Rier Sherry, Foster Warren G
The International Endometriosis Association, 8585 N. 76th Place, Milwaukee, WI 53223, USA.
Semin Reprod Med. 2003 May;21(2):145-54. doi: 10.1055/s-2003-41321.
Endometriosis is a common gynecologic problem of unknown etiology. Estrogen dependence and immune modulation are established features of this disease, and environmental contaminants have been suggested to play a role in the pathobiology of this disease as well. Previous work in nonhuman primates has shown that exposure to the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is associated with an increased prevalence and severity of endometriosis. Further animal experiments have implicated dioxin and dioxin-like compounds in this disease. Rodent studies support the plausibility of a role of environmental contaminants in the pathophysiology of endometriosis, although a convincing mechanistic hypothesis has yet to be advanced. Small hospital-based case-control studies have failed to provide compelling evidence for or against an association of environmental contaminants and endometriosis. Herein we review evidence that dioxin and dioxin-like compounds are potent modulators of immune and endocrine function critical to the pathobiology of endometriosis. Furthermore, perspectives on the potential mechanism(s) of dioxin and dioxin-like compound-induced toxicity in endometriosis, important knowledge needs, potential animal models for endometriosis studies, and considerations integral to future human case-control studies are discussed.
子宫内膜异位症是一种病因不明的常见妇科问题。雌激素依赖性和免疫调节是该疾病已确定的特征，并且有研究表明环境污染物在该疾病的病理生物学中也起作用。先前对非人类灵长类动物的研究表明，接触二噁英2,3,7,8-四氯二苯并对二噁英（TCDD）与子宫内膜异位症的患病率和严重程度增加有关。进一步的动物实验表明二噁英和二噁英类化合物与该疾病有关。啮齿动物研究支持环境污染物在子宫内膜异位症病理生理学中起作用的合理性，尽管尚未提出令人信服的机制假说。基于医院的小型病例对照研究未能提供支持或反对环境污染物与子宫内膜异位症关联的有力证据。在此，我们综述了证据表明二噁英和二噁英类化合物是对子宫内膜异位症病理生物学至关重要的免疫和内分泌功能的有效调节剂。此外，还讨论了二噁英和二噁英类化合物在子宫内膜异位症中诱导毒性的潜在机制、重要的知识需求、子宫内膜异位症研究的潜在动物模型以及未来人类病例对照研究不可或缺的考虑因素。
