| Dioxins and Endometriosis: A Plausible Hypothesis Linda S. Birnbaum and Audrey M. Cummings National Health and Environmental Effects Research Laboratory, Office of Research and Development, U. S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA Abstract
A potential connection exists between exposure to organochlorine chemicals and the increasing prevalence of endometriosis. Evidence shows that dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin) can increase the incidence and severity of the disease in monkeys and can promote the growth or survival of endometrial tissue implanted into rodents in a surgically induced model of endometriosis. The mechanism of the connection between organochlorine chemicals and endometriosis is not clear. Effects on growth factors, cytokines, and hormones (components of the immune and endocrine systems) are potential means of mediating the possible promotion of endometriosis by dioxins. Studies on epidemiology and on structure-activity relationships of organochlorine chemicals and endometriosis have been additional approaches to this problem. In this regard, toxic equivalence (TEQ) appears to be an important determinant of the effects of organochlorine chemicals on endometriosis. In this article, we review the literature related to endometriosis and dioxins and attempt to integrate the various sources of information that bolster the hypothesis connecting dioxins and endometriosis. Key words: dioxin, endometriosis, polychlorinated biphenyls, TCDD, toxic equivalence. Environ Health Perspect 110:15-21 (2002) . [Online 10 December 2001] http://ehpnet1.niehs.nih.gov/docs/2002/110p15-21birnbaum/ abstract.html Address correspondence to L.S. Birnbaum, MD-58A, HSD, U.S. EPA, Research Triangle Park, NC 27711 USA. Telephone: (919) 544-2594. Fax: (919) 544-6212. E-mail: birnbaum.linda@epa.gov The information in this article has been funded wholly by the U.S. Environmental Protection Agency. It has been subjected to review by the National Health and Environmental Effects Research Laboratory and approved for publication. Approval does not signify that the contents reflect the views of the agency, nor does mention of trade names or commercial products constitute endorsement or recommendation for use. Received 20 March 2001 ; accepted 9 May 2001.
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