Multigenerational endometriosis : consequence of fetal exposure to diethylstilbestrol ?

Environmental Health

Nicolas Kalfa¹  Charles Sultan²  Laura Gaspari³  Françoise Paris³  Marie-Odile Soyer-Gobillard⁴  Samir Hamamah⁵ 

[1] CHU Montpellier, Univ Montpellier, Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, Montpellier, France;CHU Montpellier, Univ Montpellier, Département de Chirurgie Pédiatrique, Hôpital Lapeyronie, Montpellier, France;CHU Montpellier, Univ Montpellier, Unité d’Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Montpellier, France;CHU Montpellier, Univ Montpellier, Unité d’Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Montpellier, France;CHU Montpellier, Univ Montpellier, Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, Montpellier, France;Univ Montpellier, INSERM 1203, Développement Embryonnaire Fertilité Environnement, Montpellier, France;CNRS, Université Sorbonne, Paris, France;Association Hhorages-France, F-Asnières-sur-Oise, France;Univ Montpellier, INSERM 1203, Développement Embryonnaire Fertilité Environnement, Montpellier, France;CHU Montpellier, Univ Montpellier, Département de Biologie de la Reproduction, Biologie de la Reproduction/DPI et CECOS, Montpellier, France;

关键词: Familial endometriosis;    Diethylstilbestrol (DES);    Multigenerational transmission;    Prenatal exposure;    Endocrine-disrupting chemicals (EDC);   

DOI  :  10.1186/s12940-021-00780-5

来源: Springer

【 摘 要 】

BackgroundEndometriosis, which affects 10–15 % of women of reproductive age, is an estrogen-driven condition influenced by environmental and genetic factors. Exposition to estrogen-like endocrine-disrupting chemicals (EDCs) has been reported to contribute to the fetal origin of this disease.Case presentationWe report here an informative family in which all prenatally DES-exposed daughters and subsequent granddaughters presented endometriosis, whereas the unexposed first daughter and her progeny presented no gynecological disorders. Moreover, the only post-pubertal great-granddaughter, who presents chronic dysmenorrhea that remains resistant to conventional therapy, is at risk of developing endometriosis. The mother (I-2) was prescribed DES (30 mg/day for 3 months) to inhibit lactation after each delivery.ConclusionsAlthough a direct causal link between the grandmother’s treatment with DES and the development of endometriosis in possibly three exposed generations remains speculative, this report strengthens the suspicion that fetal exposition to DES contributes to the pathogenesis of adult diseases, such as endometriosis. It also highlights a multigenerational and likely transgenerational effect of EDCs.

【 授权许可】

CC BY