O papel dos desreguladores endócrinos na fisiopatologia da endometriose: revisão da literatura

Bianca Bianco, Denise Maria Christofolini, Ângela Mara Bentes de Souza, Caio Parente Barbosa
Arquivos Brasileiros de Ciências da Saúde · 2010 · vol. 35(2) · doi:10.7322/abcs.v35i2.95 · W2018174468
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This review critically examines medical literature on the influence of environmental compounds, such as pesticides and phthalates, on the development of endometriosis, a common gynecological disease.

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This article is a literature review examining how endocrine disruptor chemicals may contribute to endometriosis pathophysiology. It synthesizes evidence spanning molecular mechanisms in reproduction (including pathways such as estrogen receptor signaling, aryl hydrocarbon receptor activation, and effects on steroidogenesis and immune/inflammatory processes) and epidemiologic/toxicologic studies that report associations between exposures such as dioxins, PCBs, TCDD, phthalates, and bisphenol compounds and endometriosis risk or related outcomes. A stated caveat in the broader discussion of the field, reflected in cited sources, is that endocrine disruptors pose challenges for testing and risk assessment, including limitations of current methods and developmental toxicology considerations. This paper is centrally about endometriosis — it reviews endocrine-disruptor roles in endometriosis pathophysiology.

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Abstract

O efeito prejudicial que os desreguladores endócrinos podem ter na saúde humana está chamando a atenção da comunidade científica. Essas substâncias são capazes de mimetizar, bloquear ou modular a resposta endócrina por meio da interação com os receptores dos hormônios esteroides e incluem substâncias como pesticidas, fungicidas, dioxinas, ftalatos, bisfenol A, fitoestrogênios, entre outros. A endometriose é uma doença ginecológica comum, que acomete cerca de 15% das mulheres em período reprodutivo e 50% das mulheres com problemas de fertilidade. Muitas teorias foram propostas para tentar explicar o desenvolvimento das lesões. Todavia, não existe, até o momento, uma teoria única que identifique e explique todos os aspectos clínicos dessa doença considerada multifatorial. Recentemente, contaminantes ambientais têm sido implicados na fisiopatologia da endometriose. Este trabalho teve por objetivo realizar uma revisão crítica da literatura médica sobre a influência de compostos ambientais no desenvolvimento da endometriose.
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O papel dos desreguladores endócrinos na fisiopatologia da endometriose: revisão da literatura Conteúdo do artigo principal Resumo Detalhes do artigo Referências Guyton AC, Hall JE. Tratado de Fisiologia Médica. 9ª ed. Rio de Janeiro: Guanabara Koogan; 1996. Hombach-Klonisch S, Pocar P, Kietz S, Klonisch T. Molecular actions of polyhalogenated arylhydrocarbons (PAHs) in female reproduction. Curr Med Chem. 2005;12(5):599-616. Caserta D, Maranghi L, Mantovani A, Marci R, Maranghi F, Moscarini M. Impact of endocrine disruptor chemicals in gynaecology. Hum Reprod Update. 2008;14(1):59-72. http://dx.doi.org/10.1093/humupd/dmm025 Damstra T, Barlow S, Bergman A, Kavlock R, Der Kraak Van, International Programme on Chemical Safety. Global assessment of the state-of-thescience of endocrine disruptors [Internet]. World Health Organization; 2002. Disponível em: http://www.who.int/ipcs/publications/new_issues/endocrine_disruptors/en/ Mantovani A, Stazi AV, Macrì C, Maranghi F, Ricciardi C. 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