A new cellular atlas of endometriosis for better understanding of the disease

In this interview, News Medical talks to Dr. Kate Lawrenson about the latest research detailing the molecular profile of endometriosis, helping improve treatment options for the millions of women suffering from endometriosis. increase.

Please introduce yourself and tell us about your background.

I am an Associate Professor in the Department of Obstetrics, Gynecology and Biomedical Sciences at Cedars-Sinai University in Los Angeles. She also serves as Director of the Women’s Cancer Research Program and Associate Director of the Postdoctoral Fellowship Program at Cedars-Sinai.

Endometriosis is a gynecological disease affecting 10% of women worldwide. What is endometriosis and why is it historically understudied?

Endometriosis is a condition in which cells that look like the lining of the uterus (uterus) are in the wrong place. Endometriosis is often found in the lining of the ovaries or pelvic cavity, but rarely in more distant sites such as the lungs (thoracic endometriosis).

Endometriotic lesions can grow and bleed much like the uterus, and can even invade the organs in which they are found. cause problems. Patients also often present with systemic symptoms such as gastrointestinal disturbances and pain hypersensitivity.

Endometriosis research is undermined by the limited funding available. Unfortunately, many underfunded conditions disproportionately affect women, so endometriosis is one of the most underfunded diseases despite being very common. There are many reasons for this, including societal attitudes towards issues that only affect women, and from a medical, social, and political perspective, endometriosis has been largely overlooked.

Nevertheless, I am optimistic that the tide is starting to turn and that women’s health issues, including endometriosis, are increasingly coming to the forefront. hope it will increase.

Most people diagnosed with endometriosis are women and are born with a uterus, but transgender men and those without a uterus (such as having a hysterectomy or congenital disorders) can also be affected. It’s important to remember one thing. Our study should not overlook these patient groups.

What is the current state of endometriosis treatment and what are the barriers to progress in this field?

Medical management of endometriosis usually involves the use of drugs that can slow the growth of lesions by lowering estrogen levels in the body (such as combined oral contraceptives – the “pill”). Many patients use pain relievers to manage their pain. However, patients often experience side effects of treatment or stop working after a while.

Treatments that suppress lesions are incompatible with pregnancy and usually do not help improve fertility because the underlying cause is still present. ) to undergo surgery. Nonetheless, recurrence is fairly common, and about half of patients undergoing surgery undergo additional surgery.

It is important to recognize that endometriosis is a chronic disease that requires decades of treatment. A comprehensive approach to care is likely to achieve the best outcomes for patients. For example, to include (where appropriate) physiotherapy for pelvic floor dysfunction, treatment of intensive pain, cognitive-behavioral therapy, and mindfulness-based therapy. Many doctors recommend a healthy diet, good sleep hygiene, and exercise to manage life with endometriosis.

How did you do your research and what were your main findings?

The past five years have seen a revolution in genomics, making it easier, cheaper, and faster to study individual cells. This means that for each patient, we can now generate data points for thousands of individual cells, whereas previously these cells were combined to create a single sample for analysis. I was. This new level of precision makes a big difference in endometriosis. In endometriosis, lesions are small (often just a few millimeters in diameter) and composed of multiple different cell types that conspire to cause the disease.

In my lab, we have developed expertise in using single-cell genomics to profile human tissues, working with surgeons and pathologists to create a cellular atlas of endometriosis. Ovarian endometriosis (endometrioma) is quite different from pelvic endometriosis, showing that endometriotic cells respond to female hormones differently than cells in the uterus I was able to. We were also able to confirm that genetic mutations in endometriosis affect gene expression and may help alter the tissues that endometriosis invades.

How will your findings lead to better care for patients with endometriosis? What’s next for you and your research?

The lack of large-scale, genome-wide molecular profiling data has hampered endometriosis research. Our study, along with others, provided important first investigations into the molecular profile of human endometriosis. Efforts by our team and others will continue to expand this important resource, delving into features of endometriosis in groups we have not been able to see.

We are currently using this information in our laboratory to address two major unmet clinical needs. Second, new therapeutics aimed at normalizing the altered behavior of endometriosis cells. is to test

Where can readers find more information?

About Dr. Kate Lawrenson

I lead a multidisciplinary research organization at Cedars Sinai in Los Angeles and have dedicated my entire career to researching the unmet needs in women’s health. My interest in endometriosis began when I completed my PhD. I met an endometriosis patient at one of her gynecological clinics, where I was recruiting patients for research. Her stories of myriad unruly symptoms left a lasting impression on me, and I began to see opportunities to do endometriosis research. Initially focused on ovarian cancer associated with endometriosis and later built the Endometriosis Research Program. Genetic associations between cervical cancer and ovarian cancer have been investigated and recently a single-cell atlas of endometriosis was developed.

rolleThe Cedars-Sinai nson Laboratory conducts bench studies and bioinformatics to study the molecular landscape of disease, with a primary focus on endometriosis and ovarian cancer. He is also conducting two of his clinical studies designed to study the causes of endometriosis and gynecologic cancers to discover new biomarkers and therapeutic targets.

I am also passionate about mentoring, especially supporting women and underrepresented minorities. As Associate Director of the Postdoctoral Scientist Program at Cedars-Sinai, I have mentored many students, fellows, interns, postdoctoral researchers, and staff scientists through their successful career advancement studies. My leadership activities are focused on building interdisciplinary teams in endometriosis and women’s cancers through my leadership role as Director of the Women’s Cancer Research Program at Cedars-Sinai.

In addition to our partnership with Cedars-Sinai, we have published an estimated 90 peer-reviewed manuscripts, reviews, and book chapters.