Endometriosis had been scientifically related, chronic systemic inflammatory disease characterized by the presence of tissue similar to endometrium outside the uterus, with depression, anxiety and eating disorders. Previous studies had also pointed out as a risk factor to suffer cardiovascular diseases or sudden death. Now, a new investigation led by the University of Barcelona (Ub) relates the appearance of pathology with having suffered traumatic experiences or stressful events during life. Specifically, the evidence of the study shows that this ailment seems to be closely linked to contact traumathat is, those cases in which there is a direct physical interaction between the victim and the abuser, such as physical abuse or sexual aggressions.
According to the research, published in the magazine ‘Jama Psychiatry’, This relationship “would be independent of the genetic predisposition to suffer from the disease.” According to the study authors, the results could be helpful in order to improve the detection of the disease, which affects 190 million women of reproductive age worldwide.
Dora Kollerfirst author of the article and researcher of the Department of Genetics, Microbiology and Statistics of the Faculty of Biology of the UB, explains that «although psychological traumas have been associated with endometriosis, so far there was little information about the role of the type of type of trauma and genetic predisposition ». «These results The established paradigms challenge Upon discovering the shared genetic mechanisms that link endometriosis with post -traumatic stress disorder and other types of traumas, while providing new knowledge about how different types of traumatic events are associated with the disease, ”he says Kollerwho is also a researcher in the Department of Psychiatry of the Yale School of Medicine.
According to the expert in statements to ABC, the results of the study will help move towards the early detection of the disease and “will turn a diagnosis.” «Until now the diagnosis is reached taking into account the basically gynecological symptoms But it is very important to give it a more global approach and also take into account the mental health of the affected one, if he has suffered traumatic experiences during his life, ”says Koller.
The expert emphasizes, in this sense, the “importance of analyzing these patients in a global way.” «The women who suffer from it pass many years without a diagnosis And that affects their mental health because it entails a lot of stress that sometimes it is difficult to resist. Hence the link indicated by an previous study between the disease and the appearance of stress tables, “says Koller.
In work has also participated Marina MitjansResearcher of the same department, of the Institute of Biomedicine of the UB (IBUB), of the Sant Joan de Déu (IRSJD) Research Institute and the CIBER Mental Health Area (CIBERSAM). The rest of the authors are part of the Bergen University (Norway), the Karolinska Institute (Sweden), la Oxford University (United Kingdom), La Harvard Th Chan School of Public Health (United States) and Massachusetts General Hospital (USA).
Research has been based on observational and genetic analysis of data from 8,276 women with endometriosis and 240,117 controls Inscribed in the United Kingdom Biobanco (UK Biobank), a biomedical database that contains genetic information, lifestyle and anonymous health, as well as biological samples of people from the United Kingdom. Participants in the study and women members of the control sample were submitted to a questionnaire to evaluate their mental health.
«Diagnosis that threatens life»
“Our study shows that people with endometriosis were more likely to experience certain traumatic events compared to healthy people,” he says Dora Koller. For example, people with endometriosis had a 17% more likely to have witnessed a sudden death, a 16% greater probability of having suffered sexual assault in adulthood and a 36% probability of having received a diagnosis than a diagnosis than a diagnosis than a diagnosis Threaten your life.
To explore the connection between the different types of trauma, the researchers made a latent class analysis, A research tool that unravels hidden groups in a data set. “A greater number of endometriosis cases could be related to emotional, physical and sexual traumas,” says Koller.
The genetic analysis of the research consisted mainly of an association study of the complete genome (GWAS) of endometriosis and also an analysis of the interaction between traumatic events and the polygenic risk of endometriosisan approach that evaluates the combined impact of multiple genetic variants in the development of a disease, instead of focusing on a single gene.
The results of these analyzes have revealed that the disease is genetically correlated with several situations associated with trauma, being the strongest evidence linked to the disorder of posttraumatic stress and child abuse. “Child trauma – for example, feeling hated by a family member when he was a child and being physically mistreated by the family – also related to endometriosis, which highlights the potential role of early adverse experiences in the configuration in the configuration of the risk and progression of endometriosis, ”says the researcher.
Other genetically inferred relationships included situations related to the existence of someone who could lead to the participants of the doctor during their childhood. According to Koller, this aspect would be “especially important” in the case of endometriosis, since having caregivers who guarantee access to medical care during this stage of life can influence the Resilience to stress And in the search behavior of this attention, reducing the probability of a diagnosis and insufficient treatment. “It is possible that people who lack the support of caregivers are less likely to defend their health,” says the researcher.
Correlations between genes and atmosphere
The results also show that the relationship between the genetic risk of endometriosis and the traumas does not seem to be due to a direct interaction between genes and environment, but would be explained by correlations between genes and environment. That is, for example, people with a certain Genetic predisposition They could be more likely to experience or remember certain traumatic events, which could influence their risk of developing endometriosis. Koller stresses that «based on the reclassification proposed by Hugh Taylor (also co -author of the current study) of endometriosis as a chronic systemic disease with manifestations outside the reproductive tract, our findings highlight how the traumas of childhood and adulthood They can contribute to pathogenesis of endometriosis with mechanisms that seem independent of their genetic predisposition ».
Previous study that links it to depression
The links identified between endometriosis and traumatic events coincide with a previous study of the same research team that related the disease to depression, anxiety and eating disorders. These combined findings show the importance of Evaluate physical and mental health of patients with endometriosis. «Although it will be necessary to confirm the results in other cohorts, the results suggest that we could design early endometriosis detection programs taking into account not only genetic factors, but also a history of physical traumas or other risk factors. This would help identify and treat the disease more comprehensive and effective, ”says Koller. “It is important to move towards an earlier diagnosis to improve the quality of life of these patients,” concludes the researcher.
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