SEVERITY OF ENDOMETRIOSIS

Levels of thyroid hormones affect chronic pain and severity of endometriosis

Levels of thyroid hormones affect chronic pain and severity of endometriosis

Endometriosis patients with thyroid dysfunction may have increased risk of more intense chronic pain and increased disease severity, a study suggests.

The underlying disease mechanism of endometriosis is still unclear.

Autoimmune thyroid disorders are associated with endometriosis, but the mechanism by which the two diseases are linked is unknown.

Each cell in the body carries protein markers called antigens that allow a cell to be identified as “self” or “non-self” by the immune system. In autoimmune thyroid disorders, the body’s own immune system attacks and damages the thyroid gland. These diseases are characterized by the production of autoantibodies against thyroid-specific antigens, including the thyroid itself and the thyroid-stimulating hormone receptor.

Now, researchers at the Université Paris Descartes looked at the relationship between endometriosis and autoimmune thyroid disorders, specifically at how thyroid disorders affect the progression of endometriosis.

They first found that both the levels of RNA and proteins involved in thyroid metabolism were altered in the biopsied endometrium of patients with endometriosis compared to healthy people. RNA molecules act as templates to make proteins, which perform key functions in the cell.

Moreover, in endometriotic cells, the amount of thyroid hormones was altered compared to that of control cells. The thyroid hormone T4 (thyroxine) is converted into T3 (triiodothyronine), which is much more active than T4. In the endometriotic cells, T4 production was increased while that of T3 was reduced.

The thyroid-stimulating hormone regulates the production of T3 and T4. In vitro (lab) studies using cells from the endometrium of endometriotic patients and healthy controls showed that thyroid-stimulating hormone increased cells’ proliferation. But the researchers saw no differences in the increase of proliferation rate between endometriotic cells and control cells.

Mouse studies confirmed the data gained in vitro since endometriotic implants were found to be bigger when thyroid hormones increased. A retrospective analysis of endometriosis patients with or without a thyroid disorder revealed an increased chronic pelvic pain and disease score in endometriotic patients with a thyroid disorder.

The study, “Role of thyroid dysimmunity and thyroid hormones in endometriosis” was published in the journal PNAS

Read more: https://www.pnas.org/content/116/24/11894

Endometriosis is more severe for obese women

cramps-810x424By I.Soussis MD

Obesity is linked to an increase in endometriosis severity and a reduced frequency of minimal stage disease, according to new research from Australia.

The study was published in the Journal of Endometriosis and Pelvic Pain Disorders.

Endometriosis is a painful gynecological disease that affects approximately 6-10% of reproductive-age women. 

Due to its high negative impact on quality of life, a better understanding of its underlying mechanisms is a priority for the development of effective therapies.

Previous studies have revealed that endometriosis patients often have a lower body mass index (BMI) than healthy women. It’s not clear how body weight is related to the disease. 

In the study titled “The association of body mass index with endometriosis and disease severity in women with pain” the research team evaluated the association between obesity and endometriosis severity.

The team analyzed the clinical records of 509 pre-menopausal women who underwent laparoscopic surgery for the investigation of gynecological pain. A final diagnosis of endometriosis was achieved in 357 of the 509 women.

In line with previous studies, researchers found that women with endometriosis had a lower mean BMI than healthy women.

They found an inverse correlation between BMI and endometriosis, with a higher incidence of the disease in underweight women and significantly reduced endometriosis frequency in overweight women.

Interestingly, women with obesity who had endometriosis were found to be less likely to have minimal (stage 1) disease. Indeed, 40% of the patients with obesity had moderate-severe endometriosis (stage 3-4) compared to 24-26% of the normal and pre-obesity patients.

In general, obese patients had significantly higher disease severity scores compared to women who were slightly overweight  as well as those with normal BMIs.

Supported by these results, the researchers suggested that there’s too much “scrutiny over a low BMI in association with endometriosis,” and research emphasis should shift to “understanding the impact of obesity on endometriosis, and in particular, the difference observed in disease severity.”

“It remains unclear what role body mass index has in the cause or effect of endometriosis,” researchers wrote. “We propose that BMI may be a useful candidate for assisting in improved endometriosis disease sub-classification,” they added, which could have implications for management and treatment decisions.

Sources: https://www.theguardian.com/society/2018/jun/12/endometriosis-is-more-painful-for-obese-women-study-finds

https://endometriosisnews.com/2018/06/13/obesity-linked-to-more-severe-endometriosis-australian-study/?utm_source=END+E-mail+List&utm_campaign=818b7a1e46-RSS_MONDAY_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_5a9732e593-818b7a1e46-72512137

 

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