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New hope for treatment of endometriosis

Endometriosis: according to research, defective cells of the uterus can be replaced with healthy cells

According to research, defective cells of the uterus can be replaced with healthy cells

While about 10% of women worldwide suffer from endometriosis, a recent study states the disease may be cured by replacing defective cells with healthy cells.

This study, published in the “Stem Cells Report” journal[1], is the first to announce that defective endometrial cells can be reprogrammed to become healthy cells, thus treating endometriosis.

According to research, defective cells of the uterus can be replaced with healthy cells called induced pluripotent stem cells. The latter, which earned Shinya Yamanaka the Nobel Prize in Physiology or Medicine in 2012, are stem cells obtained from specialised adult cells that are genetically reprogrammed.

In layman’s terms, they are cells taken from the body of an adult, and then reprogrammed to become immature cells, which can then turn into any type of cell within the body.

In this study, healthy cells are collected from the blood or skin of women with endometriosis. Tests have shown that the immune system of women on whom auto-transplantation was performed did not reject these healthy cells.

Endometriosis occurs when the cells of the endometrium – the lining of the uterus – are defective and do not respond well to the spread of progesterone, which is an implantation hormone. These defective cells are then released to the fallopian tubes, and then to the abdominal tissues, resulting in severe pelvic pain.

However, the study shows that healthy cells can multiply, and respond positively to progesterone. They are fixed on the endometrial tissue and are no longer released towards the abdominal wall.

To date, the study simply shows that healthy cells react positively in the bodies of the women tested. The next step is to replace the defective cells with these healthy cells.

Towards long-term treatment

In the world today, it is estimated that 10% of women of childbearing age (about 200 million) are affected by endometriosis. There is currently no effective long-term treatment. The women concerned are obliged to follow a hormonal treatment until menopause. It is also possible to undergo surgical procedures to curb the course of the disease over several months, but it never disappears completely.

Endometriosis causes a lot of pain: in addition to acute pain during menstruation, affected women may become infertile and are at a higher risk of developing ovarian cancer.

According to Professor Bulun, researcher for the study, the consequences of the disease can be devastating for some, “these women with endometriosis begin to suffer from the disease when they are very young. They end up being opioid dependent to calm the pain. This addiction destroys their social life and their academic potential”.

[1] Miyazaki K. et al. “Generation of Progesterone-responsive Endometrial Stromal Fibroblasts from Human Induced Pluripotent Stem Cells: Role of the WNT/CTNNB1 Pathway”, 2018 (https://www.cell.com/stem-cell-reports/fulltext/S2213-6711(18)30425-9)