Endometriosis: recent advances that could accelerate diagnosis and improve care

Griffiths, Meaghan J.; Horne, Andrew W.; Gibson, Douglas A.; Roberts, Neil; Saunders, Philippa T.K.

doi:10.1016/j.molmed.2024.06.008

Trends in Molecular Medicine

2024

DOI: 10.1016/j.molmed.2024.06.008

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Endometriosis: recent advances that could accelerate diagnosis and improve care

Meaghan J. Griffiths,

Andrew W. Horne,

Douglas A. Gibson

et al.

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2024

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Cited by 2 publications

References 121 publications

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The causal role of gastroesophageal reflux disease in endometriosis: a bidirectional Mendelian randomization study

Shi,

Li,

Wang

et al. 2024

Front. Med.

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Observational studies have reported an association between gastroesophageal reflux disease (GERD) and endometriosis. We conducted a two-sample and bidirectional Mendelian randomization analysis to determine whether those associations are causal. Two-sample and bidirectional MR analyses were performed using summary statistics from the European Individual Genome-Wide Association Study (GWAS). The inverse variance weighting (IVW) method is used as the main analysis method to evaluate causality. Sensitivity analyses were performed to assess heterogeneity, horizontal versatility, and stability. The results showed no significant causal association between GERD in women with endometriosis in the UK Bank database [ratio (OR) ≈ 0, 95% adjusted interval (CI) 1.0007∼1.0044, P = 0.006] and Finn databases [ratio (OR) = 1.29, 95% adjusted interval (CI) 0.99∼1.67, P = 0.06]. However, when studying the Finn database only for endometriosis, which is confined to the uterus, a significant increase in GERD was limited to the risk of endometriosis in the uterus [ratio (OR) = 1.47, 95% adjusted interval (CI) 1.00∼2.17, P = 0.05]. Sensitivity analysis showed that the results were robust and did not detect multi efficacy or heterogeneity. Meanwhile, reverse MR analysis showed that endometriosis did not increase the risk of GERD. This MR study supports a causal relationship between GERD and an increased risk of endometriosis confined to the uterus. Therefore, patients with gastric esophageal reflux should be treated with gynecological examination to avoid and prevent the development of endometriosis.

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The causal role of gastroesophageal reflux disease in endometriosis: a bidirectional Mendelian randomization study

Shi,

Li,

Wang

et al. 2024

Front. Med.

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Association between the Exposure to Phthalates and the Risk of Endometriosis: An Updated Review

Ribeiro,

Mariana,

Lorigo

et al. 2024

Biomedicines

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Endometriosis is a chronic gynecological disease, primarily associated with pelvic pain and infertility, that affects approximately 10% of the women of reproductive age. Estrogen plays a central role in endometriosis, and there is growing evidence that endocrine disruptors, such as phthalates, may contribute to its development. This review aimed to determine whether there is a causal relationship between phthalate exposure and the development of endometriosis, as well as the possible effects of phthalates on fertility, by analyzing epidemiological data. After a literature search with a combination of specific terms on this topic, we found that although there are limitations to the current studies, there is a clear association between phthalate exposure and endometriosis. Phthalates can interfere with the cellular processes of the endometrium; specifically, they can bind to PPAR and ER-α and activate TGF-β, promoting different signaling cascades that regulate the expression of specific target genes. This may lead to inflammation, invasion, cytokine alteration, increased oxidative stress, and impaired cell viability and proliferation, culminating in endometriosis. Nevertheless, future research is important to curb the progression and development of endometriosis, and strategies for prevention, diagnosis, and treatment are a priority. In this regard, public policies and recommendations to reduce exposure to phthalates and other endocrine disruptors should be promptly implemented.

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Endometriosis: recent advances that could accelerate diagnosis and improve care

Cited by 2 publications

References 121 publications

The causal role of gastroesophageal reflux disease in endometriosis: a bidirectional Mendelian randomization study

The causal role of gastroesophageal reflux disease in endometriosis: a bidirectional Mendelian randomization study

Association between the Exposure to Phthalates and the Risk of Endometriosis: An Updated Review

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