Endocrine disrupting chemicals and endometriosis

Endocrine disruptors and reproductive disorders

Abstract

Endometriosis is an estrogen dependent gynecologic disease with lasting implications for many women’s fertility, somatic health, and overall quality of life.

Growing evidence suggests that endocrine disrupting chemicals (EDCs) may be etiologically involved in the development and severity of disease.

We weigh the available human evidence focusing on EDCs and endometriosis, restricting to research that has individually quantified chemical concentrations for women, included a comparison group of unaffected women, and used multivariable analytic techniques.

Endocrine disrupting chemicals and endometriosis, Fertility and Sterility, Volume 106, Issue 4, Pages Pages 959–966, September 15, 2016.

laparoscopic surgery for endometriosis: fuschia_foot.

Evidence supporting an environmental etiology for endometriosis includes metals/trace elements, dioxins, and other persistent organic pollutants, as well as nonpersistent chemicals, such as benzophenones and phthalates.

To address the equivocal findings for various EDCs, future research directions for filling data gaps include

  1. use of integrated clinical and population sampling frameworks allowing for incorporation of new diagnostic modalities;
  2. the collection of various biologic media, including target tissues for quantifying exposures;
  3. study designs that offer various comparison groups to assess potentially shared etiologies with other gynecologic disorders;
  4. and novel laboratory and statistical approaches that fully explore all measured EDCs for the assessment of mixtures and low dose effects and the use of directed acyclic graphs, and supporting causal analysis for empirically delineating relationships between EDCs and endometriosis.

Stilbestrol Tablets 1mg

Taipei Veterans General Hospital, Taiwan

image of stilbestrol-1mg
Taipei Veterans General Hospital, Taiwan.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Stilbestrol tablets are current Taipei-VGH drugs marketed by Taipei Veterans General Hospital.

DES Drugs Pictures
More DES DiEthylStilbestrol Resources

Should doctors ever be allowed to modify the human species?

Genome editing: ethical considerations

Nuffield Council on Bioethics report – Genome editing: an ethical review – found materials to perform basic experiments are now available to ‘garage scientists.

“… genetic technology has become so powerful that nations need to decide whether or not doctors should ever be allowed to modify the human species.

While the creation of GM humans is not on the horizon yet, the risks and benefits of modifying a person’s genome – and having those changes pass on to future generations – are so complex that they demand urgent ethical scrutiny, …

Read Experts warn home ‘gene editing’ kits pose risk to society, the guardian, 30 September 2016. Download the ethical review short guide.

Pink October : Sheep or Not?

How do you know it’s October? The Pink !

A deadly disease should not be a bottom line booster for Fortune 500 companies. Instead, let’s boost women’s health and self image.

More information

Children’s rights and the environment

Countries have obligation to prevent childhood exposure to toxics

In recent years, numerous cases have called into question the adequacy of State measures to protect human rights from toxics, in particular children’s rights.

The intoxication of children with lead-contaminated drinking water raised questions of race, poverty and discrimination. The deadly impact of an untested consumer product on pregnant women and children laid bare the magnitude to which industries fail to conduct reasonable amounts of due diligence, and the failure of States to require basic information on health and safety. Poisonings around the world by pesticides, extractive industries and industrial emissions to air and water — and their crippling impacts on the health, development and life of children — reinforce the need for strong measures to protect those most at risk.

Report of the Special Rapporteur on the implications for human rights of the environmentally sound management and disposal of hazardous substances and wastes, United Nations, 2 August 2016.

However, the problem is not limited to poisoning. Childhood exposure is a systemic problem everywhere. All around the world, children are born with dozens, perhaps hundreds, of hazardous substances in their bodies. This is leading to what doctors are referring to as a “silent pandemic” of disease and disability affecting millions during childhood and later in life. For a number of reasons, children are left without access to an effective remedy or justice for the harms of toxics and pollution, which enables perpetrators to remain unaccountable.

Children’s rights and the environment – new UN report argues endoccountries have obligation to prevent childhood exposure to toxics, heal, 27 September 2016.

daughter swimming in nappies by edwardmusiak.

Prevention of exposure is the best remedy. The best interests of the child must be a primary consideration of States in protecting children’s rights to life, survival and development, physical integrity, health, being free from the worst forms of child labour, and also to safe food, water and housing, and other rights implicated by toxics and pollution that are enshrined in the Convention on the Rights of the Child. States have a human rights obligation and businesses a corresponding responsibility to prevent childhood exposure to toxic chemicals and pollution.

Read United Nations Human Rights Council Thirty-third session full report, 2 August 2016.

Environmental exposure to endocrine-disrupting chemicals and miscarriage

The role of environmental toxins in reproduction

Abstract

Establishment of early pregnancy is the result of complex biochemical interactions between the decidua and blastocyst.

Any alteration in this chemical dialogue has the potential to result in adverse pregnancy outcomes including miscarriage.

Sporadic miscarriage is the most common complication of pregnancy and can be caused by multiple factors.

While the most common cause of miscarriage is genetic abnormalities in the fetus, other contributing factors certainly can play a role in early loss.

Environmental exposure to endocrine-disrupting chemicals and miscarriage, Fertility and Sterility, Volume 106, Issue 4, Pages Pages 941–947, September 15, 2016.

Miscarriage Tattoo: stacylynn.

One such factor is environmental exposure, in particular to endocrine-disrupting chemicals, which has the potential to interfere with endogenous hormone action.

These effects can be deleterious, especially in early pregnancy when the hormonal milieu surrounding implantation is in delicate balance.

The purpose of this paper is to review the current evidence on the role of environmental toxins in reproduction.

Has medical science taken a turn towards darkness?

Perhaps half of the scientific literature may simply be untrue

A lot of what is published is incorrect.”
I’m not allowed to say who made this remark because we were asked to observe Chatham House rules. We were also asked not to take photographs of slides. Those who worked for government agencies pleaded that their comments especially remain unquoted, since the forthcoming UK election meant they were living in “purdah”—a chilling state where severe restrictions on freedom of speech are placed on anyone on the government’s payroll. Why the paranoid concern for secrecy and non-attribution? Because this symposium—on the reproducibility and reliability of biomedical research, held at the Wellcome Trust in London last week—touched on one of the most sensitive issues in science today: the idea that something has gone fundamentally wrong with one of our greatest human creations.

Offline: What is medicine’s 5 sigma?, the lancet, Comment, April 11, 2015.

The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, “poor methods get results”. The Academy of Medical Sciences, Medical Research Council, and Biotechnology and Biological Sciences Research Council have now put their reputational weight behind an investigation into these questionable research practices. The apparent endemicity of bad research behaviour is alarming. In their quest for telling a compelling story, scientists too often sculpt data to fit their preferred theory of the world. Or they retrofit hypotheses to fit their data. Journal editors deserve their fair share of criticism too. We aid and abet the worst behaviours. Our acquiescence to the impact factor fuels an unhealthy competition to win a place in a select few journals. Our love of “significance” pollutes the literature with many a statistical fairy-tale. We reject important confirmations. Journals are not the only miscreants. Universities are in a perpetual struggle for money and talent, endpoints that foster reductive metrics, such as high-impact publication. National assessment procedures, such as the Research Excellence Framework, incentivise bad practices. And individual scientists, including their most senior leaders, do little to alter a research culture that occasionally veers close to misconduct.

Can bad scientific practices be fixed?
Part of the problem is that no-one is incentivised to be right. Instead, scientists are incentivised to be productive and innovative. Would a Hippocratic Oath for science help? Certainly don’t add more layers of research redtape. Instead of changing incentives, perhaps one could remove incentives altogether. Or insist on replicability statements in grant applications and research papers. Or emphasise collaboration, not competition. Or insist on preregistration of protocols. Or reward better pre and post publication peer review. Or improve research training and mentorship. Or implement the recommendations from our Series on increasing research value, published last year. One of the most convincing proposals came from outside the biomedical community. Tony Weidberg is a Professor of Particle Physics at Oxford. Following several high-profi le errors, the particle physics community now invests great effort into intensive checking and rechecking of data prior to publication. By filtering results through independent working groups, physicists are encouraged to criticise. Good criticism is rewarded. The goal is a reliable result, and the incentives for scientists are aligned around this goal. Weidberg worried we set the bar for results in biomedicine far too low. In particle physics, significance is set at 5 sigma—a p value of 3 × 10–7 or 1 in 3·5 million (if the result is not true, this is the probability that the data would have been as extreme as they are). The conclusion of the symposium was that something must be done. Indeed, all seemed to agree that it was within our power to do that something. But as to precisely what to do or how to do it, there were no fi rm answers. Those who have the power to act seem to think somebody else should act first. And every positive action (eg, funding well-powered replications) has a counterargument (science will become less creative). The good news is that science is beginning to take some of its worst failings very seriously. The bad news is that nobody is ready to take the first step to clean up the system.

Richard Horton,
The Lancet, Comment, April 11, 2015.

Le Distilbène en 2016 (4/4)

Que retenir du guide pratique DES destinés aux professionnels de santé?

Vidéo publiée le 1er septembre 2016 par l’ Association Réseau DES FRANCE DISTILBENE.

Synthèse de l’étude Distilbène 3 générations, 2016.

Guide Pratique

Suite à l’étude Distilbène 3 générations qu’elle a initiée en 2013, l’association Réseau D.E.S. France a publié, fin 2015, un guide pratique pour les professionnels de la santé, synthétisant les données actuelles de la science. Deux versions sont à télécharger:

Le Distilbène DES, en savoir plus

World’s first baby born with three-person technique

First live birth using human oocytes reconstituted by spindle nuclear transfer for mitochondrial DNA mutation causing Leigh syndrome

A five-month-old boy is the first baby to be born using a new technique that incorporates DNA from three parents, New Scientist reveals, 27 September 2016.

Abstract

Five MII oocytes with birefringent spindles were subjected to meiotic SNT. The 5 oocytes were successfully reconstituted and fertilized normally by ICSI. Four out of 5 fertilized oocytes developed into blastocysts. PGS showed that one blastocyst was euploid (46XY), while 3 embryos were aneuploid. The average transmission rate of maternal mtDNA in the biopsied euploid blastocyst was 5.10 ± 1.11% and the heteroplasmy level for 8993T>G was 5.73%. Transfer of the euploid embryo resulted in an uneventful pregnancy with delivery of a healthy boy at 37 weeks of gestation. The average level of transmitted mother’s mtDNA in several neonatal tissues including buccal epithelium, hair follicles, circumcised foreskin, urine precipitate, placenta, amnion, umbilical blood, and umbilical cord was less than 1.60 ± 0.92%.

First live birth using human oocytes reconstituted by spindle nuclear transfer for mitochondrial DNA mutation causing Leigh syndrome, Fertility and Sterility, S0015-0282(16)62670-5, October 2016.

Human oocytes reconstituted by SNT are capable of producing a healthy live birth. SNT may provide a novel treatment option in minimizing pathogenic mtDNA transmission from mothers to their babies.

Morphologic and molecular changes in the placenta: what we can learn from environmental exposures

Environmental exposures: pregnancy, placenta, and miscarriage

Abstract

In mammals, the extraembryonic tissues, which include the placenta, are crucial for embryonic development and growth.

Because the placenta is no longer needed for postnatal life, however, it has been relatively understudied as a tissue of interest in biomedical research.

Recently, increased efforts have been placed on understanding the placenta and how it may play a key role in human health and disease.

Morphologic and molecular changes in the placenta: what we can learn from environmental exposures, Fertility and Sterility, Volume 106, Issue 4, Pages Pages 930–940, September 15, 2016.

Pregnancy image: kulden.

In this review, we discuss two very different types of environmental exposures: assisted reproductive technologies and in utero exposure to endocrine-disrupting chemicals.

We summarize the current literature on their effects on placental development in both rodent and human, and comment on the potential use of placental biomarkers as predictors of offspring health outcomes.