By I.Soussis, MD, MSc, FRCOG, Fertility Specialist
Scientists from the Feinstein Institute for Medical Research announced an experimental, rapid and non-invasive way to diagnose endometriosis, which may lead to earlier and more effective treatments for this disorder that affects approximately 176 million women globally.
The scientists found that a particular feature of cells found in menstrual blood suggests that a patient has endometriosis, according to findings published in Molecular Medicine.
The simple test uses menstrual blood and takes only a few days to report. This is a dramatic improvement over current diagnostic methods that rely on laparoscopy, which patients try to avoid, delaying diagnosis typically five to 10 years from the onset of symptoms.
Endometriosis is a chronic condition in which the endometrium grows outside the uterus, typically in the abdominal cavity or on internal organs. Patients often experience significant pain and discomfort during their period or intercourse. Endometriosis may also lead to infertility or hysterectomy.
Researchers at the Feinstein Institute established the Research Out-Smarts Endometriosis (ROSE) program to study the genetic basis of endometriosis and what is occurring at the cellular level in this disease. As part of ROSE, healthy women and others with endometriosis, provide peripheral and menstrual blood samples which are stored in a biobank so that they can be analysed in current and future research studies.
The recently-published study focused on the role of stromal fibroblasts, a type of stem cell found in menstrual blood, and the immune system. Professors Christine N.Metz, PhD and Peter K.Gregersen, MD, along with Laura A. Warren, an MD-PhD student at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell have led this research effort.
“The cause of endometriosis is not known. One theory is retrograde menstruation, which is where menstrual blood containing uterine tissue is transported into the abdominal cavity instead of out of the body. Almost all women experience retrograde menstruation, but we’re unsure why in some women this endometrial tissue latches on to the abdominal wall and internal organs and grows causing endometriosis,” said Dr. Metz. “In this study, we found that the stem cells in the menstrual blood of women with endometriosis are very different from those of healthy women and we are learning from these differences to develop a novel non-invasive diagnostic test.”
Metz and her colleagues observed that the menstrual blood of endometriosis patients contained a significantly smaller number of uterine natural killer (uNK) cells compared with healthy participants. In addition to this decrease, they observed that endometriosis patients’ stem cells showed impaired decidualization, a process that prepares the uterus for embryo implantation.
“Instead of having to undergo surgery to accurately diagnose endometriosis, these findings will enable us to develop a rapid test for endometriosis based on menstrual blood, which can be easily collected. This will allow medical professionals to know if someone is at risk of developing endometriosis and start treatment sooner, and it will help them monitor patients’ responses to treatment,” said Dr. Gregersen. “Endometriosis is a chronic, complex condition and improved understanding of this disease through studying menstrual blood is likely to drive personalization of new therapies.”
You can read the data published in Molecular Medicine, here:
https://molmed.biomedcentral.com/articles/10.1186/s10020-018-0009-6.
Image credit: http://healthizmo.com/endometriosis-what-you-need-to-know