The Neural Immune Mechanisms and Genetic Influences on C

C的神经免疫机制和遗传影响

• 批准号: 7212379
• 负责人: pamela stratton
• 金额: --
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7212379
• 关键词: asthma; autoimmune disorder; chronic fatigue syndrome; chronic pain; comorbidity; disease /disorder etiology; endometriosis; endometrium; epidemiology; female; fertility; fibromyalgia; gene expression; human data; human subject; human tissue; hypersensitivity; hypothyroidism; neuroimmunomodulation; patient oriented research; pelvis; postoperative state; scars; women' s health

Chronic pelvic pain accounts for 10 percent of all gynecology visits and is a significant problem for thousands of women. Most women with chronic pelvic pain have endometriosis. To determine the possible contribution of pelvic adhesions in women with pelvic pain, we evaluated adhesion reformation following laparoscopic excision of endometriosis and adhesiolysis in women with chronic pelvic pain in 38 women who had two surgeries. Adhesions, or adhesions combined with endometriotic lesions, were significantly more likely to reform at second surgery compared to sites having only an endometriosis lesion. Thick adhesions were associated with a significantly increased likelihood of adhesion reformation, compared to thin adhesions. Endometriotic lesions or adhesions involving the ovary were more likely to be associated with adhesions at a subsequent surgery, compared to lesions in the adjacent ovarian fossa or fallopian tube. Most patients developed adhesions after radical surgical excision of endometriosis for pelvic pain. The high incidence of adhesion formation following surgery for endometriosis underscores the importance of optimizing surgical techniques to potentially reduce adhesion formation. In order to better understand endometriosis, chronic pelvic pain and their co-morbidities, we analyzed a survey of almost 4000 women with surgically diagnosed endometriosis conducted by the Endometriosis Association. Almost all responders had pain (99%), and many reported infertility (41%). In this cohort of women with endometriosis, hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies, and asthma were all significantly more common than in women in the general U.S. population. In the coming year, we plan to conduct a more in depth analysis of women with endometriosis to assess the diagnostic process and utilization and effectiveness of treatments, to estimate the prevalence of co-morbid diseases including cancers, endocrine diseases, and infections, and to evaluate the reproductive and gynecologic health of women who responded to the survey.

慢性盆腔疼痛占所有妇科就诊的10%，是成千上万妇女的一个重要问题。大多数患有慢性盆腔疼痛的女性患有子宫内膜异位症。为了确定盆腔粘连在盆腔疼痛女性中的可能作用，我们评估了38名接受过两次手术的慢性盆腔疼痛女性腹腔镜子宫内膜异位症切除术和粘连松解术后的粘连重建。与仅有子宫内膜异位病灶的部位相比，粘连或粘连合并子宫内膜异位病灶在第二次手术时更有可能改革。与薄粘连相比，厚粘连与粘连再形成的可能性显著增加相关。与邻近卵巢窝或输卵管的病变相比，涉及卵巢的子宫内膜异位病变或粘连更可能与后续手术中的粘连相关。大多数患者因盆腔疼痛行子宫内膜异位症根治性手术切除后发生粘连。子宫内膜异位症手术后粘连形成的高发生率强调了优化手术技术以减少粘连形成的重要性。 为了更好地了解子宫内膜异位症，慢性盆腔疼痛及其合并症，我们分析了子宫内膜异位症协会对近4000名手术诊断为子宫内膜异位症的妇女进行的调查。几乎所有的反应者都有疼痛（99%），许多人报告不孕症（41%）。在这组患有子宫内膜异位症的女性中，甲状腺功能减退症，纤维肌痛，慢性疲劳综合征，自身免疫性疾病，过敏和哮喘都比美国普通人群中的女性更常见。在未来的一年里，我们计划对子宫内膜异位症患者进行更深入的分析，以评估诊断过程和治疗的利用率和有效性，估计包括癌症，内分泌疾病和感染在内的共病的患病率，并评估回答调查的女性的生殖和妇科健康。