Posted by Article on 4/2/2002, 11:01 am

Hi Friends, This theory behind endo has been out there for some time and now a defective gene is supected as the mechanism, according to recent research. You will see the mention of angiogenic factors, 'which stimulate the formation of new blood vessels, as well as enzymes and adhesion factors, which promote cell implantation and the appearance of lesions.' I posted an article some time ago on the possibility of anti-angiogenisis drugs being developed that may one day target endo, which I felt was very interesting. If you missed that article, you can find it linked below. ********* Quebec-based Research Team Makes Significant Breakthrough in Diagnosis and Potential Treatment of Endometriosis NOTE: The following article appeared on March 21, 2002. It is provided herein for information purposes only. All content copyright © 2002 by CNW. -------------------------------------------------------------------------------- Centre hospitalier universitaire de Québec - March 21, 2002 - /CNW/ - Women with endometriosis, a disease that affects one woman in ten, could soon have access to a simple, precise diagnostic test. Furthermore, they could possibly have access to a new medication to treat this disease, which causes abdominal pain and infertility. These are the possibilities stemming from a breakthrough discovery made recently by Dr. Ali Akoum, a researcher at the Hôpital Saint-François d'Assise research centre-CHUQ, and his team, in collaboration with his colleagues, Drs André Lemay and Rodolphe Maheux, from the same Centre. They identified a major deficiency in a gene that plays a key role in controlling the inflammatory reaction associated with endometriosis. THE VEIL IS LIFTED This defective gene could be the explanation that scientists had been seeking for so long. It is present in the cells of the membrane that lines the inside of the uterus (the endometrium) in normal women, but is partially or totally absent in women with endometriosis. This defective gene results in an inflammatory reaction in the endometrium and localized changes to the immune system in the tissue, as well as significant changes to the normal functions of the endometrial cells. "When these same cells end up in the abdominal cavity because of retrograde menstruation, they can trigger and exacerbate the immune/inflammatory reaction. Instead of being eliminated by the immune system, as is the case in normal women, these defective cells resist and overreact by secreting growth and angiogenic factors, which stimulate the formation of new blood vessels, as well as enzymes and adhesion factors, which promote cell implantation and the appearance of lesions", explains Dr. Akoum. The impact of this new discovery is major: It will promote the development of a diagnostic test based on a simple biopsy of the endometrium by a specific, natural route. Physicians must currently perform a laparoscopy under general anesthesia to make a diagnosis. "It is a major problem for infertile patients or those with pelvic pain; a non-invasive diagnostic test would be of great help", says Dr. Maheux. DRUG TREATMENT The most interesting avenue is certainly the treatment of the disease, which could change considerably. Currently, physicians perform surgery under general anesthesia to treat the disease. Another technique is to induce menopause artificially, using hormones. In more serious cases, physicians perform a uterine and ovarian ablation, a major surgical procedure. According to Dr. Lemay, who is himself involved in the hormonal treatment of women with endometriosis, Dr. Akoum's discovery is significant because it offers a better understanding of the progression of the disease and should allow for new approaches in medical treatment. "We could compensate for the gene's deficiency by administering a medication to treat the endometriosis in a more targeted manner and prevent the development of major complications, such as pelvic pain and infertility", adds Dr. Akoum. The latter also specified that in vivo studies with an endometriosis model would confirm the efficacy of the treatment. To date, laboratory in vitro studies have been promising. In 2001, this research project was ranked second in Canada by the Clinical Investigations Committee of the Canadian Institutes of Health Research (CIHR) and was backed by a $500,000 grant to Dr. Akoum, over a period of 5 years. Dr. Akoum's team will also receive a $300,000 grant from the CIHR for the study of the angiogenic aspects of the disease. The first papers on this discovery were published in 2001 in the prestigious The American Journal of Pathology. The results confirming this discovery will be published, or have already been published, in two of the most highly reputed journals in the field of reproduction (Biology of Reproduction, 2001 and 2002; Fertility and Sterility, accepted in 2002). SOME FACTS ABOUT ENDOMETRIOSIS Endometriosis generally appears in the form of lesions or cysts in the abdominal cavity. In 40-45% of cases, this disease results in pain during menstruation or sexual relations, as well as infertility. Endometriosis occurs when fragments of the endometrium (the mucous membrane lining the uterus) and menstrual blood leak into the fallopian tubes and abdominal cavity, where they adhere, implant themselves and develop into endometrial lesions. This phenomenon is known as retrograde menstruation. The lesions take different forms. The most active are highly vascularized. Others are microscopic and hard to detect during a laparoscopic examination. Retrograde menstruation occurs in 90% of menstruating women. Until now, researchers had been unable to clearly determine why this tissue implants itself in some women and forms lesions. This discovery allows a better understanding of the process and paves the way to new therapeutic strategies. Researchers noted, "we are grateful for the invaluable collaboration of our colleagues, Dr. Yves Labelle at our research centre, and Dr. Paola Bossû of Dompé SpA laboratories, in L'Aquila, Italy, and the gynecologists, nurses, students and research assistants, as well as for the financial support of the CIHR and the Fonds de recherche en santé du Québec (FRSQ)." Dr. Ali Akoum is a FRSQ senior research fellow.

Link: Anti-angiogenesis Drugs