Guo Sun-Wei, Zhang Qi, Liu Xishi
Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai 200011, China.
Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China.
Reprod Biomed Online. 2017 Mar;34(3):225-239. doi: 10.1016/j.rbmo.2016.11.012. Epub 2016 Dec 16.
Exposure to chronic stress before and well after the induction of endometriosis is reported to increase lesion sizes in rats, but it is unclear whether stress, exposed shortly after the induction of endometriosis, would also promote the development of endometriosis, nor is it clear what the underlying possible molecular mechanism is. This study was undertaken to test the hypothesis that chronic stress can promote the development of endometriosis. A prospective randomized mouse experiment was conducted that subjected mice with induced endometriosis to predator stress. In addition, a cross-sectional immunohistochemistry study was performed in ectopic and eutopic endometrial tissue samples from age- and roughly menstrual phase-matched women with ovarian endometriomas. It was found that the chronic psychogenic stress induced epigenetic changes in the hippocampus in mouse independent of endometriosis. It was also found that chronic psychogenic stress induced epigenetic changes in the hippocampus of mice with endometriosis, and seemingly activated the adrenergic signalling in ectopic endometrium, resulting in increased angiogenesis and accelerated growth of endometriotic lesions. Thus, chronic psychogenic stress promotes endometriosis development, raising the possibility that the use of anti-depressants in cases of prolonged and intense stress might forestall the negative impact of stress on the development of endometriosis.
据报道,在子宫内膜异位症诱导之前及之后长时间暴露于慢性应激会增加大鼠的病灶大小,但尚不清楚在子宫内膜异位症诱导后不久暴露于应激是否也会促进子宫内膜异位症的发展,其潜在的分子机制也尚不明确。本研究旨在验证慢性应激可促进子宫内膜异位症发展这一假说。进行了一项前瞻性随机小鼠实验,使诱导出子宫内膜异位症的小鼠遭受捕食者应激。此外,对年龄和月经周期大致匹配的患有卵巢子宫内膜异位囊肿的女性的异位和在位子宫内膜组织样本进行了横断面免疫组织化学研究。研究发现,慢性心理应激在与子宫内膜异位症无关的小鼠海马体中诱导了表观遗传变化。还发现,慢性心理应激在患有子宫内膜异位症的小鼠海马体中诱导了表观遗传变化,并且似乎激活了异位子宫内膜中的肾上腺素能信号传导,导致血管生成增加和子宫内膜异位病灶生长加速。因此,慢性心理应激会促进子宫内膜异位症发展,这增加了在长期强烈应激情况下使用抗抑郁药可能预防应激对子宫内膜异位症发展产生负面影响的可能性。