Moustakli Efthalia, Potiris Anastasios, Grigoriadis Themos, Zikopoulos Athanasios, Drakaki Eirini, Zouganeli Ioanna, Theofanakis Charalampos, Gerede Angeliki, Zachariou Athanasios, Domali Ekaterini, Drakakis Peter, Stavros Sofoklis
Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Third Department of Obstetrics and Gynecology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Int J Mol Sci. 2025 Aug 6;26(15):7600. doi: 10.3390/ijms26157600.
Globally, endometriosis affects almost 10% of reproductive-aged women, leading to chronic pain and discomfort. Endocrine-disrupting compounds (EDCs) seem to play a pivotal role as a causal factor. The current manuscript aims to explain potential molecular pathways, synthesize current evidence regarding EDCs as causative agents of endometriosis, and highlight implications in the general population and clinical work. A thorough review of experimental, epidemiologic, and mechanistic research studies was conducted to explain the association between EDCs and endometriosis. Among the primary EDCs under investigation are polychlorinated biphenyls, dioxins, phthalates, and bisphenol A (BPA). Despite methodological heterogeneity and some discrepancies, epidemiologic evidence supports a positive association between some increased levels of BPA, phthalates, and dioxins in urine or in blood, and endometriosis. Experiments support some effect of EDCs on endometrial cells and causing endometriosis. EDCs function as xenoestrogens, alter immune function, induce oxidative stress, and disrupt progesterone signaling. Epigenetic reprogramming may play a role in mediating EDC-induced endometriosis. Endocrine, immunological, and epigenetic pathways link EDCs and endometriosis. Prevention techniques require deeper comprehension of those factors. Causal linkages and possible treatment targets should be based on longitudinal studies and multi-omics techniques. Restriction of EDCs could be beneficial for endometriosis prevalence limitation.
在全球范围内,子宫内膜异位症影响着近10%的育龄妇女,导致慢性疼痛和不适。内分泌干扰化合物(EDCs)似乎作为一个致病因素发挥着关键作用。本手稿旨在解释潜在的分子途径,综合当前关于EDCs作为子宫内膜异位症致病因素的证据,并强调其在一般人群和临床工作中的意义。我们对实验、流行病学和机制研究进行了全面回顾,以解释EDCs与子宫内膜异位症之间的关联。正在研究的主要EDCs包括多氯联苯、二恶英、邻苯二甲酸盐和双酚A(BPA)。尽管存在方法学上的异质性和一些差异,但流行病学证据支持尿液或血液中某些BPA、邻苯二甲酸盐和二恶英水平升高与子宫内膜异位症之间存在正相关。实验支持EDCs对子宫内膜细胞有一定作用并导致子宫内膜异位症。EDCs作为外源性雌激素发挥作用,改变免疫功能,诱导氧化应激,并干扰孕酮信号传导。表观遗传重编程可能在介导EDC诱导的子宫内膜异位症中起作用。内分泌、免疫和表观遗传途径将EDCs与子宫内膜异位症联系起来。预防技术需要对这些因素有更深入的理解。因果联系和可能的治疗靶点应基于纵向研究和多组学技术。限制EDCs可能有助于限制子宫内膜异位症的患病率。
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