The Link Between Stress and Endometriosis: from Animal Models to the Clinical Scenario.
The Link Between Stress and Endometriosis: from Animal Models to the Clinical Scenario.
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DOI：
10.1007/s43032-020-00205-7
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发表时间：
2020-09
影响因子：
2.9
通讯作者：
Torres-Reveron, Annelyn
中科院分区：
文献类型：
--
作者：
Appleyard, Caroline B.;Flores, Idhaliz;Torres-Reveron, Annelyn
来自人类和动物模型的有力证据表明，下丘脑垂体肾上腺 (HPA) 轴和/或炎症反应系统的异常功能会破坏神经内分泌和免疫系统的反馈调节，从而导致疾病。众所周知，压力会影响盆腔器官的生理机能并扰乱 HPA 轴，导致慢性、疼痛、炎症性疾病。压力与疾病之间的联系已经被记录在许多慢性疾病中。子宫内膜异位症是一种复杂的慢性妇科疾病，与严重盆腔疼痛和不孕症相关，影响 10% 的育龄妇女。患者报告子宫内膜异位症症状对生活质量、工作/学习效率和人际关系产生负面影响，进而导致严重的心理和情绪困扰。压力与子宫内膜异位症之间的关系尚不清楚。尽管如此，我们最近在动物模型中证明，压力会增加病变的大小和严重程度以及炎症参数。此外，压力的“可控性”影响该模型中的病理生理学，为在患者中使用压力管理技术提供了可能性。通过 HPA 轴活动，压力-炎症-疼痛之间的串扰表明，压力缓解应该减轻炎症，进而减少疼痛反应。这开辟了改变脑-身体-脑通路作为子宫内膜异位症潜在新治疗选择的机会。本综述的目的是收集关于压力（心理和生理）与子宫内膜异位症的发生和进展之间的相互作用及其症状恶化的研究证据，目的是为这种仍然无法治愈的疾病提出新的新兴研究路线和可能的治疗方式。
There is strong evidence from humans and animal models showing that abnormal functioning of the hypothalamic pituitary adrenal (HPA) axis and/or the inflammatory response system disrupts feedback regulation of both neuroendocrine and immune systems, contributing to disease. Stress is known to affect the physiology of pelvic organs and to disturb the HPA axis leading to chronic, painful, inflammatory disorders. A link between stress and disease has already been documented for many chronic conditions. Endometriosis is a complex chronic gynecological disease associated with severe pelvic pain and infertility that affects 10% of reproductive aged women. Patients report the negative impact of endometriosis symptoms on quality of life, work/study productivity, and personal relationships, which in turn cause high levels of psychological and emotional distress. The relationship between stress and endometriosis is not clear. Still, we have recently demonstrated that stress increases the size and severity of the lesions as well as inflammatory parameters in an animal model. Furthermore, the ‘controllability’ of stress influences the pathophysiology in this model, offering the possibility of using stress management techniques in patients. The crosstalk between stress-inflammation-pain through HPA axis activity indicates that stress relief should alleviate inflammation, and in turn, decrease painful responses. This opens up the opportunity of altering brain-body-brain pathways as potential new therapeutic option for endometriosis. The goal of this review is to gather the research evidence regarding the interaction between stress (psychological and physiological) and the development and progression of endometriosis on the exacerbation of its symptoms with the purpose of proposing new lines of emerging research and possible treatment modalities for this still incurable disease.
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影响因子：
7.4
作者：
Bushnell MC;Case LK;Ceko M;Cotton VA;Gracely JL;Low LA;Pitcher MH;Villemure C
通讯作者：
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影响因子：
5.1
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通讯作者：
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影响因子：
4
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
2.9
作者：
Cuevas, Marielly;Cruz, Myrella L.;Appleyard, Caroline B.
通讯作者：
Appleyard, Caroline B.