Journal of endometriosis最新文献

Endometriosis is a debilitating disease common in women of reproductive age characterized by pain and infertility. Macrophage migration inhibitory factor (MIF) is a cytokine whose expression is elevated in endometriotic tissue from women with the disease but the functional role of this factor in the pathogenesis of the disease is uncertain. To examine the role of MIF in the pathogenesis of endometriosis, we induced experimental disease in mice and examined the ability of the MIF antagonist, ISO-1, to reduce endometriotic implant size. Administration of ISO-1 resulted in a significant reduction in implant size and vascularity (as assessed by Flk1 mRNA expression) which was not associated with an alteration in the reproductive cycle. These data suggest that inhibition of MIF activity is associated with a significant reduction in endometriotic implant size and leads us to speculate that a similar approach of targeting MIF may prove useful in treating endometriosis in humans.

Background: In the one study examining the relationship, adolescent physical activity was not associated with risk for endometriosis. Case-control studies have shown 40-80% reductions in risk for adult activity, while only an 11% reduction in endometriosis risk was observed in a recent prospective analysis.

Methods: Using data collected from the Nurses' Health Study II, a prospective cohort study of premenopausal US nurses that began in 1989, we have attempted to clarify this relation. Data are updated every 2 yrs with follow-up for these analyses through to 2001. Women reported the average amount of time per week spent in moderate and strenuous recreational activity during three age periods: ages 12-13, ages 14-17, and ages 18-22. A metabolic equivalent (MET) score was assigned to each activity and these were summed to estimate total activity.

Results: During 637,747 person-years of follow-up, 1,481 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. After adjusting for age, calendar time, birth weight, age at menarche, parity, oral contraceptive use, and body mass index (BMI), we observed a 16% increase in the risk for endometriosis comparing the greatest amount of activity (≥80 MET-h/wk) with the least (<20 MET-h/wk) during ages 12-13 (RR=1.16, 95% CI=0.98-1.37, p-value test for trend=0.02), and no associations for ages 14-17 or ages 18-22. In analyses of the individual activity types within each time period, only strenuous activity during ages 12-13 was associated with endometriosis.

Conclusions: We did not find evidence of a beneficial association between adolescent physical activity and laparoscopically confirmed endometriosis, but in fact found a small increase in risk.

Introduction: Endometriosis can be difficult to diagnose clinically and models that use symptoms to predict whether the disease is present or not are based on limited patient populations. Endometriosis also influences health-related quality of life, but little is known about its impact across the world. We therefore initiated two integrated multicentre studies to collect prospective, standardised, epidemiological data, to 1) examine the global impact of endometriosis and relative effect of risk-factors, and 2) develop a symptom-based diagnostic tool.

Methods: The Global Study of Women's Health (GSWH) and the Women's Health Symptom Survey (WHSS) prospectively recruit 18-45 year old women having a laparoscopy across 23 and 19 centres, respectively, worldwide. Women with a previous surgical diagnosis of endometriosis are excluded. Multi-lingual patient questionnaires and a surgical questionnaire, incorporating validated instruments, are used to collect the data. The GSWH aims to recruit >2,000 women by December 2009; the WHSS to recruit 1,000 women in each of the two model-generating and validation stages.

Results: A six-week pilot study in Oxford, UK, established the feasibility of the study protocols. Of 32 eligible women, 27 participated (response rate - 84.4%); 26% completed the questionnaire online. Endometriosis was found in 47.4%. Extrapolating the recruitment rates from the pilot study, the target sample sizes for the GWSH and WHSS were deemed feasible.

Conclusions: Using standardised data collection, the GSWH and WHSS will provide insight into the global impact of endometriosis and develop a validated, symptom-based, diagnostic tool. They have the potential to provide the basis for future, longitudinal, follow-up studies and a collaborative Endometriosis Biobank implementing standardised collection of DNA and tissue samples.