Nutritional aspects related to endometriosis / Aspectos nutricionais relacionados à endometriose

SUMMARY This literature review analyzed the evidence on nutritional aspects related to the pathogenesis and progression of endometriosis. Diets deficient in nutrients result in changes in lipid metabolism, oxidative stress and promote epigenetic abnormalities, that may be involved in the genesis and progression of the disease. Foods rich in omega 3 with anti-inflammatory effects, supplementation with Nacetylcysteine, vitamin D and resveratrol, in addition to the increased consumption of fruits, vegetables (preferably organic) and whole grains exert a protective effect, reducing the risk of development and possible regression of disease. Dietary re-education seems to be a promising tool in the prevention and treatment of endometriosis.

RESUMO Esta revisão de literatura analisou as evidências sobre aspectos nutricionais relacionados com a etiopatogenia e a progressão da endometriose. Dietas deficientes em nutrientes refletem-se em alterações no metabolismo lipídico, estresse oxidativo e favorecem anormalidades epigenéticas que podem estar envolvidas na gênese e na progressão da doença. Alimentos ricos em ômega-3, com efeito anti-inflamatório, suplementação com N-acetilcisteína, vitamina D e resveratrol, além do maior consumo de frutas, verduras (preferencialmente orgânicas) e cereais integrais, exercem efeito protetor, com redução no risco de desenvolvimento e possível regressão da doença. A reeducação alimentar parece ser uma ferramenta promissora na prevenção e no tratamento da endometriose.

Nutritional aspects related to endometriosis.

This literature review analyzed the evidence on nutritional aspects related to the pathogenesis and progression of endometriosis. Diets deficient in nutrients result in changes in lipid metabolism, oxidative stress and promote epigenetic abnormalities, that may be involved in the genesis and progression of the disease. Foods rich in omega 3 with anti-inflammatory effects, supplementation with N-acetylcysteine, vitamin D and resveratrol, in addition to the increased consumption of fruits, vegetables (preferably organic) and whole grains exert a protective effect, reducing the risk of development and possible regression of disease. Dietary re-education seems to be a promising tool in the prevention and treatment of endometriosis.

Contraceptive effect of Uncaria tomentosa (cat's claw) in rats with experimental endometriosis.

PURPOSE: Evaluate the histological changes in parenchyma's epithelial layer of the uterus and ovarian of rats with induced endometriosis, treated with Uncaria tomentosa extract. METHODS: 29 rats with experimental endometriosis, were selected and divided in three groups: The uncaria group received 32 mg/ml of Uncaria tomentosa extract, 1 ml administered daily and the placebo group received 1 ml of saline 0.9% per day, during for 14 days (both groups); the leuprolide group received leuprolide acetate 1mg/kg body weight applied single subcutaneous dose. In the 15th day of treatment the uterine horn and ovaries were removed for histopathological analysis. RESULTS: The uncaria group presented nine samples (90%) with immature ovarian follicles, whereas the placebo group did not present any case and in the leuprolide group there were eight rats (88%) with the same change. The placebo group showed mature corpus luteum in all animals, occurring less frequent in uncaria (10%) and leuprolide (22%) groups. The uterine epithelium showed weak proliferative in nine (90%) samples of the uncaria group, in two (20%) animals in the placebo group and seven (77.8%) rats in the leuprolide group. CONCLUSIONS: The findings suggest that Uncaria tomentosa has contraceptive effect.

Changes in the volume and histology of endometriosis foci in rats treated with copaiba oil (Copaiferalangsdorffii).

PURPOSE: The aim of this study was to analyze the changes that occur in rats with experimental endometriosis after treatment with copaiba oil. METHODS: Experimental endometriosis was induced in rats. The experimental group received copaiba oil (Copaiferalangsdorffii) orally (0.63 mg/day), and the control group received a 0.9% sodium chloride solution orally (1 ml/100 g of body weight/day). Both groups were treated with gavage for 14 days. After this period, the animals were euthanized, and the implant volume was calculated. The autologous transplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. RESULTS: The average final volumes were significantly different between the groups (p=0.007). There was a significant increase (p=0.012) between the initial and final volumes in the control group, whereas treatment with Copaiferalangsdorffii caused a marked reduction in endometrial growth over time (p=0.016). Histologically, 6/11 (55.00%) rats in the experimental group had a well-preserved epithelial layer, and 3 (45.00%) had mildly preserved epithelium. The control group had seven cases (58.30%) of well-preserved epithelial cells and five cases (41.70%) of mildly preserved epithelial cells (p>0.05). CONCLUSION: Copaiba oil (Copaiferalangsdorffii) appears to be a promising alternative treatment for endometriosis.

Experimental endometriosis reduction in rats treated with Uncaria tomentosa (cat's claw) extract.

OBJECTIVE: The aim of this study was to analyze the macroscopic and histological changes that occur in experimental endometriosis after treatment with Uncaria tomentosa. STUDY DESIGN: Experimental endometriosis was induced in twenty-five female Wistar rats. After three weeks, 24 animals developed grade III experimental endometriosis and were divided into two groups. Group "U" received U. tomentosa extract orally (32 mg/day), and group "C" (control group) received a 0.9% sodium chloride solution orally (1 ml/100g of body weight/day). Both groups were treated with gavage for 14 days. At the surgical intervention and after the animal was euthanized, the implant volume was calculated with the following formula: [4π (length/2)×(width/2)×(height/2)/3]. The autotransplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. The Mann-Whitney test was used for the independent samples, and the Wilcoxon test analyzed the related samples, with a significance level of 5%. RESULTS: The difference between the initial average volumes of the autotransplants was not significant between the groups (p = 0.18). However, the final average volumes were significantly different between the groups (p = 0.001). There was a significant increase (p = 0.01) between the initial and final average volumes in the control group, and treatment with the U. tomentosa caused a marked reduction in the growth over time (p = 0.009). Histologically, in the experimental group (n = 10) six rats had a well-preserved epithelial layer, three had mildly preserved epithelium, and one had poorly preserved epithelium. The epithelial layer occasionally presented sporadic epithelial cells. The control group (n = 12) presented seven cases (58.3%) of well-preserved epithelial cells and five cases (41.7%) of mildly preserved epithelial cells. CONCLUSIONS: Cat's claw extract appears to be a promising alternative for treating endometriosis.

Contraceptive effect of Uncaria tomentosa (cat's claw) in rats with experimental endometriosis / Efeito anticoncepcional da Uncaria tomentosa (unha-de-gato) em ratas com endometriose experimental

PURPOSE: Evaluate the histological changes in parenchyma´s epithelial layer of the uterus and ovarian of rats with induced endometriosis, treated with Uncaria tomentosa extract. METHODS: 29 rats with experimental endometriosis, were selected and divided in three groups: The uncaria group received 32mg/ml of Uncaria tomentosa extract, 1ml administered daily and the placebo group received 1ml of saline 0.9 percent per day, during for 14 days (both groups); the leuprolide group received leuprolide acetate 1mg/kg body weight applied single subcutaneous dose. In the 15th day of treatment the uterine horn and ovaries were removed for histopathological analysis. RESULTS: The uncaria group presented nine samples (90 percent) with immature ovarian follicles, whereas the placebo group did not present any case and in the leuprolide group there were eight rats (88 percent) with the same change. The placebo group showed mature corpus luteum in all animals, occurring less frequent in uncaria (10 percent) and leuprolide (22 percent) groups. The uterine epithelium showed weak proliferative in nine (90 percent) samples of the uncaria group, in two (20 percent) animals in the placebo group and seven (77.8 percent) rats in the leuprolide group. CONCLUSIONS: The findings suggest that Uncaria tomentosa has contraceptive effect.

OBJETIVO: Avaliação histológica do útero e parênquima ovariano de ratas com endometriose induzida tratadas com extrato de Uncaria tomentosa. MÉTODOS: Foram selecionadas 29 ratas com endometriose experimental e formados três grupos: O grupo uncaria recebeu extrato de Uncaria tomentosa com 32mg/ml, administrado 1ml ao dia e o grupo placebo recebeu 1ml de solução salina a 0,9 por cento, ambos por 14 dias; o grupo leuprolida recebeu acetato de leuprolida 1mg/kg de peso corporal aplicado via subcutânea dose única. No 15° dia de tratamento realizou-se retirada de corno uterino e ovários para análise histopatológica. RESULTADOS: O grupo uncaria apresentou nove amostras (90 por cento) com maturação incompleta dos folículos ovarianos, já o grupo placebo não apresentou nenhum caso e no grupo leuprolida houve oito ratas (88 por cento) com a mesma alteração. O grupo placebo apresentou corpo lúteo maduro em todos os animais, acontecendo de forma menos freqüente nos grupos uncaria (10 por cento) e leuprolida (22 por cento). O epitélio uterino se mostrou fracamente proliferativo em nove (90 por cento) das amostras do grupo unacaria, em dois (20 por cento) casos do grupo placebo e sete (77.8 por cento) casos no grupo leuprolida. CONCLUSÃO: Os achados sugerem que a Uncaria tomentosa tem efeito anticoncepcional.

Changes in the volume and histology of endometriosis foci in rats treated with copaiba oil (Copaiferalangsdorffii) / Mudanças no volume e histologia do foco de endometriose em ratas tratadas com óleo de Copaíba (Copaiferalangsdorffii)

PURPOSE: The aim of this study was to analyze the changes that occur in rats with experimental endometriosis after treatment with copaiba oil. METHODS: Experimental endometriosis was induced in rats. The experimental group received copaiba oil (Copaiferalangsdorffii) orally (0.63 mg/day), and the control group received a 0.9 percent sodium chloride solution orally (1 ml/100 g of body weight/day). Both groups were treated with gavage for 14 days. After this period, the animals were euthanized, and the implant volume was calculated. The autologous transplants were removed, dyed with hematoxylin-eosin, and analyzed by light microscopy. RESULTS: The average final volumes were significantly different between the groups (p=0.007). There was a significant increase (p=0.012) between the initial and final volumes in the control group, whereas treatment with Copaiferalangsdorffii caused a marked reduction in endometrial growth over time (p=0.016). Histologically, 6/11 (55.00 percent) rats in the experimental group had a well-preserved epithelial layer, and 3 (45.00 percent) had mildly preserved epithelium. The control group had seven cases (58.30 percent) of well-preserved epithelial cells and five cases (41.70 percent) of mildly preserved epithelial cells (p>0.05). CONCLUSION: Copaiba oil (Copaiferalangsdorffii) appears to be a promising alternative treatment for endometriosis.

OBJETIVO: O objetivo deste estudo foi analisar as mudanças que ocorreram em ratas com endometrioses experimental tratadas com óleo de copaíba. MÉTODOS: Foi induzida a endometriose experimental nas ratas. O grupo experimental recebeu óleo de copaíba (Copaiferalangsdorffii) oralmente (0,63mg/dia) e o grupo controle recebeu oralmente solução salina 0,9 por cento (1mL/100g/dia). Ambos grupos foram tratados por gavagem por 14 dias. Depois desse período, foi realizada a eutanásia dos animais e calculado o volume do implante. Os transplantes autólogos foram removidos, corados com Hematoxilina-eosina e realizada a microscopia óptica. RESULTADOS: A média final dos volumes foi significativamente diferente entre os grupos (p=0,007). Houve um aumente significante (p=0,12) entre o volume inicial e final do grupo controle, enquanto no grupo tratado com Copaiferalangsdorffii causou uma redução acentuada no crescimento endometrial ao longo durante o período (p=0,016). Histologicamente,6 das 11 (55 por cento) ratas do grupo experimental tinha uma camada epitelial bem preservada e 3 (45 por cento) apresentaram epitélio levemente preservado. O grupo controle apresentou sete casos (58,3 por cento) de células epiteliais bem preservadas e cinco casos (41,7 por cento) de células epiteliais levemente preservadas (p>0,05). CONCLUSÃO: O óleo de copaíba (Copaiferalangsdorffii) parece ser um tratamento alternativo promissor para endometriose.