Mechanisms and interventions addressing accelerated cardiovascular disease risk in women with endometriosis

项目总结 尽管每10名育龄妇女中就有1人受到影响，但子宫内膜异位症的诊断延迟了7年。 症状的出现。在非西班牙裔黑人(NHB)女性中，尽管有类似的患病率 子宫内膜异位症被低估的原因有很多，包括与症状学有关的报道。 NHB女性和医疗保健提供者之间的偏见、医疗保健差异和隐性偏见。这些 因素可能导致NHB妇女被诊断为子宫内膜异位症的可能性比 非西班牙裔白人(Nhw)女性。重要的是，这意味着当NHB妇女确实接受了子宫内膜异位症 确诊后，往往在晚年导致疾病的进一步发展和更差的预后。给定 子宫内膜异位症妇女心血管疾病风险增加，NHB妇女延迟治疗 可能导致在这一人群中观察到的心血管疾病发病率和死亡率的增加。NHB妇女 与NHW的同龄人相比，他们的心血管疾病发生率高得不成比例，总体结果更差。 因为父母的资助旨在分解炎症和氧化应激在早期 子宫内膜异位症患者心血管疾病的表现，首先了解种族差异是至关重要的 是这些病理生理状态的基础。因此，对这一多样性副刊的拟议研究 将系统地询问与种族相关的内皮和微血管功能的差异，提供 告知家长拨款的重要基础，并使我们能够有效地将种族作为 重要的研究。我们将测试健康的非西班牙裔黑人内皮功能受损的假设 (NHB)女性相对于非西班牙裔白人(NHW)女性是由炎症机制调节的。使用 在安慰剂对照设计中系统抑制核因子kappaB细胞(NF-κB)的稳健方法 (口服水杨酸盐)，将在微循环中评估内皮功能(激光多普勒血流仪耦合 皮内微透析)和大循环(肱动脉血流介导的血管扩张；FMD)。 外周血单个核细胞(PBMC)中的特异性免疫细胞检测将提供体外证据 对功能性血管研究的支持。这一补充将提供生物医学研究方面的培训 具有不同背景的合格候选人。

PROJECT SUMMARY Despite impacting 1 in 10 women of reproductive age, endometriosis has a delay in diagnosis of 7 years from the onset of symptoms. In Non-Hispanic Black (NHB) women, despite having a similar prevalence of endometriosis it is underdiagnosed due to a myriad of factors, including symptomatology-related reporting biases, healthcare disparities, and implicit biases among both NHB women and healthcare providers. These factors may contribute to NHB women being half as likely to be diagnosed with endometriosis as compared to Non-Hispanic White (NHW) women. Importantly, this means that when NHB women do receive an endometriosis diagnosis, it tends to be later in life resulting in further disease progression and worse prognoses. Given the increased risk of cardiovascular disease risk in women with endometriosis, the delayed treatment in NHB women may contribute to the increase in morbidity and mortality from CVD observed in this population. NHB women have disproportionately higher rates of CVD and overall poorer outcomes compared to their NHW counterparts. As the parent grant aims to disaggregate the roles of inflammation and oxidative stress contributing to early manifestations of CVD in women with endometriosis, it is critical to first understand the race-related differences that underlying these pathophysiological states. Therefore, the proposed studies for this diversity supplement will systematically interrogate race-related differences in endothelial and microvascular function, providing a crucial foundation to inform the parent grant and allow us to effectively account for race as a variable in the overarching study. We will test the hypothesis that impaired endothelial function in healthy non-Hispanic Black (NHB) women relative to non-Hispanic White (NHW) women is mediated by inflammatory mechanisms. Using a robust approach to systemically knockdown nuclear factor kappa B cells (NF-κB) in a placebo control design (oral salsalate), endothelial function will be assessed in the microcirculation (laser Doppler flowmetry coupled with intradermal microdialysis) and the macrocirculation (brachial artery flow-mediated vasodilation; FMD). Specific immune cell assays in peripheral blood mononuclear cells (PBMCs) will provide ex vivo evidence to support of functional vascular studies. This supplement will provide training in biomedical research for a highly qualified candidate from a diverse background.