The role of endocrine-disrupting chemicals in uterine fibroid pathogenesis.
The role of endocrine-disrupting chemicals in uterine fibroid pathogenesis.
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DOI：
10.1097/med.0000000000000578
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Zota AR
中科院分区：
文献类型：
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作者：
Bariani MV;Rangaswamy R;Siblini H;Yang Q;Al-Hendy A;Zota AR
子宫平滑肌瘤（纤维瘤）是一种影响美国大多数女性的妇科疾病。当这些非癌性肿瘤出现症状时，可导致严重的发病率，包括盆腔疼痛、月经过多和不孕。内分泌干扰物（EDCs）可能是一种可改变的风险因素。这篇综述的目的是总结最近的人体和实验证据内分泌干扰物的暴露和肌瘤。多种内分泌干扰物与纤维瘤结局和/或过程相关，包括邻苯二甲酸酯、对羟基苯甲酸酯、环境酚、替代增塑剂、己烯雌酚、有机磷酸酯和三丁基锡。流行病学研究表明，暴露于某些内分泌干扰物，如邻苯二甲酸二（2-乙基己基）酯（DEHP），与子宫肌瘤风险和严重程度增加有关。人类和实验研究表明，表观遗传过程可能在将内分泌干扰物与纤维瘤发病机制联系起来方面发挥重要作用。体外和体内研究表明，DEHP、双酚A和己烯雌酚可影响对纤维瘤发病至关重要的生物学途径。虽然关于EDC和肌瘤的研究仍在发展中，但最近的证据表明EDC暴露可能会导致肌瘤风险和进展。需要进一步的研究来检查EDC混合物的影响，并确定关键的生物途径和暴露窗口。这些结果可能为肌瘤的新预防策略打开大门。
Uterine leiomyoma (fibroids) is a gynecologic disorder impacting the majority of women in the United States. When symptomatic, these noncancerous tumors can cause severe morbidity including pelvic pain, menorrhagia, and infertility. Endocrine-disrupting chemicals (EDCs) may represent a modifiable risk factor. The aim of this review is to summarize recent human and experimental evidence on EDCs exposures and fibroids. Multiple EDCs are associated with fibroid outcomes and/or processes including phthalates, parabens, environmental phenols, alternate plasticizers, Diethylstilbestrol, organophosphate esters, and tributyltin. Epidemiologic studies suggest exposure to certain EDCs, such as di-(2-ethylhxyl)-phthalate (DEHP), are associated with increased fibroid risk and severity. Both human and experimental studies indicate that epigenetic processes may play an important role in linking EDCs to fibroid pathogenesis. In-vitro and in-vivo studies show that DEHP, bisphenol A, and diethylstilbestrol can impact biological pathways critical to fibroid pathogenesis. While research on EDCs and fibroids is still evolving, recent evidence suggests EDC exposures may contribute to fibroid risk and progression. Further research is needed to examine the impacts of EDC mixtures and to identify critical biological pathways and windows of exposure. These results could open the door to new prevention strategies for fibroids.