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dkrupa@the-aps.org
New Study Finds
Uncontrollable Stress Worsens Symptoms Of Endometriosis
Study
presents evidence, for the first time, of the negative consequences of
stress in the progression of the disease
SAN DIEGO, CA – Endometriosis is a poorly
understood condition that incapacitates and affects the productivity and
lifestyle of millions of women around the world. In the US, it affects
approximately six million women and adolescents at a cost of some $1.6
billion per year. It is a chronic painful disease which occurs when
endometrial tissue grows as lesions outside the uterus, mainly in the area
of the ovaries and fallopian tubes, but can also affect the intestinal
tract. The condition results in chronic pelvic pain, painful menstrual
periods and pain during intercourse.
Many patients report suffering from high levels of
stress due to the impact that painful symptoms have on all aspects of their
life, including work, family and personal relationships. For example, the
physical pain they experience during intercourse can disrupt a healthy
sexual relationship, thus causing anguish and discord which leads to further
stress.
Circumstantial evidence suggests that a variety of
stress management techniques can help women handle stressful situations
related to the disease. However, it is not yet known whether stress affects
the prevalence or progression of the disease.
A new study investigating the relationship between
stress and the painful symptoms of the disease is currently underway. It
offers, for the first time, evidence of the negative consequences of stress
in the progression of endometriosis, most likely through an effect on the
immune system.
Presentation at the 121st Annual Meeting
of the American Physiological Society
The study was conducted by an interdisciplinary team of
investigators with expertise in endometriosis, animal physiology and
behavior. Marielly Cuevas, Olga I. Santiago, Kenira J. Thompson and Caroline
B. Appleyard, Department of Physiology and Pharmacology, Ponce School of
Medicine, Ponce, Puerto Rico, and Idhaliz Flores of the Department of
Microbiology. Dr. Appleyard and her graduate student, Marielly Cuevas, will
present the team’s findings, entitled The Pathophysiology of Intestinal
Endometriosis is Exacerbated by Uncontrollable Stress during the 121st
annual meeting of The American Physiological Society (APS;
www.the-APS.org/press), part of the Experimental Biology 2008 scientific
conference.
The Study
Seven female rats were induced with endometriosis. Of
the total, half were subjected to stressful swim tests for ten consecutive
days, a chronic and stressful situation the animals could not control. The
“endo-stress” group (n=3) was subjected to the swim trials. The
“endo-control” rats (n=4) had endometriosis but did not swim. The
sham-stress group (n=3) did not have the disease nor did they swim.
Sixty days after the induction of the endometriosis the
rats were sacrificed and examined for the presence of endometriotic vesicles
(small structures inside cells used to transport liquids such as proteins),
and damage to the adjacent organs (including the colon and small
intestine). The presence of the enzyme myeloperoxidase (MPO), which is
linked to inflammation, was also assayed.
Results
The researchers found that:
none of the sham-stress animals developed vesicles.
the endo-control group developed a total vesicle length that
averaged 6.57±0.96mm per animal.
the endo-stress group developed a total vesicle length that
averaged 11.26±5.27mm per animal.
the endo-control rats had higher colonic damage scores than
sham-stressed animals, which was increased further by stress.
the endo-stress rats had the shortest colon length, the
highest levels of MPO, the greatest number of colonic mast cells, and an
increase in peritoneal fluid immune cell infiltration, all indicative of
activation of inflammatory mechanisms.
Conclusion
According to the senior researcher for the study, Dr.
Appleyard, “These findings contribute to our understanding of how stress may
affect the severity of endometriosis. We think there is likely a connection
with the immune system because of the observed levels of mast cells in the
colon and the increased levels of inflammatory cells in the peritoneum of
the affected rats, since this has also been observed in patients with
endometriosis.” Appleyard continued, “The results offer a jumping off point
to help identify stress-management interventions that will help those women
who are affected by the disease.”
*****
Physiology is the study of how molecules, cells, tissues and organs
function to create health or disease. The American Physiological Society (APS;
www.The-APS.org/press) has been an integral part of this discovery
process since it was established in 1887.
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NOTE TO EDITORS: The APS annual meeting is part
of the Experimental Biology 2008 (EB ’08) gathering and will be held April
5-9, 2008 at the San Diego, CA Convention Center. To schedule an interview
with Dr. Appleyard please contact Donna Krupa at 301.634.7209
(office), 703.967.2751 (cell) or
Dkrupa@The-APS.org.
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