Saturday, September 7, 2013

Epigenetic factors in endometriosis

Could epigenetic factors explain the hereditary factor and the environmental factors in endo?

"Endometriosis, a common, benign, estrogen-dependent disease affecting 3-10% of women of reproductive age, is characterized by the ectopic growth of endometrial tissue that is found primarily in the peritoneum, ovaries and rectovaginal septum. Recently, endometriosis has been alternatively described as an immune disease, a genetic disease and a disease caused by exposure to environmental factors, in addition to its usual description as a hormonal disease. In addition, accumulating evidence suggests that various epigenetic aberrations play definite roles in the pathogenesis of endometriosis."

"Unlike DNA mutations, epigenetic modifications are dynamic, constantly affected by environmental and lifestyle factors, which makes enzymes that affect epigenetic changes sought-after targets for drug development. Santanam emphasizes that so little is known about the epigenetics of pain. "When you look at pain research, they mostly focus on back pain, fibromyalgia – those types of diseases. There are only now looking at epigenetics of pain," says Santanam. "If you look at all the other fields, there are already epigenetic-related drugs available in the market."

"Conclusions: Our findings suggest that an epigenetically suppressed tumor suppressor gene is involved in the pathogenesis of endometriosis by creating the proliferative, antiapoptotic, and other disease-specific characteristics of endometriosis. The results also suggest that histone deacetylase inhibitors are promising agents for the treatment of endometriosis."

So what is epigenetics?

"Epigenetics is the study of changes in gene activity which are not caused by changes in the DNA sequence.[1] It is the study of gene expression, the way genes bring about their phenotypic effects.[2]
These changes in gene activity may stay for the remainder of the cell's life and may also last for many generations of cells, through cell divisions. However, there is no change in the underlying DNA sequence of the organism.[3] Instead, non-hereditary factors cause the organism's genes to behave (express themselves) differently."

Other Studies (courtesy of the great Endometriosis Research Center!):

Thursday, September 5, 2013

Article, Pathology: "My approach to the interpretation of endometrial biopsies and curettings"

"In evaluating an endometrial biopsy specimen, an adequate clinical history is important, including the age of the patient and the reason for the biopsy. The menopausal status as well as the date of onset of the last menstrual period and the length of the menstrual cycle in premenopausal women should be provided. In many cases of postmenopausal bleeding, the patient is not actually postmenopausal but rather is perimenopausal, with a prolonged interval between periods. This results in the clinician and the patient assuming that the woman is postmenopausal. Before biopsy, many women with abnormal uterine bleeding are already taking exogenous hormones, especially progestogenic compounds, to control the bleeding, and this information is not always conveyed to the pathologist. Other women may be taking hormone replacement therapy or contraceptives. These hormonal compounds may alter the morphological appearance of the endometrium and a knowledge that these, and other relevant drugs such as tamoxifen, are being taken is of paramount importance to the pathologist."

Wednesday, September 4, 2013

Article stem cell involvement in origin of endometriosis

"Endometriosis is a common gynecological disease. It is unique to have benign histology but

with malignant characteristics. Easy recurrence, multiple organ involvement and malignant

transformation potential make endometriosis a complex disease. Multi-factors contribute to

the pathophysiology. Recently, endometriosis has been regarded as a stem cell disease

(Sasson & Taylor, 2008). Some studies have provided evidence of the possible existence of

stem cells in endometrial tissue (Gargett et al., 2004, 2007). We successfully isolated eutopic

and ectopic endometrial mesenchymal stem cells (EN-MSCs) derived from one donor to

examine the genetic difference analysis that provided a powerful tool for investigating the

disease origin (Kao et al., 2011). Our results are consistent with the concept that

endometriosis is a stem cell disease."

Monday, September 2, 2013

Dealing with Endo (funny pictures)

Okay, there are a lot of things you have to deal with when you have endometriosis. And everyone is different in the type and severity of these things. Let's look at the symptoms first.
Okay, so pain. Your period hit.

You're like

So, rate your pain:

Ha! One more??? Try "I lost count!" 
You go to the doctor and the experimentation begins. They try a myriad of medications to try to help. The birth control pills, Depo, IUDs, Lupron, NSAIDS, depression drugs used to treat pain, etc etc
Of course, all those have side effects.

And you're like:

Meanwhile your uterus is all up in your grill.

And you just feel like this most of the time (curled up with your heating pad, of course):


Add in all the other symptoms and you're like:
There are the bowel issues.
The bloating.

 Pain with sex, which can make you avoid it. Like the plague.

Memory problems, especially with some of hormone treatments.

The fatigue.

In the end, it's like:
But you soldier on in your search for relief:

Then there's surgery. Or in many cases, surgeries.
You hope you don't get one like:
You feel like they've been doing this:
Or by the time, they're through:


 Then there are the people who try to be "helpful." "So and so's sister's cousin's best friend got pregnant/had hysterectomy/took this all natural herb and was cured!"
If it's a man, you're like:
The questions of "when are you getting married/pregnant?
You get to the point where you want to curse or kick some a*s.
In your mind you're like:

Or give them the dissertation:
But really, you wish they wouldn't judge what they don't know.

We all need a good support system. Sometimes the only place we find it is through those who know what we're going through (shout out to my facebook endo ladies!!!! You rock!!).

We understand the magic of:

But we realize we can't just wait for things to change.