Friday 30 October 2009

Endometriosis: Polychlorinated biphenyls found to trigger mutation in GSTM1 gene

2009
By Syed Akbar
Hyderabad, Oct 29: City health researchers have found an environmental and genetic link to endometriosis,
one of the most commonly encountered problems in gynaecology.
Endometriosis is associated with chronic pelvic pain and irregular monthly cycles. It is also one of the
major causes of infertility in women. It is a debilitating gynaecological disorder affecting about 15 per cent
of women of child bearing age.

The city team has noticed that polychlorinated biphenyls, the liquid used in coolants, transformers and capacitors, interferes with the genetic set up of women exposed to the compound, thereby causing endometriosis. The PCBs cause mutations in the GSTM1 gene (glutathione S-transferase).
This is the first attempt to resolve the conundrum of conjugation of both PCBs and GSTM1 gene deletion frequency in the pathogenesis of endometriosis.
The team comprised Dr Rozati Roya, Dr Giragalla Simha Baludu and Dr B Satyanarayana Reddy of the department of obstetrics & gynaecology, Owaisi Hospital & Research Centre and the department of
reproductive medicine, Maternal Health & Research Trust, Hyderabad. Their study established the link between PCBs and GSTM1 mutation as women suffering from endometriosis showed high concentration of the environmental pollutant.
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Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body. Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum.In addition, it can be found in caecarian-section scars, laparoscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. But these locations are not so common.
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"Women with endometriosis showed significantly higher concentrations of PCBs compared with control
group. Twenty six per cent of women with endometriosis had the GSTM1 null genotype, which showed
significant association with endometriosis," Dr Roya said.

As part of the study, the team selected 97 unrelated women, who were diagnosed to have endometriosis. It
also took 102 women with other gynaecological problems like fibroids, tubal defects and polycystic ovaries,
as the control group.
The research group is of the view that the compromised detoxification, determined genetically, might be a risk factor for the development of endometriosis. Significant increase in the concentrations PCBs was observed in plasma of women as the severity of endometriosis increased.

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