   MATSUZAKI S , BOTCHORISHVILI R , POULY J L et al. Targeting the Wnt/β-catenin pathway in endometriosis:a potentially effective approach for treatment and prevention[J]. Mol Cell Ther, 2014, 2 (1): 36
doi: 10.1186/s40591-014-0036-9
[28]   GRIFFITH J S , LIU Y G , TEKMAL R R et al. Menstrual endometrial cells from women with endometriosis demonstrate increased adherence to peritoneal cells and increased expression of CD44 splice variants[J]. Fertil Steril, 2010, 93 (6): 1745- 1749
doi: 10.1016/j.fertnstert.2008.12.012
[29]   PAZHOHAN A , AMIDI F , AKBARI-ASBAGH F et al. Expression and shedding of CD44 in the endometrium of women with endometriosis and modulating effects of vitamin D:a randomized exploratory trial[J]. J Steroid Biochem Mol Biol, 2018, 178 150- 158
doi: 10.1016/j.jsbmb.2017.12.001
[30]   MATSUZAKI S, DARCHA C. Involvement of the Wnt/β-catenin signaling pathway in the cellular and molecular mechanisms of fibrosis in endometriosis[J/OL]. PLoS One, 2013, 8(10): e76808.
[31]   张宗梅, 顾盼, 易祥华 et al. 骨化三醇对博来霉素诱导的小鼠肺纤维化的影响[J]. 中华结核和呼吸杂志, 2013, 36 (11): 814- 820
ZHANG Zongmei , GU Pan , YI Xianghua et al. Effects of 1, 25(OH)2D3 on bleomycin-induced pulmonary fibrosis in mice[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2013, 36 (11): 814- 820
doi: 10.3760/cma.j.issn.1001-0939.2013.11.006
[32]   PROESTLING K , BIRNER P , GAMPERL S et al. Enhanced epithelial to mesenchymal transition (EMT) and upregulated MYC in ectopic lesions contribute independently to endometriosis[J]. Reprod Biol Endocrinol, 2015, 13 (1): 75
[33]   BARTLEY J, J , LICHER A , HOTZ B et al. Epithelial to mesenchymal transition (EMT) seems to be regulated differently in endometriosis and the endometrium[J]. Arch Gynecol Obstet, 2014, 289 (4): 871- 881
doi: 10.1007/s00404-013-3040-4
[34]   YANG L N , FAN Y , ZHANG X L et al. 1, 25(OH)(2)D-3 treatment attenuates high glucose-induced peritoneal epithelial to mesenchymal transition in mice[J]. Mol Med Rep, 2017, 16 (4): 3817- 3824
doi: 10.3892/mmr.2017.7096
[35]   HARRIS H R , CHAVARRO J E , MALSPEIS S et al. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis:a prospective cohort study[J]. Am J Epidemiol, 2013, 177 (5): 420- 430
doi: 10.1093/aje/kws247
[36]   YESIL H , SUNGUR U , AKDENIZ S et al. Association between serum vitamin D levels and neuropathic pain in rheumatoid arthritis patients:a cross-sectional study[J]. Int J Rheum Dis, 2018, 21 (2): 431- 439
doi: 10.1111/apl.2018.21.issue-2
[37]   GHAI B, BANSAL D, KANUKULA R, et al. Vitamin D supplementation in patients with chronic low back pain: an open label, single arm clinical trial[J/OL]. Pain Physician, 2017, 20(1): E99-E105.
[38]   ANASTASI E, FUGGETTA E, DE VITO C, et al. Low levels of 25-OH vitamin D in women with endometriosis and associated pelvic pain[J/OL]. Clin Chem Lab Med, 2017, 55(12): e282-e284.
[1] WANG Xiaoling, OUYANG Xumei, SUN Xiaoyi. Application of mesenchymal stem cells in antineoplastic drugs delivery for tumor-targeted therapy[J]. J Zhejiang Univ (Med Sci), 2018, 47(5): 525-533.
[2] HU Caiqin, ZHU Biao. Progress on pathogenesis of progressive multifocal leukoence-phalopathy[J]. J Zhejiang Univ (Med Sci), 2018, 47(5): 534-540.
[3] SHI Ting, YE Xiujin. Roles of CCAAT enhancer binding protein α in acute myeloblastic leukemia[J]. J Zhejiang Univ (Med Sci), 2018, 47(5): 552-557.
[4] YE Jianyu, SUN Ziyu, HU Weiwei. Roles of astrocytes in cerebral infarction and related therapeutic strategies[J]. J Zhejiang Univ (Med Sci), 2018, 47(5): 493-498.
[5] LI Gaopeng, HE Jia, WANG Qingqing. Progress on cancer associated fibroblasts in tumor immunoregulation[J]. J Zhejiang Univ (Med Sci), 2018, 47(5): 558-563.
[6] HE Jiayi,ZHANG Xinmei. Research progress on oxidative stress in pathogenesis of endometriosis[J]. J Zhejiang Univ (Med Sci), 2018, 47(4): 419-425.
[7] XU Zhili,CUI Yiyi,LI Yan,GUO Yong. Research progress on nonspecific immune microenvironment in breast cancer[J]. J Zhejiang Univ (Med Sci), 2018, 47(4): 426-434.
[8] WANG Xingxing,WANG Panpan,YANG Xuyan. Research progress on systemic lupus erythematosus overlapping organ-specific autoimmune diseases[J]. J Zhejiang Univ (Med Sci), 2018, 47(4): 435-440.
[9] TIAN Guangfeng,GAO Hui,HU Shasha,SHU Qiang. Research progress on genetic and epigenetic mechanisms in congenital heart disease[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 227-238.
[10] LI Fushan,FANG Ran,RAO Lin,MENG Feilong,ZHAO Xiaoli. Research progress on exosomes in diagnosis and treatment of cardiovascular diseases[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 320-326.
[11] QIAN Bo,ZHANG Yanling,MO Xuming. Research progress on transcription factors and signal pathways involved in congenital esophageal atresia[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 239-243.
[12] ZHANG Xiaoyan,KANG Lijun. Molecular and cell biological mechanism of olfactory adaptation in Caenorhabditis elegans[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 307-312.
[13] CHEN Ting,ZHAO Zhengyan,JIANG Pingping,SHU Qiang. Research progress on phenotype and genotype of hyperphenylalaninemia[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 219-226.
[14] WANG Wei,LIU Zhen,LIU Jun,ZHEN Ping,LI Xusheng,SONG Mingjia. Choice of total knee arthroplasty: posterior cruciate ligament preserved or not[J]. J Zhejiang Univ (Med Sci), 2018, 47(3): 313-319.
[15] JIANG Xiyi,LI Lu,TANG Huijuan,CHEN Tianhui. Multiple risk factors prediction models for high risk population of colorectal cancer[J]. J Zhejiang Univ (Med Sci), 2018, 47(2): 194-200.