Influence of Oxidative Stress-Mediated Inflammation on the Pathogenesis of Reproductive Disorders: Exploring the Benefits of Carnosine for Prevention and Treatment of Endometriosis

Endometriosis is a chronic pathological condition characterized by the growth of endometrial-like tissue outside the uterine cavity and is frequently associated with severe pain, persistent inflammation, and fibrosis within the pelvic region and other parts of the body. The exact causes of endometriosis are not clear, but an innate or adaptive immune response defect has recently been suggested as a factor in the disease's development. Carnosine is a natural dipeptide formed by the ligation of β-alanine and L-histidine and characterized by a multimodal mechanism of action that includes antioxidant and anti-inflammatory activities. Carnosine has also been shown to modulate glucose, nucleotide, and lipid metabolism as well as the response of immune cells, all processes that play a key role in the context of endometriosis. Despite numerous reviews published on the structure, role, function, and biological activities of carnosine in preclinical and clinical settings, none have focused on its therapeutic potential for the prevention or treatment of reproductive disorders, including endometriosis. In this review, after a brief introduction to the pathogenesis and pathophysiology of endometriosis, we focus on the use of carnosine for the management of reproductive disorders, concluding with its ability to modulate specific cellular and molecular mechanisms closely related to endometriosis. Given the central role of oxidative stress and inflammation across several reproductive disorders, carnosine may represent a promising therapeutic candidate not only in endometriosis, but also in broader reproductive health contexts.