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环境因素与子宫内膜异位症

Environmental factors and endometriosis.

作者信息

Bellelis Patrick, Podgaec Sergio, Abrão Maurício Simões

机构信息

Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2011 Jul-Aug;57(4):448-52. doi: 10.1590/s0104-42302011000400022.

Abstract

Endometriosis represents a common gynecological condition affecting 5%-15% of childbearing age women and up to 3% 5% of post-menopausal women. This disease is defined by the presence of stromal and/or endometrial glandular epithelium implants in extra-uterine locations possibly compromising several sites. Humans and animals are daily exposed to chemical pollutants that could adversely influence physiological processes and potentially cause diseases, including endometriosis. In this review, the authors aimed at settling the influence of environmental and dietary factors on endometriosis pathogenesis. The mechanism by which dioxin and its similes (TCDD/PCBs) act changing the endometrial physiology remains uncertain and is speculative due to the difficulty in assessing the exposure over intrauterine life, childhood and adulthood and its actual consequences, in addition to the limitations to its in vitro reproducibility. We need to better understand the mechanism of action of these environmental pollutants, not only on reproductive health, but also on overall health of individuals and so prevention strategies, including not only population education, but setting exposure limits, less polluting techniques and a better use of our natural resources, could be promoted.

摘要

子宫内膜异位症是一种常见的妇科疾病,影响5%-15%的育龄妇女,绝经后妇女中也有高达3%-5%患病。这种疾病的定义是子宫外出现间质和/或子宫内膜腺上皮植入物,可能累及多个部位。人类和动物每天都会接触到化学污染物,这些污染物可能会对生理过程产生不利影响,并有可能引发包括子宫内膜异位症在内的疾病。在这篇综述中,作者旨在确定环境和饮食因素对子宫内膜异位症发病机制的影响。二恶英及其类似物(TCDD/多氯联苯)改变子宫内膜生理功能的作用机制仍不确定,且具有推测性,这是因为除了其体外再现性存在局限性外,评估子宫内生活、童年和成年期的接触情况及其实际后果也存在困难。我们需要更好地了解这些环境污染物的作用机制,不仅要了解其对生殖健康的影响,还要了解其对个体整体健康的影响,这样才能推广预防策略,包括不仅开展人群教育,还要设定接触限值、采用污染较小的技术以及更好地利用我们的自然资源。

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