1 6338 121 THE ROLE OF ENDOCRINE-DISRUPTING CHEMICALS IN UTERINE FIBROID PATHOGENESIS. PURPOSE OF REVIEW: UTERINE LEIOMYOMA (FIBROIDS) IS A GYNECOLOGIC DISORDER IMPACTING THE MAJORITY OF WOMEN IN THE UNITED STATES. WHEN SYMPTOMATIC, THESE NONCANCEROUS TUMORS CAN CAUSE SEVERE MORBIDITY INCLUDING PELVIC PAIN, MENORRHAGIA, AND INFERTILITY. ENDOCRINE-DISRUPTING CHEMICALS (EDCS) MAY REPRESENT A MODIFIABLE RISK FACTOR. THE AIM OF THIS REVIEW IS TO SUMMARIZE RECENT HUMAN AND EXPERIMENTAL EVIDENCE ON EDCS EXPOSURES AND FIBROIDS. RECENT FINDINGS: MULTIPLE EDCS ARE ASSOCIATED WITH FIBROID OUTCOMES AND/OR PROCESSES INCLUDING PHTHALATES, PARABENS, ENVIRONMENTAL PHENOLS, ALTERNATE PLASTICIZERS, DIETHYLSTILBESTROL, ORGANOPHOSPHATE ESTERS, AND TRIBUTYLTIN. EPIDEMIOLOGIC STUDIES SUGGEST EXPOSURE TO CERTAIN EDCS, SUCH AS DI-(2-ETHYLHXYL)-PHTHALATE (DEHP), ARE ASSOCIATED WITH INCREASED FIBROID RISK AND SEVERITY. BOTH HUMAN AND EXPERIMENTAL STUDIES INDICATE THAT EPIGENETIC PROCESSES MAY PLAY AN IMPORTANT ROLE IN LINKING EDCS TO FIBROID PATHOGENESIS. IN-VITRO AND IN-VIVO STUDIES SHOW THAT DEHP, BISPHENOL A, AND DIETHYLSTILBESTROL CAN IMPACT BIOLOGICAL PATHWAYS CRITICAL TO FIBROID PATHOGENESIS. SUMMARY: WHILE RESEARCH ON EDCS AND FIBROIDS IS STILL EVOLVING, RECENT EVIDENCE SUGGESTS EDC EXPOSURES MAY CONTRIBUTE TO FIBROID RISK AND PROGRESSION. FURTHER RESEARCH IS NEEDED TO EXAMINE THE IMPACTS OF EDC MIXTURES AND TO IDENTIFY CRITICAL BIOLOGICAL PATHWAYS AND WINDOWS OF EXPOSURE. THESE RESULTS COULD OPEN THE DOOR TO NEW PREVENTION STRATEGIES FOR FIBROIDS. 2020 2 4723 16 NONHUMAN PRIMATE MODELS OF POLYCYSTIC OVARY SYNDROME. WITH CLOSE GENOMIC AND PHENOTYPIC SIMILARITY TO HUMANS, NONHUMAN PRIMATE MODELS PROVIDE COMPREHENSIVE EPIGENETIC MIMICS OF POLYCYSTIC OVARY SYNDROME (PCOS), SUGGESTING EARLY LIFE TARGETING FOR PREVENTION. FETAL EXPOSURE TO TESTOSTERONE (T), OF ALL NONHUMAN PRIMATE EMULATIONS, PROVIDES THE CLOSEST PCOS-LIKE PHENOTYPES, WITH EARLY-TO-MID GESTATION T-EXPOSED FEMALE RHESUS MONKEYS EXHIBITING ADULT REPRODUCTIVE, ENDOCRINOLOGICAL AND METABOLIC DYSFUNCTIONAL TRAITS THAT ARE CO-PATHOLOGIES OF PCOS. LATE GESTATIONAL T EXPOSURE, WHILE INDUCING ADULT OVARIAN HYPERANDROGENISM AND MENSTRUAL ABNORMALITIES, HAS LESS DYSFUNCTIONAL METABOLIC ACCOMPANIMENT. FETAL EXPOSURES TO DIHYDROTESTOSTERONE (DHT) OR DIETHYLSTILBESTROL (DES) SUGGEST ANDROGENIC AND ESTROGENIC ASPECTS OF FETAL PROGRAMMING. NEONATAL EXPOSURE TO T PRODUCES NO PCOS-LIKE OUTCOME, WHILE CONTINUOUS T TREATMENT OF JUVENILE FEMALES CAUSES PRECOCIOUS WEIGHT GAIN AND EARLY MENARCHE (HIGH T), OR HIGH LH AND WEIGHT GAIN (MODERATE T). ACUTE T EXPOSURE OF ADULT FEMALES GENERATES POLYFOLLICULAR OVARIES, WHILE CHRONIC T EXPOSURE INDUCES SUBTLE MENSTRUAL IRREGULARITIES WITHOUT METABOLIC DYSFUNCTION. 2013 3 1744 32 EARLY LIFE ADVERSE ENVIRONMENTAL EXPOSURES INCREASE THE RISK OF UTERINE FIBROID DEVELOPMENT: ROLE OF EPIGENETIC REGULATION. UTERINE FIBROIDS [UF(S), AKA: LEIOMYOMA] ARE THE MOST IMPORTANT BENIGN NEOPLASTIC THREAT TO WOMEN'S HEALTH. THEY ARE THE MOST COMMON CAUSE OF HYSTERECTOMY IMPOSING UNTOLD PERSONAL CONSEQUENCES AND 100S OF BILLIONS OF HEALTHCARE DOLLARS, WORLDWIDE. CURRENTLY, THERE IS NO LONG TERM EFFECTIVE FDA-APPROVED MEDICAL TREATMENT AVAILABLE, AND SURGERY IS THE MAINSTAY. THE ETIOLOGY OF UFS IS NOT FULLY UNDERSTOOD. IN THIS REGARD, WE AND OTHERS HAVE RECENTLY REPORTED THAT SOMATIC MUTATIONS IN THE GENE ENCODING THE TRANSCRIPTIONAL MEDIATOR SUBUNIT MED12 ARE FOUND TO OCCUR AT A HIGH FREQUENCY ( APPROXIMATELY 85%) IN UFS. UFS LIKELY ORIGINATE WHEN A MED12 MUTATION OCCURS IN A MYOMETRIAL STEM CELL CONVERTING IT INTO A TUMOR-FORMING STEM CELL LEADING TO A CLONAL FIBROID LESION. ALTHOUGH THE MOLECULAR ATTRIBUTES UNDERLYING THE MECHANISTIC FORMATION OF UFS IS LARGELY UNKNOWN, A GROWING BODY OF LITERATURE IMPLICATES UNFAVORABLE EARLY LIFE ENVIRONMENTAL EXPOSURES AS POTENTIALLY IMPORTANT CONTRIBUTORS. EARLY LIFE EXPOSURE TO EDCS DURING SENSITIVE WINDOWS OF DEVELOPMENT CAN REPROGRAM NORMAL PHYSIOLOGICAL RESPONSES AND ALTER DISEASE SUSCEPTIBILITY LATER IN LIFE. NEONATAL EXPOSURE TO THE EDCS SUCH AS DIETHYLSTILBESTROL (DES) AND GENISTEIN DURING REPRODUCTIVE TRACT DEVELOPMENT HAS BEEN SHOWN TO INCREASE THE INCIDENCE, MULTIPLICITY AND OVERALL SIZE OF UFS IN THE EKER RAT MODEL, CONCOMITANTLY REPROGRAMMING ESTROGEN-RESPONSIVE GENE EXPRESSION. IMPORTANTLY, EDC EXPOSURE REPRESSES ENHANCER OF ZESTE 2 (EZH2) AND REDUCES LEVELS OF HISTONE 3 LYSINE 27 TRIMETHYLATION (H3K27ME3) REPRESSIVE MARK THROUGH ESTROGEN RECEPTOR/PHOSPHATIDYLINOSITIDE 3-KINASES/PROTEIN KINASE B NON-GENOMIC SIGNALING IN THE DEVELOPING UTERUS. CONSIDERING THE FACT THAT DISTINCT MEDIATOR COMPLEX SUBUNIT 12 (MED12) MUTATIONS ARE DETECTED IN DIFFERENT FIBROID LESIONS IN THE SAME UTERUS, THE EMERGENCE OF EACH MED12 MUTATION IS LIKELY AN INDEPENDENT EVENT IN AN ALTERED MYOMETRIAL STEM CELL. IT IS THEREFORE POSSIBLE THAT A CHRONIC REDUCTION IN DNA REPAIR CAPACITY EVENTUALLY CAUSES THE EMERGENCE OF MUTATIONS SUCH AS MED12 IN MYOMETRIAL STEM CELLS CONVERTING THEM INTO FIBROID TUMOR-FORMING STEM CELLS, AND THEREBY LEADS TO THE DEVELOPMENT OF UFS. ADVANCING OUR UNDERSTANDING OF THE MECHANISTIC ROLE EPIGENETIC REGULATION OF STEM CELLS PLAYS IN MEDIATING RISK AND TUMORIGENESIS WILL HELP IN POINTING THE WAY TOWARD THE DEVELOPMENT OF NOVEL THERAPEUTIC OPTIONS. 2016 4 3174 35 H19 LNCRNA IDENTIFIED AS A MASTER REGULATOR OF GENES THAT DRIVE UTERINE LEIOMYOMAS. UTERINE LEIOMYOMAS OR FIBROIDS (UFS) ARE BENIGN TUMORS CHARACTERIZED BY HYPERPLASTIC SMOOTH MUSCLE CELLS AND EXCESSIVE DEPOSITION OF EXTRACELLULAR MATRIX (ECM). AFFLICTING ~80% OF WOMEN, AND SYMPTOMATIC IN 25%, UFS BRING TREMENDOUS SUFFERING AND ARE AN ECONOMIC BURDEN WORLDWIDE; THEY CAUSE SEVERE PAIN AND BLEEDING, AND ARE THE LEADING CAUSE OF HYSTERECTOMY. YET, UFS ARE SEVERELY UNDERSTUDIED WITH FEW EFFECTIVE TREATMENT OPTIONS AVAILABLE; THOSE THAT ARE AVAILABLE FREQUENTLY HAVE SIGNIFICANT SIDE EFFECTS SUCH AS MENOPAUSAL SYMPTOMS. RECENTLY, INTEGRATED GENOME-SCALE STUDIES HAVE REVEALED MUTATIONS AND FIBROID SUBTYPE-SPECIFIC EXPRESSION CHANGES IN KEY DRIVER GENES, WITH MED12 AND HMGA2 TOGETHER CONTRIBUTING TO NEARLY 90% OF ALL UFS, BUT THEIR REGULATION OF EXPRESSION IS POORLY CHARACTERIZED. HERE WE REPORT THAT THE EXPRESSION OF H19 LONG NONCODING RNA (LNCRNA) IS ABERRANTLY INCREASED IN UFS. USING CELL CULTURE AND GENOME-WIDE TRANSCRIPTOME AND METHYLATION PROFILING ANALYSES, WE DEMONSTRATE THAT H19 PROMOTES EXPRESSION OF MED12, HMGA2, AND KEY ECM-REMODELING GENES VIA MULTIPLE MECHANISMS INCLUDING A NEW CLASS OF EPIGENETIC MODIFICATION BY TET3. OUR RESULTS MARK THE FIRST EXAMPLE OF AN EVOLUTIONARILY CONSERVED LNCRNA IN PATHOGENESIS OF UFS AND REGULATION OF TET EXPRESSION. GIVEN THE LINK BETWEEN A H19 SINGLE-NUCLEOTIDE POLYMORPHISM (SNP) AND INCREASED RISK AND TUMOR SIZE OF UFS, AND THE EXISTENCE OF MULTIPLE FIBROID SUBTYPES DRIVEN BY KEY PATHWAY GENES REGULATED BY H19, WE PROPOSE A UNIFYING MECHANISM FOR PATHOGENESIS OF UTERINE FIBROIDS MEDIATED BY H19 AND IDENTIFY A PATHWAY FOR FUTURE EXPLORATION OF NOVEL TARGET THERAPIES FOR UTERINE LEIOMYOMAS. 2019 5 1929 31 ENVIRONMENTAL EXPOSURE, DNA METHYLATION, AND GENE REGULATION: LESSONS FROM DIETHYLSTILBESTEROL-INDUCED CANCERS. DNA METHYLATION IS AN EPIGENETIC MECHANISM THAT REGULATES CHROMOSOMAL STABILITY AND GENE EXPRESSION. ABNORMAL DNA METHYLATION PATTERNS HAVE BEEN OBSERVED IN MANY TYPES OF HUMAN TUMORS, INCLUDING THOSE OF THE BREAST, PROSTATE, COLON, THYROID, STOMACH, UTERUS, AND CERVIX. WE AND OTHERS HAVE SHOWN THAT EXPOSURE TO A WIDE VARIETY OF XENOBIOTICS DURING CRITICAL PERIODS OF MAMMALIAN DEVELOPMENT CAN PERSISTENTLY ALTER THE PATTERN OF DNA METHYLATION, RESULTING IN POTENTIALLY ADVERSE BIOLOGICAL EFFECTS SUCH AS ABERRANT GENE EXPRESSION. THUS, THIS EPIGENETIC MECHANISM MAY UNDERLIE THE OBSERVED INCREASED RISK IN ADULTHOOD OF SEVERAL CHRONIC DISEASES, INCLUDING CANCER, IN RESPONSE TO XENOBIOTIC EXPOSURES EARLY IN LIFE. WE PRESENT HERE THE LESSONS LEARNED FROM STUDIES ON THE EFFECTS OF PERINATAL DIETHYLSTILBESTEROL (DES) EXPOSURE ON THE METHYLATION PATTERN OF THE PROMOTERS OF SEVERAL ESTROGEN-RESPONSIVE GENES ASSOCIATED WITH THE DEVELOPMENT OF REPRODUCTIVE ORGANS. PERINATAL DES EXPOSURE, WHICH INDUCES EPITHELIAL TUMORS OF THE UTERUS IN MICE AND IS ASSOCIATED WITH SEVERAL REPRODUCTIVE TRACT ABNORMALITIES AND INCREASED VAGINAL AND CERVICAL CANCER RISK IN WOMEN, PROVIDES A CLEAR EXAMPLE OF HOW ESTROGENIC XENOBIOTIC EXPOSURE DURING A CRITICAL PERIOD OF DEVELOPMENT CAN ABNORMALLY DEMETHYLATE DNA SEQUENCES DURING ORGAN DEVELOPMENT AND POSSIBLY INCREASE CANCER RISK LATER IN LIFE. IN ADDITION, NUTRITIONAL FACTORS AND STRESS MAY ALSO ALTER DNA METHYLATION DURING EARLY LIFE AND MODULATE THE RISK OF CANCER AND OTHER CHRONIC DISEASES IN ADULTHOOD. WE SUGGEST THAT DNA METHYLATION STATUS MAY BE INFLUENCED BY ENVIRONMENTAL EXPOSURES IN EARLY LIFE, LEADING TO INCREASED RISK OF CANCER IN ADULTHOOD. 2003 6 2295 27 EPIGENETIC REGULATION IN UTERINE FIBROIDS-THE ROLE OF TEN-ELEVEN TRANSLOCATION ENZYMES AND THEIR POTENTIAL THERAPEUTIC APPLICATION. UTERINE FIBROIDS (UFS) ARE MONOCLONAL, BENIGN TUMORS THAT CONTAIN ABNORMAL SMOOTH MUSCLE CELLS AND THE ACCUMULATION OF EXTRACELLULAR MATRIX (ECM). ALTHOUGH BENIGN, UFS ARE A MAJOR SOURCE OF GYNECOLOGIC AND REPRODUCTIVE DYSFUNCTION, RANGING FROM MENORRHAGIA AND PELVIC PAIN TO INFERTILITY, RECURRENT MISCARRIAGE, AND PRETERM LABOR. MANY RISK FACTORS ARE INVOLVED IN THE PATHOGENESIS OF UFS VIA GENETIC AND EPIGENETIC MECHANISMS. THE LATTER INVOLVING DNA METHYLATION AND DEMETHYLATION REACTIONS PROVIDE SPECIFIC DNA METHYLATION PATTERNS THAT REGULATE GENE EXPRESSION. ACTIVE DNA DEMETHYLATION REACTIONS MEDIATED BY TEN-ELEVEN TRANSLOCATION PROTEINS (TETS) AND ELEVATED LEVELS OF 5-HYDROXYMETHYLCYTOSINE HAVE BEEN SUGGESTED TO BE INVOLVED IN UF FORMATION. THIS REVIEW PAPER SUMMARIZES THE MAIN FINDINGS REGARDING THE FUNCTION OF TET ENZYMES AND THEIR ACTIVITY DYSREGULATION THAT MAY TRIGGER THE DEVELOPMENT OF UFS. UNDERSTANDING THE ROLE THAT EPIGENETICS PLAYS IN THE PATHOGENESIS OF UFS MAY POSSIBLY LEAD TO A NEW TYPE OF PHARMACOLOGICAL FERTILITY-SPARING TREATMENT METHOD. 2022 7 4413 35 MOLECULAR AND CELLULAR INSIGHTS INTO THE DEVELOPMENT OF UTERINE FIBROIDS. UTERINE LEIOMYOMAS REPRESENT THE MOST COMMON BENIGN GYNECOLOGIC TUMOR. THESE HORMONE-DEPENDENT SMOOTH-MUSCLE FORMATIONS OCCUR WITH AN ESTIMATED PREVALENCE OF ~70% AMONG WOMEN OF REPRODUCTIVE AGE AND CAUSE SYMPTOMS INCLUDING PAIN, ABNORMAL UTERINE BLEEDING, INFERTILITY, AND RECURRENT ABORTION. DESPITE THE PREVALENCE AND PUBLIC HEALTH IMPACT OF UTERINE LEIOMYOMAS, AVAILABLE TREATMENTS REMAIN LIMITED. AMONG THE POTENTIAL CAUSES OF LEIOMYOMAS, EARLY HORMONAL EXPOSURE DURING PERIODS OF DEVELOPMENT MAY RESULT IN DEVELOPMENTAL REPROGRAMMING VIA EPIGENETIC CHANGES THAT PERSIST IN ADULTHOOD, LEADING TO DISEASE ONSET OR PROGRESSION. RECENT DEVELOPMENTS IN UNBIASED HIGH-THROUGHPUT SEQUENCING TECHNOLOGY ENABLE POWERFUL APPROACHES TO DETECT DRIVER MUTATIONS, YIELDING NEW INSIGHTS INTO THE GENOMIC INSTABILITY OF LEIOMYOMAS. CURRENT DATA ALSO SUGGEST THAT EACH LEIOMYOMA ORIGINATES FROM THE CLONAL EXPANSION OF A SINGLE TRANSFORMED SOMATIC STEM CELL OF THE MYOMETRIUM. IN THIS REVIEW, WE PROPOSE AN INTEGRATED CELLULAR AND MOLECULAR VIEW OF THE ORIGINS OF LEIOMYOMAS, AS WELL AS PARADIGM-SHIFTING STUDIES THAT WILL LEAD TO BETTER UNDERSTANDING AND THE FUTURE DEVELOPMENT OF NON-SURGICAL TREATMENTS FOR THESE HIGHLY FREQUENT TUMORS. 2021 8 1767 39 EARLY-LIFE EXPOSURE TO ENDOCRINE DISRUPTING CHEMICALS AND LATER-LIFE HEALTH OUTCOMES: AN EPIGENETIC BRIDGE? A GROWING BODY OF EVIDENCE DEMONSTRATES THAT ADVERSE EVENTS EARLY IN DEVELOPMENT, AND PARTICULARLY DURING INTRAUTERINE LIFE, MAY PROGRAM RISKS FOR DISEASES IN ADULT LIFE. INCREASING EVIDENCE HAS BEEN ACCUMULATED INDICATING THE IMPORTANT ROLE OF EPIGENETIC REGULATION INCLUDING DNA METHYLATION, HISTONE MODIFICATIONS AND MIRNAS IN DEVELOPMENTAL PROGRAMMING. AMONG THE ENVIRONMENTAL FACTORS WHICH PLAY AN IMPORTANT ROLE IN PROGRAMMING OF CHRONIC PATHOLOGIES, THE ENDOCRINE-DISRUPTING CHEMICALS (EDCS) THAT HAVE ESTROGENIC, ANTI-ESTROGENIC, AND ANTI-ANDROGENIC ACTIVITY ARE OF SPECIFIC CONCERN BECAUSE THE DEVELOPING ORGANISM IS EXTREMELY SENSITIVE TO PERTURBATION BY SUBSTANCES WITH HORMONE-LIKE ACTIVITY. AMONG EDCS, THERE ARE MANY SUBSTANCES THAT ARE CONSTANTLY PRESENT IN THE MODERN HUMAN ENVIRONMENT OR ARE IN WIDESPREAD USE, INCLUDING DIOXIN AND DIOXIN-LIKE COMPOUNDS, PHTHALATES, AGRICULTURAL PESTICIDES, POLYCHLORINATED BIPHENYLS, INDUSTRIAL SOLVENTS, PHARMACEUTICALS, AND HEAVY METALS. APART FROM THEIR COMMON ENDOCRINE ACTIVE PROPERTIES, SEVERAL EDCS HAVE BEEN SHOWN TO DISRUPT DEVELOPMENTAL EPIGENOMIC PROGRAMMING. THE PURPOSE OF THIS REVIEW IS TO PROVIDE A SUMMARY OF RECENT RESEARCH FINDINGS WHICH INDICATE THAT EXPOSURE TO EDCS DURING IN-UTERO AND/OR NEONATAL DEVELOPMENT CAN CAUSE LONG-TERM HEALTH OUTCOMES VIA MECHANISMS OF EPIGENETIC MEMORY. 2014 9 6682 34 UTERINE LEIOMYOMA: AVAILABLE MEDICAL TREATMENTS AND NEW POSSIBLE THERAPEUTIC OPTIONS. CONTEXT: UTERINE LEIOMYOMAS (FIBROIDS OR MYOMAS) ARE BENIGN TUMORS OF THE UTERUS AND ARE CLINICALLY APPARENT IN UP TO 25% OF REPRODUCTIVE-AGE WOMEN. HEAVY OR ABNORMAL UTERINE BLEEDING, PELVIC PAIN OR PRESSURE, INFERTILITY, AND RECURRENT PREGNANCY LOSS ARE GENERALLY ASSOCIATED WITH LEIOMYOMA. ALTHOUGH SURGICAL AND RADIOLOGICAL THERAPIES ARE FREQUENTLY USED FOR THE MANAGEMENT OF THIS TUMOR, MEDICAL THERAPIES ARE CONSIDERED THE FIRST-LINE TREATMENT OF LEIOMYOMA. EVIDENCE ACQUISITION AND SYNTHESIS: A REVIEW WAS CONDUCTED OF ELECTRONIC AND PRINT DATA COMPRISING BOTH ORIGINAL AND REVIEW ARTICLES ON PATHOPHYSIOLOGY AND MEDICAL TREATMENTS OF UTERINE LEIOMYOMA RETRIEVED FROM THE PUBMED OR GOOGLE SCHOLAR DATABASE UP TO JUNE 2012. THESE RESOURCES WERE INTEGRATED WITH THE AUTHORS' KNOWLEDGE OF THE FIELD. CONCLUSION: TO DATE, SEVERAL PATHOGENETIC FACTORS SUCH AS GENETIC FACTORS, EPIGENETIC FACTORS, ESTROGENS, PROGESTERONE, GROWTH FACTORS, CYTOKINES, CHEMOKINES, AND EXTRACELLULAR MATRIX COMPONENTS HAVE BEEN IMPLICATED IN LEIOMYOMA DEVELOPMENT AND GROWTH. ON THE BASIS OF CURRENT HYPOTHESES, SEVERAL MEDICAL THERAPIES HAVE BEEN INVESTIGATED. GNRH AGONIST HAS BEEN APPROVED BY US FOOD AND DRUG ADMINISTRATION FOR REDUCING FIBROID VOLUME AND RELATED SYMPTOMS. IN ADDITION, THE FDA ALSO APPROVED AN INTRAUTERINE DEVICE, LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM (MIRENA), FOR ADDITIONAL USE TO TREAT HEAVY MENSTRUAL BLEEDING IN INTRAUTERINE DEVICE USERS ONLY. CURRENTLY, MIFEPRISTONE, ASOPRISNIL, ULIPRISTAL ACETATE, AND EPIGALLOCATECHIN GALLATE HAVE BEEN SHOWN TO BE EFFECTIVE FOR FIBROID REGRESSION AND SYMPTOMATIC IMPROVEMENT WHICH ARE ALL IN CLINICAL TRIAL. IN ADDITION, SOME SYNTHETIC AND NATURAL COMPOUNDS AS WELL AS GROWTH FACTOR INHIBITORS ARE NOW UNDER LABORATORY INVESTIGATION, AND THEY COULD SERVE AS FUTURE THERAPEUTIC OPTIONS. 2013 10 3610 28 IN UTERO EXPOSURE TO ENDOCRINE-DISRUPTING CHEMICALS, MATERNAL FACTORS AND ALTERATIONS IN THE EPIGENETIC LANDSCAPE UNDERLYING LATER-LIFE HEALTH EFFECTS. WIDESPREAD PERSISTENCE OF ENDOCRINE-DISRUPTING CHEMICALS (EDCS) IN THE ENVIRONMENT HAS MANDATED THE NEED TO STUDY THEIR POTENTIAL EFFECTS ON AN INDIVIDUAL'S LONG-TERM HEALTH AFTER BOTH ACUTE AND CHRONIC EXPOSURE PERIODS. IN THIS REVIEW ARTICLE A PARTICULAR FOCUS IS GIVEN ON IN UTERO EXPOSURE TO EDCS IN RODENT MODELS WHICH RESULTED IN ALTERED EPIGENETIC PROGRAMMING AND TRANSGENERATIONAL EFFECTS IN THE OFFSPRING CAUSING DISRUPTED REPRODUCTIVE AND METABOLIC PHENOTYPES. THE LITERATURE TO DATE ESTABLISHES THE IMPACT OF TRANSGENERATIONAL EFFECTS OF EDCS POTENTIALLY ASSOCIATED WITH EPIGENETIC MEDIATED MECHANISMS. THEREFORE, THIS REVIEW AIMS TO PROVIDE A COMPREHENSIVE OVERVIEW OF EPIGENETIC PROGRAMMING AND IT'S REGULATION IN MAMMALS, PRIMARILY FOCUSING ON THE EPIGENETIC PLASTICITY AND SUSCEPTIBILITY TO EXOGENOUS HORMONE ACTIVE CHEMICALS DURING THE EARLY DEVELOPMENTAL PERIOD. FURTHER, WE HAVE ALSO IN DEPTH DISCUSSED THE EPIGENETIC ALTERATIONS ASSOCIATED WITH THE EXPOSURE TO SELECTED EDCS SUCH AS BISPHENOL A (BPA), DI-2-ETHYLHEXYL PHTHALATE (DEHP) AND VINCLOZLIN UPON IN UTERO EXPOSURE ESPECIALLY IN RODENT MODELS. 2022 11 828 35 CHARACTERIZATION OF M (6) A MODIFIERS AND RNA MODIFICATIONS IN UTERINE FIBROIDS. UTERINE LEIOMYOMA OR FIBROIDS ARE THE MOST COMMON PREVALENT NONCANCEROUS TUMORS OF THE UTERINE MUSCLE LAYER. COMMON SYMPTOMS ASSOCIATED WITH FIBROIDS INCLUDE PELVIC PAIN, HEAVY MENSTRUAL BLEEDING, ANEMIA, AND PELVIC PRESSURE. THESE TUMORS ARE A LEADING CAUSE OF GYNECOLOGICAL CARE BUT LACK LONG-TERM THERAPY AS THE ORIGIN AND DEVELOPMENT OF FIBROIDS ARE NOT WELL UNDERSTOOD. SEVERAL NEXT-GENERATION SEQUENCING TECHNOLOGIES HAVE BEEN PERFORMED TO IDENTIFY THE UNDERLYING GENETIC AND EPIGENETIC BASIS OF FIBROIDS. HOWEVER, THERE REMAINS A SYSTEMIC GAP IN OUR UNDERSTANDING OF MOLECULAR AND BIOLOGICAL PROCESS THAT DEFINE UTERINE FIBROIDS. RECENT EPITRANSCRIPTOMICS STUDIES HAVE UNRAVELED RNA MODIFICATIONS THAT ARE ASSOCIATED WITH ALL FORMS OF RNA AND ARE THOUGHT TO INFLUENCE BOTH NORMAL PHYSIOLOGICAL FUNCTIONS AND THE PROGRESSION OF DISEASES. WE QUANTIFIED RNA EXPRESSION PROFILES BY ANALYZING PUBLICLY AVAILABLE RNA-SEQ DATA FOR 15 KNOWN EPIGENETIC MEDIATORS TO IDENTIFY THEIR EXPRESSION PROFILE IN UTERINE FIBROIDS COMPARED TO MYOMETRIUM. TO VALIDATE OUR FINDINGS, WE PERFORMED RT-QPCR ON A SEPARATE COHORT OF UTERINE FIBROIDS TARGETING THESE MODIFIERS CONFIRMING OUR RNA-SEQ DATA. WE THEN EXAMINED PROTEIN PROFILES OF KEY M (6) A MODIFIERS IN FIBROIDS AND THEIR MATCHED MYOMETRIUM. IN CONCORDANCE WITH OUR RNA EXPRESSION PROFILES, NO SIGNIFICANT DIFFERENCES WERE OBSERVED IN THESE PROTEINS IN UTERINE FIBROIDS COMPARED TO MYOMETRIUM. TO DETERMINE ABUNDANCE OF RNA MODIFICATIONS, MRNA AND SMALL RNA FROM FIBROIDS AND MATCHED MYOMETRIUM WERE ANALYZED BY UHPLC MS/MS. IN ADDITION TO THE PREVALENT N6-METHYLADENOSINE (M (6) A), WE IDENTIFIED 11 OTHER KNOWN MODIFIERS BUT DID NOT IDENTIFY ANY ABERRANT EXPRESSION IN FIBROIDS. WE THEN MINED A PREVIOUSLY PUBLISHED DATASET AND IDENTIFIED DIFFERENTIAL EXPRESSION OF M (6) A MODIFIERS THAT WERE SPECIFIC TO FIBROID GENETIC SUB-TYPE. OUR ANALYSIS ALSO IDENTIFIED M (6) A CONSENSUS MOTIFS ON GENES PREVIOUSLY IDENTIFIED TO BE DYSREGULATED IN UTERINE FIBROIDS. OVERALL, USING STATE-OF-THE-ART MASS SPECTROMETRY, RNA EXPRESSION AND PROTEIN PROFILES, WE CHARACTERIZED AND IDENTIFIED DIFFERENTIALLY EXPRESSED M (6) A MODIFIERS IN RELATION TO DRIVER MUTATIONS. DESPITE THE USE OF SEVERAL DIFFERENT APPROACHES, WE IDENTIFIED LIMITED DIFFERENTIAL EXPRESSION OF RNA MODIFIERS AND ASSOCIATED MODIFICATIONS IN UTERINE FIBROIDS. HOWEVER, CONSIDERING THE HIGHLY HETEROGENOUS GENOMIC AND CELLULAR NATURE OF FIBROIDS, AND THE POSSIBLE CONTRIBUTION OF SINGLE MOLECULE M (6) A MODIFICATIONS TO FIBROID PATHOLOGY, THERE IS A NEED FOR GREATER IN-DEPTH CHARACTERIZATION OF M (6) A MARKS AND MODIFIERS IN A LARGER AND VARIED PATIENT COHORT. 2023 12 5127 25 POSTMENOPAUSAL UTERINE LEIOMYOMAS AND CHRONIC LYMPHADENOPATHY: EXPLORING EPIGENETIC CHANGES AND PATHOPHYSIOLOGY. UTERINE LEIOMYOMAS (LM) ARE TUMORS ARISING FROM THE NON-NEOPLASTIC PROLIFERATION OF SMOOTH MUSCLE CELLS WITHIN THE MYOMETRIUM. LIKE BENIGN TUMORS, LM ARE NOT GENERALLY SPREAD THROUGH THE LYMPHATIC SYSTEM, AND THEREFORE SHOULD NOT BE ASSOCIATED WITH LYMPHADENOPATHY. HEREIN, WE PRESENT A CASE OF A 60-YEAR-OLD FEMALE WHO PRESENTED TO THE CLINIC WITH POSTMENOPAUSAL BLEEDING IN THE SETTING OF SONOGRAPHICALLY EVIDENT UTERINE LM AND ABDOMINAL LYMPHADENOPATHY. A LYMPH NODE BIOPSY REVEALED PLASMA CELLS AND AN EOSINOPHILIC MATERIAL PRESUMPTIVELY DIAGNOSED AS AMYLOID. SHE THEN UNDERWENT AN ABDOMINAL HYSTERECTOMY FOR DEFINITIVE TREATMENT OF LM. SURGICAL PATHOLOGY CONFIRMED THE CLINICAL DIAGNOSIS OF UTERINE AND CERVICAL LEIOMYOMA. CURRENT LITERATURE SUGGESTS THAT GENETIC AND EPIGENETIC ABNORMALITIES CONTRIBUTE TO THE PATHOGENESIS OF LM IN ADDITION TO HORMONAL SIGNALS SUCH AS ESTROGEN AND PROGESTERONE. IT IS UNUSUAL FOR LM TO OCCUR IN POST-MENOPAUSAL WOMEN DUE TO REDUCED HORMONAL INFLUENCE. THEREFORE, THIS CASE EXPLORED AN ALTERNATIVE MECHANISM OF TUMOR PROLIFERATION. THIS CASE HYPOTHESIZES THAT GENETIC MUTATIONS AND EPIGENETIC CHANGES RESULTING FROM CHRONIC INFLAMMATORY OFFENSES CONTRIBUTED TO LM GROWTH AND LYMPHADENOPATHY. 2021 13 4541 41 MULTISYSTEMIC ALTERATIONS IN HUMANS INDUCED BY BISPHENOL A AND PHTHALATES: EXPERIMENTAL, EPIDEMIOLOGICAL AND CLINICAL STUDIES REVEAL THE NEED TO CHANGE HEALTH POLICIES. A VAST AMOUNT OF EVIDENCE INDICATES THAT BISPHENOL A (BPA) AND PHTHALATES ARE WIDELY DISTRIBUTED IN THE ENVIRONMENT SINCE THESE COMPOUNDS ARE MASS-PRODUCED FOR THE MANUFACTURE OF PLASTICS AND PLASTICIZERS. THESE COMPOUNDS BELONG TO A LARGE GROUP OF SUBSTANCES TERMED ENDOCRINE-DISRUPTING CHEMICALS (EDC). IT IS WELL KNOWN THAT HUMANS AND LIVING ORGANISMS ARE UNAVOIDABLY AND UNINTENTIONALLY EXPOSED TO BPA AND PHTHALATES FROM FOOD PACKAGING MATERIALS AND MANY OTHER EVERYDAY PRODUCTS. BPA AND PHTHALATES EXERT THEIR EFFECT BY INTERFERING WITH HORMONE SYNTHESIS, BIOAVAILABILITY, AND ACTION, THEREBY ALTERING CELLULAR PROLIFERATION AND DIFFERENTIATION, TISSUE DEVELOPMENT, AND THE REGULATION OF SEVERAL PHYSIOLOGICAL PROCESSES. IN FACT, THESE EDC CAN ALTER FETAL PROGRAMMING AT AN EPIGENETIC LEVEL, WHICH CAN BE TRANSGENERATIONAL TRANSMITTED AND MAY BE INVOLVED IN THE DEVELOPMENT OF VARIOUS CHRONIC PATHOLOGIES LATER IN THE ADULTHOOD, INCLUDING METABOLIC, REPRODUCTIVE AND DEGENERATIVE DISEASES, AND CERTAIN TYPES OF CANCER. IN THIS REVIEW, WE DESCRIBE THE MOST RECENT PROPOSED MECHANISMS OF ACTION OF THESE EDC AND OFFER A COMPELLING SELECTION OF EXPERIMENTAL, EPIDEMIOLOGICAL AND CLINICAL STUDIES, WHICH SHOW EVIDENCE OF HOW EXPOSURE TO THESE POLLUTANTS AFFECTS OUR HEALTH DURING DEVELOPMENT, AND THEIR ASSOCIATION WITH A WIDE RANGE OF REPRODUCTIVE, METABOLIC AND NEUROLOGICAL DISEASES, AS WELL AS HORMONE-RELATED CANCERS. WE STRESS THE IMPORTANCE OF CONCERN IN THE GENERAL POPULATION AND THE URGENT NEED FOR THE MEDICAL HEALTH CARE SYSTEM TO CLOSELY MONITOR EDC LEVELS IN THE POPULATION DUE TO UNAVOIDABLE AND INVOLUNTARY EXPOSURE TO THESE POLLUTANTS AND THEIR IMPACT ON HUMAN HEALTH. 2021 14 5097 41 PLASTICS DERIVED ENDOCRINE-DISRUPTING COMPOUNDS AND THEIR EFFECTS ON EARLY DEVELOPMENT. DESPITE THE FACT THAT THE ESTROGENIC EFFECTS OF BISPHENOLS WERE FIRST DESCRIBED 80 YEARS AGO, RECENT DATA ABOUT ITS POTENTIAL NEGATIVE IMPACT ON BIRTH OUTCOME PARAMETERS RAISES A STRONG RATIONALE TO INVESTIGATE FURTHER. THE ADVERSE HEALTH EFFECTS OF PLASTICS RECOMMEND TO MEASURE THE IMPACTS OF ENDOCRINE-DISRUPTING COMPOUNDS (EDCS) SUCH AS BISPHENOLS (BPA, BPS, BPF), BIS(2-ETHYLHEXYL) PHTHALATE, AND DIBUTYL PHTHALATE (DBP) IN HUMAN HEALTH. EXPOSURE TO THESE COMPOUNDS IN UTERO MAY PROGRAM THE DISEASES OF THE TESTIS, PROSTATE, KIDNEY AND ABNORMALITIES IN THE IMMUNE SYSTEM, AND CAUSE TUMORS, UTERINE HEMORRHAGE DURING PREGNANCY AND POLYCYSTIC OVARY. THESE COMPOUNDS ALSO CONTROL THE PROCESSES OF EPIGENETIC TRANSGENERATIONAL INHERITANCE OF ADULT-ONSET DISEASES BY MODULATING DNA METHYLATION AND EPIMUTATIONS IN REPRODUCTIVE CELLS. THE EARLY DEVELOPMENTAL STAGE IS THE MOST SUSCEPTIBLE WINDOW FOR DEVELOPMENTAL AND GENOMIC PROGRAMMING. THE CRITICAL STAGES OF THE EVENTS FOR A NORMAL HUMAN BIRTH LIE BETWEEN THE MANY TRANSITIONS OCCURRING BETWEEN SPERMATOGENESIS, EGG FERTILIZATION AND THE FULLY FORMED FETUS. AS THE CELLS BEGIN TO GROW AND DIFFERENTIATE, THERE ARE CRITICAL BALANCES OF HORMONES, AND PROTEIN SYNTHESIS. DATA ARE EMERGING ON HOW THESE PLASTIC-DERIVED COMPOUNDS AFFECT EMBRYOGENESIS, PLACENTATION AND FETO-PLACENTAL DEVELOPMENT SINCE PREGNANT WOMEN AND UNBORN FETUSES ARE OFTEN EXPOSED TO THESE FACTORS DURING PRECONCEPTION AND THROUGHOUT GESTATION. IMPAIRED EARLY DEVELOPMENT THAT ULTIMATELY INFLUENCES FETAL OUTCOMES IS AT THE CENTER OF MANY DEVELOPMENTAL DISORDERS AND CONTRIBUTES AN INDEPENDENT RISK FACTOR FOR ADULT CHRONIC DISEASES. THIS REVIEW WILL SUMMARIZE THE CURRENT STATUS ON THE IMPACT OF EXPOSURE TO PLASTIC DERIVED EDCS ON THE GROWTH, GENE EXPRESSION, EPIGENETIC AND ANGIOGENIC ACTIVITIES OF THE EARLY FETAL DEVELOPMENT PROCESS AND THEIR POSSIBLE EFFECTS ON BIRTH OUTCOMES. 2020 15 1915 33 ENVIRONMENTAL AND OCCUPATIONAL EXPOSURE OF METALS AND FEMALE REPRODUCTIVE HEALTH. UNTAINTED ENVIRONMENT PROMOTES HEALTH, BUT THE LAST FEW DECADES EXPERIENCED STEEP UPSURGE IN ENVIRONMENTAL CONTAMINANTS POSING DETRIMENTAL PHYSIOLOGICAL IMPACT. THE RESPONSIBLE FACTORS MAINLY INCLUDE THE EXPONENTIAL GROWTH OF HUMAN POPULATION, HAVOC RISE IN INDUSTRIALIZATION, POORLY PLANNED URBANIZATION, AND SLAPDASH ENVIRONMENT MANAGEMENT. ENVIRONMENTAL DEGRADATION CAN INCREASE THE LIKELIHOOD OF HUMAN EXPOSURE TO HEAVY METALS, RESULTING IN HEALTH CONSEQUENCES SUCH AS REPRODUCTIVE PROBLEMS. AS A RESULT, RESEARCH INTO METAL-INDUCED CAUSES OF REPRODUCTIVE IMPAIRMENT AT THE GENETIC, EPIGENETIC, AND BIOCHEMICAL LEVELS MUST BE STRENGTHENED FURTHER. THESE METALS IMPACT UPON THE FEMALE REPRODUCTION AT ALL STRATA OF ITS REGULATION AND FUNCTIONS, BE IT DEVELOPMENT, MATURATION, OR ENDOCRINE FUNCTIONS, AND ARE LINKED TO AN INCREASE IN THE CAUSES OF INFERTILITY IN WOMEN. CHRONIC EXPOSURES TO THE HEAVY METALS MAY LEAD TO BREAST CANCER, ENDOMETRIOSIS, ENDOMETRIAL CANCER, MENSTRUAL DISORDERS, AND SPONTANEOUS ABORTIONS, AS WELL AS PRE-TERM DELIVERIES, STILLBIRTHS. FOR EXAMPLE, ENDOMETRIOSIS, ENDOMETRIAL CANCER, AND SPONTANEOUS ABORTIONS ARE ALL CAUSED BY THE METALLOESTROGEN CADMIUM (CD); LEAD (PB) LEVELS OVER A CERTAIN THRESHOLD CAN CAUSE SPONTANEOUS ABORTION AND HAVE A TERATOGENIC IMPACT; TOXIC AMOUNTS OF MERCURY (HG) HAVE AN INFLUENCE ON THE MENSTRUAL CYCLE, WHICH CAN LEAD TO INFERTILITY. IMPACT OF ENVIRONMENTAL EXPOSURE TO HEAVY METALS ON FEMALE FERTILITY IS THEREFORE A WELL-KNOWN FACT. THUS, THE UNDERLYING MECHANISMS MUST BE EXPLAINED AND PERIODICALLY UPDATED, GIVEN THE GROWING EVIDENCE ON THE INFLUENCE OF INCREASING ENVIRONMENTAL HEAVY METAL LOAD ON FEMALE FERTILITY. THE PURPOSE OF THIS REVIEW IS TO GIVE A CONCISE OVERVIEW OF HOW HEAVY METAL AFFECTS FEMALE REPRODUCTIVE HEALTH. 2022 16 236 26 ADENOMYOSIS: MECHANISMS AND PATHOGENESIS. ADENOMYOSIS IS A COMMON DISORDER OF THE UTERUS, AND IS ASSOCIATED WITH AN ENLARGED UTERUS, HEAVY MENSTRUAL BLEEDING (HMB), PELVIC PAIN, AND INFERTILITY. IT IS CHARACTERIZED BY ENDOMETRIAL EPITHELIAL CELLS AND STROMAL FIBROBLASTS ABNORMALLY FOUND IN THE MYOMETRIUM WHERE THEY ELICIT HYPERPLASIA AND HYPERTROPHY OF SURROUNDING SMOOTH MUSCLE CELLS. WHILE BOTH THE MECHANISTIC PROCESSES AND THE PATHOGENESIS OF ADENOMYOSIS ARE UNCERTAIN, SEVERAL THEORIES HAVE BEEN PUT FORWARD ADDRESSING HOW THIS DISEASE DEVELOPS. THESE INCLUDE INTRINSIC OR INDUCED (1) MICROTRAUMA OF THE ENDOMETRIAL-MYOMETRIAL INTERFACE; (2) ENHANCED INVASION OF ENDOMETRIUM INTO MYOMETRIUM; (3) METAPLASIA OF STEM CELLS IN MYOMETRIUM; (4) INFILTRATION OF ENDOMETRIAL CELLS IN RETROGRADE MENSTRUAL EFFLUENT INTO THE UTERINE WALL FROM THE SEROSAL SIDE; (5) INDUCTION OF ADENOMYOTIC LESIONS BY ABERRANT LOCAL STEROID AND PITUITARY HORMONES; AND (6) ABNORMAL UTERINE DEVELOPMENT IN RESPONSE TO GENETIC AND EPIGENETIC MODIFICATIONS. DYSMENORRHEA, HMB, AND INFERTILITY ARE LIKELY RESULTS OF INFLAMMATION, NEUROGENESIS, ANGIOGENESIS, AND CONTRACTILE ABNORMALITIES IN THE ENDOMETRIAL AND MYOMETRIAL COMPONENTS. ELUCIDATING MECHANISMS UNDERLYING THE PATHOGENESIS OF ADENOMYOSIS RAISE POSSIBILITIES TO DEVELOP TARGETED THERAPIES TO AMELIORATE SYMPTOMS BEYOND THE CURRENT AGENTS THAT ARE LARGELY INEFFECTIVE. HEREIN, WE ADDRESS THESE POSSIBLE ETIOLOGIES AND DATA THAT SUPPORT UNDERLYING MECHANISMS. 2020 17 5197 22 PRENATAL GLUCOCORTICOIDS EXPOSURE AND FETAL ADRENAL DEVELOPMENTAL PROGRAMMING. CLINICALLY, WE APPLY SYNTHETIC GLUCOCORTICOIDS TO TREAT FETAL AND MATERNAL DISEASES, SUCH AS PREMATURE LABOR AND AUTOIMMUNE DISEASES. ALTHOUGH ITS CLINICAL EFFICACY IS POSITIVE, THE FETUS WILL BE EXPOSED TO EXOGENOUS SYNTHETIC GLUCOCORTICOIDS. PRENATAL ADVERSE ENVIRONMENTS (SUCH AS XENOBIOTICS EXPOSURE, MALNUTRITION, INFECTION, HYPOXIA AND STRESS) CAN CAUSE FETUSES OVEREXPOSURE TO EXCESSIVE ENDOGENOUS MATERNAL GLUCOCORTICOIDS. THE LEVEL OF GLUCOCORTICOIDS IS THE KEY TO FETAL TISSUE MATURATION AND POSTNATAL FATE. A LARGE NUMBER OF STUDIES HAVE FOUND THAT PRENATAL GLUCOCORTICOIDS EXPOSURE CAN LEAD TO FETAL ADRENAL DYSPLASIA AND DYSFUNCTION, CONTINUING AFTER BIRTH AND EVEN INTO ADULTHOOD. AS THE CORE ORGAN OF FETAL-ORIGINATED ADULT DISEASES, FETAL ADRENAL DYSPLASIA IS CLOSELY RELATED TO THE SUSCEPTIBILITY AND OCCURRENCE OF MULTIPLE CHRONIC DISEASES, AND THERE ARE ALSO OBVIOUS GENDER DIFFERENCES. HOWEVER, ITS INTRAUTERINE PROGRAMMING MECHANISMS HAVE NOT BEEN FULLY ELUCIDATED. THIS REVIEW SUMMARIZES RECENT ADVANCES IN PRENATAL GLUCOCORTICOIDS EXPOSURE AND FETAL ADRENAL DEVELOPMENTAL PROGRAMMING ALTERATIONS, WHICH IS OF GREAT SIGNIFICANCE FOR EXPLAINING ADRENAL DEVELOPMENTAL TOXICITY AND THE INTRAUTERINE ORIGIN OF FETAL-ORIGINATED ADULT DISEASES. 2019 18 1644 37 DOES THE ENVIRONMENT AFFECT MENOPAUSE? A REVIEW OF THE EFFECTS OF ENDOCRINE DISRUPTING CHEMICALS ON MENOPAUSE. ENDOCRINE DISRUPTING CHEMICALS ARE WIDELY DISTRIBUTED IN OUR ENVIRONMENT. HUMANS ARE EXPOSED TO THESE COMPOUNDS NOT ONLY THROUGH THEIR OCCUPATIONS, BUT ALSO THROUGH DIETARY CONSUMPTION AND EXPOSURE TO CONTAMINATED WATER, PERSONAL CARE PRODUCTS AND TEXTILES. CHEMICALS THAT ARE PERSISTENT IN THE BODY AND IN OUR ENVIRONMENT INCLUDE DIOXINS AND POLYCHLORINATED BIPHENYLS. NON-PERSISTENT CHEMICALS INCLUDING BISPHENOL A, PHTHALATES AND PARABENS ARE EQUALLY AS IMPORTANT BECAUSE THEY ARE UBIQUITOUS IN OUR ENVIRONMENT. HEAVY METALS, INCLUDING LEAD AND CADMIUM, CAN ALSO HAVE ENDOCRINE DISRUPTING PROPERTIES. ALTHOUGH DIFFICULT TO STUDY DUE TO THEIR VARIETY OF SOURCES OF EXPOSURES AND MECHANISMS OF ACTION, THESE CHEMICALS HAVE BEEN ASSOCIATED WITH EARLY MENOPAUSE, INCREASED FREQUENCY OF VASOMOTOR SYMPTOMS, ALTERED STEROID HORMONE LEVELS AND MARKERS OF DIMINISHED OVARIAN RESERVE. UNDERSTANDING THE IMPACTS OF THESE EXPOSURES IS IMPORTANT GIVEN THE POTENTIAL FOR EPIGENETIC MODIFICATION, WHICH CAN ALTER GENE FUNCTION AND RESULT IN MULTI-GENERATIONAL EFFECTS. THIS REVIEW SUMMARIZES FINDINGS IN HUMANS AND ANIMALS OR CELL-BASED MODELS FROM THE PAST DECADE OF RESEARCH. CONTINUED RESEARCH IS NEEDED TO ASSESS THE EFFECTS OF MIXTURES OF CHEMICALS, CHRONIC EXPOSURES AND NEW COMPOUNDS THAT ARE CONTINUOUSLY BEING DEVELOPED AS REPLACEMENTS FOR TOXIC CHEMICALS THAT ARE BEING PHASED OUT. 2023 19 5450 32 REPRODUCTIVE TOXICITY OF COMBINED EFFECTS OF ENDOCRINE DISRUPTORS ON HUMAN REPRODUCTION. CONFLUENCE OF ENVIRONMENTAL, GENETIC, AND LIFESTYLE VARIABLES IS RESPONSIBLE FOR DETERIORATION OF HUMAN FECUNDITY. ENDOCRINE DISRUPTORS OR ENDOCRINE DISRUPTING CHEMICALS (EDCS) MAY BE FOUND IN A VARIETY OF FOODS, WATER, AIR, BEVERAGES, AND TOBACCO SMOKE. IT HAS BEEN DEMONSTRATED IN EXPERIMENTAL INVESTIGATIONS THAT A WIDE RANGE OF ENDOCRINE DISRUPTING CHEMICALS HAVE NEGATIVE EFFECTS ON HUMAN REPRODUCTIVE FUNCTION. HOWEVER, EVIDENCE ON THE REPRODUCTIVE CONSEQUENCES OF HUMAN EXPOSURE TO ENDOCRINE DISRUPTING CHEMICALS IS SPARSE AND/OR CONFLICTING IN THE SCIENTIFIC LITERATURE. THE COMBINED TOXICOLOGICAL ASSESSMENT IS A PRACTICAL METHOD FOR ASSESSING THE HAZARDS OF COCKTAILS OF CHEMICALS, CO-EXISTING IN THE ENVIRONMENT. THE CURRENT REVIEW PROVIDES A COMPREHENSIVE OVERVIEW OF STUDIES EMPHASIZING THE COMBINED TOXICITY OF ENDOCRINE DISRUPTING CHEMICALS ON HUMAN REPRODUCTION. ENDOCRINE DISRUPTING CHEMICALS INTERACT WITH EACH OTHER TO DISRUPT THE DIFFERENT ENDOCRINE AXES, RESULTING IN SEVERE GONADAL DYSFUNCTIONS. TRANSGENERATIONAL EPIGENETIC EFFECTS HAVE ALSO BEEN INDUCED IN GERM CELLS, MOSTLY THROUGH DNA METHYLATION AND EPIMUTATIONS. SIMILARLY, AFTER ACUTE OR CHRONIC EXPOSURE TO ENDOCRINE DISRUPTING CHEMICALS COMBINATIONS, INCREASED OXIDATIVE STRESS (OS), ELEVATED ANTIOXIDANT ENZYMATIC ACTIVITY, DISRUPTED REPRODUCTIVE CYCLE, AND REDUCED STEROIDOGENESIS ARE OFTEN REPORTED CONSEQUENCES. THE ARTICLE ALSO DISCUSSES THE CONCENTRATION ADDITION (CA) AND INDEPENDENT ACTION (IA) PREDICTION MODELS, WHICH REVEAL THE IMPORTANCE OF VARIOUS SYNERGISTIC ACTIONS OF ENDOCRINE DISRUPTING CHEMICALS MIXTURES. MORE CRUCIALLY, THIS EVIDENCE-BASED STUDY ADDRESSES THE RESEARCH LIMITATIONS AND INFORMATION GAPS, AS WELL AS PARTICULARLY PRESENTS THE FUTURE RESEARCH VIEWS ON COMBINED ENDOCRINE DISRUPTING CHEMICALS TOXICITY ON HUMAN REPRODUCTION. 2023 20 1403 24 DIETARY APPROACHES TO WOMEN'S SEXUAL AND REPRODUCTIVE HEALTH. OVER THE COURSE OF THE REPRODUCTIVE LIFE SPAN, IT IS COMMON FOR WOMEN TO EXPERIENCE ONE OR MORE OF THE MOST COMMON GYNECOLOGIC CONDITIONS, INCLUDING SEXUAL DYSFUNCTION, POLYCYSTIC OVARY SYNDROME, FIBROIDS, ENDOMETRIOSIS, AND INFERTILITY. ALTHOUGH CURRENT MANAGEMENT GUIDELINES OFTEN TURN TO THE ESTABLISHED PHARMACEUTICAL APPROACHES FOR EACH OF THESE DIAGNOSES, THE SCIENTIFIC LITERATURE ALSO SUPPORTS AN EVIDENCE-BASED APPROACH ROOTED IN THE PARADIGM OF FOOD AS MEDICINE. ACHIEVING HEALTHY DIETARY PATTERNS IS A CORE GOAL OF LIFESTYLE MEDICINE, AND A PLANT-FORWARD APPROACH AKIN TO THE MEDITERRANEAN DIET HOLDS GREAT PROMISE FOR IMPROVING MANY CHRONIC GYNECOLOGIC DISEASES. FURTHERMORE, CREATING AN OPTIMAL PRECONCEPTION ENVIRONMENT FROM A NUTRITIONAL STANDPOINT MAY FACILITATE EPIGENETIC SIGNALING, THUS IMPROVING THE HEALTH OF FUTURE GENERATIONS. THIS STATE-OF-THE-ART REVIEW EXPLORES THE LITERATURE CONNECTING DIET WITH SEXUAL AND REPRODUCTIVE HEALTH IN PREMENOPAUSAL WOMEN. 2021