“But we would also like to understand which mechanisms the environment uses to generate these pathologies", Michelle Nisolle continues. “As regards endometriosis, the project we are developing aims to research the expression of microRNA in the samples taken. MicroRNA modulates the expression of the genes involved in the inflammation, apoptosis, cell adhesion, angiogenesis, etc., in short, all the mechanisms that influence the major stages in the development of endometriosis."
The project will use new biotechnology tools to explore the methylation of the RNA’s entire genome and the expression profiles of the microRNAs. It will endeavour to uncover the epigenetic abnormalities at work in the different forms of endometriosis (peritoneal, ovarian and rectal) whose impact on fertility varies.
It will then be a question of investigating the link between these methylated genes and the environmental contaminants. This will be achieved through a questionnaire on place of origin, ethnicity (women who have lived in countries where certain pesticides that are banned here are in common use, are more likely to suffer from endometriosis), age when menstruation started, the number of pregnancies, diet (especially fish and chicken, owing to the PCB content), etc. "We often hear that Belgium is a highly polluted country with a high level of dioxin and endometriosis, but in reality, I think that the situation isn’t any worse here than elsewhere. We're quite simply concerned about it in Belgium and we carry out essential tests to try and make an early diagnosis!” It is indeed more reassuring seen from that point of view!
A spin-off in the making
Another step will be to identify endometriosis biomarkers that will allow the diagnosis of endometriosis through endometrial biopsies, or even based on menstrual blood, which contains sloughed off endometrial cells. For this purpose, we have to compare the endometrium of patients who have endometriosis with those of women who don’t have it, and see if there are differences in gene expression. The Department of anatomo-pathology of Professor Philippe Delvenne is focusing on this part of the research. “It's a bit like trying to find a needle in a haystack: the researchers are trying to identify genes in the endometrium of women with endometriosis that are expressed differently from the endometrium in women without endometriosis.” Painstaking work that is nevertheless starting to bear fruit. Several genes have already been identified and a spin-off is under development to exploit the patents that will soon be registered...
Being able to establish a predisposition to endometriosis will allow earlier diagnosis and the possibility of earlier treatment. “Since endometriosis develops very quickly after puberty, it isn’t uncommon to find a lot of it in an 18 year old. So, for instance, we could offer to block her periods until she desires a pregnancy, which would prevent the condition from getting worse.” Looking to the future, by using techniques aimed at counteracting the action of the identified microRNAs, we may even be able to attempt to neutralise this ectopic endometrium. But this certainly isn’t for tomorrow. The day after tomorrow perhaps?
