Possible new directions for the treatment of endometriosis involve targeting angiogenesis (the formation of new blood vessels), which encourages endometriosis by providing a rich blood supply. The new approaches were outlined at the 23rd annual conference of the European Society of Human Reproduction and Embryology. Dr. Edurne Novella-Maestre, from the Valencia Infertility Institute in Spain, detailed his experiments with Vascular Endometrial Growth Factor (VEGF), which is known to be involved in the angiogenesis process and endometriosis. The Spanish researchers created an experimental model of endometriosis in mice in order to test whether dopamine agonists (used in infertility treatments) could represent a new strategy for inhibiting endometrial lesions. "We know that dopamine agonists are a safe treatment, and that they have been used for many years without any major side effects", said Novella-Maestre, "so we decided to see what effect they would have on the experimental mice."
The team found that the blood vessel formation in the lesions was significantly decreased with the dopamine agonist. "The percentage of new blood vessels in the two treatment groups was reduced in comparison to the control group, and we also found that the percentage of old blood vessels in these groups were higher", said Novella-Maestre. "The total number of the blood vessels was not dissimilar in the treatment and control groups, but the ratio of new/old blood vessels, the numbers of cells growing in the endometrial area, and the area lesions were totally different, suggesting that there was inhibition of blood vessel replacement in the treatment group."
Novella-Maestre now intends to follow up the work in humans. "Our initial experiments have confirmed the presence of the dopamine receptor in human endometriosis, and therefore we believe that treatment with dopamine agonists will have the same effect on humans as it does on mice. This is encouraging, since current therapies are still associated with a high recurrence rate, and many of them can only be used for a limited time due to unacceptable side effects and/or osteoporosis. A long-term, safe, and non-invasive solution is badly needed," she noted.
In another presentation at the conference, Dr. Ofer Fainaru, from Harvard Medical School, will announce that his team has found that dendritic cells - highly specialised immune cells - support angiogenesis by enhancing blood vessel growth. Using a mouse model of endometriosis, they found that these cells incorporate into the endometriosis lesions and enhance their growth. "We also found that these cells have a similar effect on intra-abdominal tumours", he said. "We therefore believe that targeting dendritic cells may prove to be a promising strategy for treating conditions dependent on angiogenesis, such as endometriosis and cance. Our next step will be to look for specific dendritic cell inhibitors that could have the potential to decrease angiogenesis in these conditions."
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Source: European Society for Human Reproduction and Embryology
