Fatores ambientais e endometriose Environmental factors and endometriosis

• Main Authors: Patrick Bellelis, Sergio Podgaec, Maurício Simões Abrão
• Format: Article
• Language: English
• Published: Associação Médica Brasileira 2011-08-01
• Series: Revista da Associação Médica Brasileira
• Subjects: Dioxinas; receptores de hidrocarboneto arílico; tetraclorodibenzodioxina; endometriose; dieta; hábitos alimentares; Dioxins; aryl hydrocarbon receptor; tetrachlordibenzodioxin; endometriosis; diet; food habits
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302011000400022
• ISSN: 0104-4230; 1806-9282

A endometriose representa uma afec&#231;&#227;o ginecol&#243;gica comum, atingindo de 5%-15% das mulheres no per&#237;odo reprodutivo e at&#233; 3%-5% na fase p&#243;s-menopausa. Essa doen&#231;a &#233; definida pelo implante de estroma e/ou epit&#233;lio glandular endometrial em localiza&#231;&#227;o extrauterina, podendo comprometer diversos locais. Humanos e animais s&#227;o expostos diariamente a poluentes qu&#237;micos que t&#234;m a capacidade de influenciar negativamente processos fisiol&#243;gicos e, potencialmente, causar doen&#231;as, dentre elas a endometriose. Com esta revis&#227;o tivemos por objetivo relacionar a influ&#234;ncia dos fatores ambientais e diet&#233;ticos na g&#234;nese da endometriose. O mecanismo pelo qual a dioxina e seus s&#237;miles (TCDD/PCBs) atuam na altera&#231;&#227;o da fisiologia endometrial permanence incerta e &#233; especulativa devido à dificuldade em se avaliar a exposi&#231;&#227;o na vida intraútero, inf&#226;ncia e vida adulta e suas reais consequ&#234;ncias, al&#233;m das limita&#231;&#245;es de sua reprodu&#231;&#227;o in vitro. Devemos entender melhor o mecanismo de a&#231;&#227;o desses poluentes amibentais n&#227;o s&#243; na saúde reprodutiva, mas na saúde em geral do indiv&#237;duo, para se promover estrat&#233;gias de preven&#231;&#227;o que devem incluir n&#227;o s&#243; a educa&#231;&#227;o populacional, mas o estabelecimento de limites de exposi&#231;&#227;o, t&#233;cnicas menos poluentes e melhor aproveitamento dos nossos recursos naturais.<br>Endometriosis represents a common gynecological condition affecting 5%-15% of childbearing age women and up to 3% 5% of post-menopausal women. This disease is defined by the presence of stromal and/or endometrial glandular epithelium implants in extra-uterine locations possibly compromising several sites. Humans and animals are daily exposed to chemical pollutants that could adversely influence physiological processes and potentially cause diseases, including endometriosis. In this review, the authors aimed at settling the influence of environmental and dietary factors on endometriosis pathogenesis. The mechanism by which dioxin and its similes (TCDD/PCBs) act changing the endometrial physiology remains uncertain and is speculative due to the difficulty in assessing the exposure over intrauterine life, childhood and adulthood and its actual consequences, in addition to the limitations to its in vitro reproducibility. We need to better understand the mechanism of action of these environmental pollutants, not only on reproductive health, but also on overall health of individuals and so prevention strategies, including not only population education, but setting exposure limits, less polluting techniques and a better use of our natural resources, could be promoted.