Endometriosis is a chronic gynecological disorder defined as the presence of endometrial glands and stroma outside the endometrial cavity, mainly in ovaries, fallopian tubes, cul-de-sac and the uterine ligaments. Theories of endometriosis suggest that its etiology arises from a complex interaction of both genetic and environmental influences. This condition is characterized by peritoneal inflammation, fibrosis, adhesions and ovarian cysts, which result in chronic pelvic pain, pain during intercourse (dyspareunia), painful periods (dysmenorrhea) and infertility. Still today, endometriosis remains a poorly understood condition that continues to incapacitate and affect the productivity and lifestyle of millions of women around the world. Research indicates that stress is a significant component of many recurrent and chronic health problems, including chronic pain disorders. The negative effects of stress on many diseases include impairment of immune function, increasing cortisol levels and alteration of the hormonal balance. It is generally accepted that dealing with the symptoms of endometriosis on a daily basis is stressful by itself. Circumstantial evidence suggests that a variety of stress management techniques, including effectively handling stressful situations and implementing lifestyle changes, can help women suffering from endometriosis and other reproductive disorders. However, whether stress affects the prevalence and progression of endometriosis in women is still unknown. This study will test the hypothesis that stress and its controllability, can affect disease progression and phenotype through different mechanisms, including dysregulation of the immune system and involvement of central pain centers, in an established animal model of endometriosis.
The specific aims of this translational study will examine whether stress can exacerbate the development and progression of endometriosis, and determine whether the ability to control stress can decrease the extent of endometriosis. It will contribute to the goals of the AREA program by strengthening the institutional environment through support of an interdisciplinary group of experienced investigators with expertise in endometriosis, animal physiology and behavior. It will provide opportunities for exposure of students at various levels to multidisciplinary research areas, providing a unique training opportunity and further encouraging their continued studies in the biomedical sciences. The results of these studies are also expected to identify possible interventions that will ultimately help women affected by this disease to live healthy and productive lives, in accordance with the mission of the NIH.

Public Health Relevance

Endometriosis is a poorly understood condition that incapacitates and affects the productivity and well- being of millions of women in their reproductive years around the world. These studies will contribute to our understanding of the impact of stress on the underlying pathophysiological mechanisms of endometriosis, and exacerbation of its painful symptoms, and to the possibility of implementing stress management interventions as a therapeutic target.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Academic Research Enhancement Awards (AREA) (R15)
Project #
1R15AT006373-01A1
Application #
8180413
Study Section
Special Emphasis Panel (ZAT1-PK (16))
Program Officer
Glowa, John R
Project Start
2011-08-01
Project End
2014-07-31
Budget Start
2011-08-01
Budget End
2014-07-31
Support Year
1
Fiscal Year
2011
Total Cost
$424,216
Indirect Cost
Name
Ponce School of Medicine
Department
Physiology
Type
Schools of Medicine
DUNS #
105742043
City
Ponce
State
PR
Country
United States
Zip Code
00732
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Ramos-Ortolaza, Dinah L; Doreste-Mendez, Raura J; Alvarado-Torres, John K et al. (2017) Ovarian hormones modify anxiety behavior and glucocorticoid receptors after chronic social isolation stress. Behav Brain Res 328:115-122
Torres-Reverón, Annelyn; Palermo, Karylane; Hernández-López, Anixa et al. (2016) Endometriosis Is Associated With a Shift in MU Opioid and NMDA Receptor Expression in the Brain Periaqueductal Gray. Reprod Sci 23:1158-67
Appleyard, Caroline B; Cruz, Myrella L; Hernández, Siomara et al. (2015) Stress management affects outcomes in the pathophysiology of an endometriosis model. Reprod Sci 22:431-41
Hernandez, Siomara; Cruz, Myrella L; Torres-Reveron, Annelyn et al. (2015) Impact of physical activity on pain perception in an animal model of endometriosis. J Endometr Pelvic Pain Disord 7:89-114
Cuevas, Marielly; Flores, Idhaliz; Thompson, Kenira J et al. (2012) Stress exacerbates endometriosis manifestations and inflammatory parameters in an animal model. Reprod Sci 19:851-62