Treatment of endometriosis could progress, especially in those who cannot or do not want to take hormone therapy or prevent a recurrence after surgery.
Endometriosis is a still little-known chronic disease that affects one in ten women worldwide, according to figures from Inserm. If this disease and the number of people who suffer from it remains difficult to apprehend for the medical profession, it is because there are no screening techniques for the general population. The symptoms of endometriosis are mainly defined by pain (painful periods, painful intercourse, pain when urinating or defecating, pelvic pain radiating to the legs, etc.) and infertility. These pains can be chronic or periodic, just as the disease can be asymptomatic in some.
A new study, made by researchers from the University of Edinburgh (Scotland), suggests that it would be possible to alleviate the symptoms of endometriosis thanks to anti-cancer drugs. Their research was funded by the charity Wellbeing of Women, supported by PwC and the Medical Research Council UK, and the results of their work were published in November in the journal Proceedings of the National Academy of Sciences.
A different wall
Endometriosis is characterized by the presence of endometrial tissue, which makes up the lining of the uterus, outside the uterine cavity. This misplaced endometrial tissue causes damage where it is, which creates the pain that some women are prone to.
For their study, the researchers focused on the cellular structure of endometrial tissue. They realized that the cells of the pelvic wall of women with endometriosis have a different metabolism from that of other women. Their cells produce higher amounts of lactate, which is similar to the behavior of cancer cells. Cells from women with endometriosis returned to normal metabolic behavior when treated with dichloroacetate. This ion inhibits the production of lactate and reduces the growth of endometrial cells developing with pelvic cells. Finally, the scientists noticed a reduction in lactate concentrations and lesion size after seven days in additional tests in a mouse model of endometriosis.
Currently, the treatments available are either hormonal, and can produce unpleasant side effects, or surgical, which lets the lesions reappear five years later, in half of the cases. This new discovery could improve the management of endometriosis in women who do not want or cannot take hormonal treatments, or who fear a recurrence after surgery.
A preliminary clinical trial to confirm these findings
For Professor Andrew Horne, Senior Researcher at the MRC Center for Reproductive Health at the University of Edinburgh, “Endometriosis changes the lives of so many women. Now that we better understand cell metabolism in women with endometriosis, we can work to develop a non-hormonal treatment. Through a clinical trial with dichloroacetate, we should be able to see if the conditions we observed in the lab reproduce in women.”
Janet Lindsay, chief executive of the charity Wellbeing for Women, adds: “More than 176 million women have endometriosis, but few people have heard of it. Current treatment, which may affect fertility, has made very little progress in over 40 years. That’s why we’re so excited about the results of this research that Wellbeing of Women has funded, which could lay the groundwork for the first non-hormonal treatment to give women a life-changing option. We are delighted that Professor Andrew Horne’s treatment, which is currently in clinical trial, can have a huge impact on the lives of so many women.”
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