Environmental dioxins and endometriosis.
Endometriosis is a common gynecologic problem of unknown etiology. Estrogen dependence and immune modulation are established features of this disease, and environmental contaminants have been suggested to play a role in the pathobiology of this disease as well. Previous work in nonhuman primates has shown that exposure to the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is associated with an increased prevalence and severity of endometriosis. Further animal experiments have implicated dioxin and dioxin-like compounds in this disease. Rodent studies support the plausibility of a role of environmental contaminants in the pathophysiology of endometriosis, although a convincing mechanistic hypothesis has yet to be advanced. Small hospital-based case-control studies have failed to provide compelling evidence for or against an association of environmental contaminants and endometriosis. Herein we review evidence that dioxin and dioxin-like compounds are potent modulators of immune and endocrine function critical to the pathobiology of endometriosis. Furthermore, perspectives on the potential mechanism(s) of dioxin and dioxin-like compound-induced toxicity in endometriosis, important knowledge needs, potential animal models for endometriosis studies, and considerations integral to future human case-control studies are discussed.
Rier
Sherry
S
The International Endometriosis Association, 8585 N. 76th Place, Milwaukee, WI 53223, USA.
Foster
Warren G
WG
D000818:Animals; D004147:Dioxins / Q000009:adverse effects*; D004715:Endometriosis / Q000139:chemically induced*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D011078:Polychlorinated Biphenyls / Q000009:adverse effects; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects
D004147:Dioxins; D000072317:Polychlorinated Dibenzodioxins; D011078:Polychlorinated Biphenyls