Gums and Gremlins: Endometriosis research update.
This information is provided for couples who are trying to conceive and have an interest in endometriosis research. For further information on this complex disorder see the information on this website and link to www.endometriosisassn.org. The association has a focus on research into dioxins in the environment and the link to this disorder. This article is provided by CNY Fertility Centers in Rochester, NY, Syracuse, NY and Albany, New York.
International findings from endometriosis research were grouped into the February 2009 issue of Fertility and Sterility, the journal of the American Society for Reproductive Medicine. Perhaps the most innovative came from China. Levels of Gremlin 1, an oddly named chemical antibody, were found to be elevated the blood of women with endometriosis. This is a highly specific test which relates to growth of small blood vessels such as occur in the endometrium. It is hoped that this could develop into a biomarker for the disease which is a common cause of infertility. Currently only laparoscopy is definitive in diagnosing endometriosis. Other biomarkers are being explored but have not proven to be specific. Sha G et al. Elevated levels of gremlin-1 in …patients with endometriosis Fertil Steril 2009; 350-37.
In a study of interest from the University of Michigan, the link between two diseases which involve inflammatory processes were explored. The odds of having gingivitis inflammation of the gums were 57% higher than normal if a woman had endometriosis. Both diseases involve altered immune response. Interestingly preterm labor is among several disorders associated with gingivitis. Further, women with endometriosis and gingivitis have increased incidence of other autoimmune diseases such as asthma, lupus, and multiple sclerosis. The term global immune dissociation has been used. Kavoussi SK et al Periodontal disease and endometriosis Fertil Steril 2009; 91:335-342
A team for Florence Italy explored the reduced immunity which allows endometrial cells to implant in the pelvis in women who have endometriosis. It is normal for cells shed form the endometrium to travel out the tubes and into the pelvis during menses. In 5-20 % of women, there may be an immune defect in the peritoneal cavity which allows those cells to grow. It has been shown that the endometriosis patients have decreased natural killer cells and T cells. A special messenger peptide called CXCL10 has been found to be low in the blood and abdominal cavity in women with endometriosis. Galleri L, et al Low serum … CXCL10… in endometriosis. Fertil Steril 2009;91:331-334
Perhaps the reduced immunity which allows endometriosis to occur also predisposes to gingivitis and other disorders.
Editor, Joe B Massey MD