A. Koppan et al. / Health 3 (2011) 571-576
Copyright © 2011 SciRes. Openly accessible at http://www.scirp.org/journal/HEALTH/
575575
sufficient to clarify this point [23-26]. Moreover, these
studies had different end points and they did not focus
on improvement in general condition and pain after
therapy in endometriosis patie nts earlier reporting pelvic
pain. Also, in the study by Mato rras et al., only a trend to
a protective effect of smoking was detected [26]. Miss-
mer et al. observed a complex relation with cigarette
smoking [27]. The rate of endometriosis was not linearly
associated with past smoking dose. However, the rela-
tion with current smoking differed by case-infertility
status. Among women who had never reported infertility,
cigarette smoking was directly associated with risk.
However, when cases were concurrently infertile, cur-
rent smoking was associated with reduced risk.
Based on our results, we can conclude, that regular
smoking might have a disadvantageous impact on the
success rate of combined surgical and medical therapy
for endometriosis re lated pelvic pain. Although there are
several studies focusing on the patomechanism of en-
dometriosis with regard to smoking, to our knowledge,
this is the first report dealing with a possible correlation
between therapy issues and smoking in this field. Even
though our data passed strict statistical analyses, consid-
ering their limited amount, we consider this work as a
preliminary one to initiate specially aimed international
studies to further clarify the issue.
REFERENCES
[1] Birnbaum, L.S. and Cummings, A.M. (2002) Dioxins and
endometriosis: A plausible hypothesis. Environmental
Health Perspectives, 110, 15-21.
doi:10.1289/ehp.0211015
[2] Garai, J., Molnar, V., Varga, T., Koppan, M., Torok, A.
and Bodis, J. (2006) Endometriosis: Harmful survival of
an ectopic tissue. Frontiers in Bioscience, 11, 595-619.
doi:10.2741/1821
[3] Balasch, J., Creus, M., Fabregue s, F., et al. (1996) Visible
and non-visible endometriosis at laparoscopy in fertile
and infertile women and in patients with chronic pelvic
pain: A prospective study. Human Reproduction, 11,
387-391.
[4] Tinelli, A., Martignago, R., Vergara, D., Leo, G., Malvasi,
A. and Tinelli, R. (2008) Endometriosis management:
Workflow on genomics and proteomics and future bio-
molecular pharmacotherapy. Current Medicinal Chemis-
try, 15: 2099-2107. doi:10.2174/092986708785747571
[5] Prentice, A. (2001) Regular review: Endometriosis. Brit-
ish Medical Journal, 323, 93-95.
doi:10.1136/bmj.323.7304.93
[6] McCann, S.E., Freudenheim, J.L., Darrow, S.L., Batt,
R.E. and Zielezny, M.A. (1993) Endometriosis and body
fat distribution. Obstetrics & Gynecology, 82, 545-549.
doi:10.1097/00006250-199310000-00014
[7] Batt, R.E., Buck, G.M. and Smith, R.A. (1997) Health
and fertility outcomes among women surgically treated
for endometriosis. The Journal of the American Associa-
tion of Gynecologic Laparoscopists, 4, 435-442.
doi:10.1016/S1074-3804(05)80035-0
[8] Sutton, C.J., Ewen, S.P., Whitelaw, N. and Haines, P.
(1994) Prospective, randomized, double-blind, controlled
trial of laser laparoscopy in the treatment of pelvic pain
associated with minimal, mild, and moderate endome-
triosis. Fertility and Sterility, 62, 696-700.
[9] Birnbaum, L.S. (1994) Evidence for the role of the Ah
receptor in response to dioxin. In: Spitzer, H.L., Slaga, T.J.,
Greenlee, W.F. and McClain, M., Ed., Receptor-Mediated
Biological Processes: Implications for Evaluating Car-
cinogenesis, Progress in Clinical and Biological Research,
387, Wiley-Liss, New York, 139-54.
[10] Kitamura, M. and Kasai, A. (2007) Cigarette smoke as a
trigger for the dioxin receptor-mediated signaling path-
way. Cancer Letters, 252, 184-194.
doi:10.1016/j.canlet.2006.11.015
[11] Gerhard, I. and Runnebaum, B. (1992) The limits of
hormone substitution in pollutant exposure and fertility
disorders. Zentralblatt für Gynäkologie, 114, 593-602.
[12] Koninckx, P.R., Braet, P., Kennedy, S.H. and Barlow,
D.H. (1994) Dioxin pollution and endometriosis in Bel-
gium. Human Reproduction, 9, 1001-1002.
[13] Eskenazi, B., Mocarelli, P., Warner, M., et al. (2002)
Serum dioxin concentrations and endometriosis: A cohort
study in Seveso, Italy. Environmental Health Perspec-
tives, 110, 629-634. doi:10.1289/ehp.02110629
[14] Bruner, K.L., Matrisian, L.M., Rodgers, W.H., Gorstein,
F. and Osteen, K.G. (1997) Suppression of matrix metal-
loproteinases inhibits establishment of ectopic lesions by
human endometrium in nude mice. The Journal of Clini-
cal Investigation, 99, 2851-2857. doi:10.1172/JCI119478
[15] Cummings, A.M. and Metcalf, J.L. (1995) Effects of
estrogen, progesterone, and methoxychlor on surgically
induced endometriosis in rats. Fundamental and Applied
Toxicology, 27, 287-290. doi:10.1006/faat.1995.1135
[16] Wilson, C.L., Bodnar, J.A., Brown, B.G., Morgan, W.T.,
Potts, R.J. and Borgerding, M.F. (2008) Assessment of
dioxin and dioxin-like compounds in mainstream smoke
from selected US cigarette brands and reference ciga-
rettes. Food and Chemical Toxicology, 46, 1721-1733.
doi:10.1016/j.fct.2008.01.009
[17] IARC Working Group (1997) The evaluation of carcino-
genic risks to humans: Polychlorinated dibenzo-para-
dioxins and polychlorinated dibenzofurans. IARC Mono-
graphs on the Evaluation of Carcinogenic Risks to Hu-
mans, 69, 1-631.
[18] Birnbaum, L.S. and Tuomisto, J. (2000) Non-carcinogenic
effects of TCDD in animals. Food Additives & Contami-
nants, 17, 275-288. doi:10.1080/026520300283351
[19] Yonemoto, J. (2000) The effects of dioxin on reproduc-
tion and developmen t. Industrial Health, 38, 259-268.
doi:10.2486/indhealth.38.259
[20] Lai, Z.W., Pineau, T. and Esser, C. (1996) Identification
of dioxin-responsive elements (DREs) in the 5’ regions
of putative dioxin-inducible genes. Chemico-Biological
Interactions, 100, 97-112.
doi:10.1016/0009-2797(96)03691-5
[21] Lai, Z.W., Hundeiker, C., Gleichmann, E. and Esser, C.
(1997) Cytokine gene expression during ontogeny in
murine thymus on activation of the aryl hydrocarbon re-
ceptor by 2,3,7,8-tetrachlorodibenzo-p-dioxin. Molecular
Pharmacology, 52, 30-37.