Endometriosis
Conditions
Keywords
Steroidome, exposome, LC-HRMS
Brief summary
Endometriosis is a systemic, steroid-dependent, inflammatory disease characterized by the growth of endometrial-like tissue outside the uterus, affecting approximately 10 % of women of childbearing age. The etiology and pathophysiology of endometriosis is not completely understood to support effective treatment and prevention strategies. Despite the steroid dependency, little is known concerning the underlying metabolism of estrogen and other tightly related steroids. Moreover, shortening the long diagnostic delays is a major priority in endometriosis research.
Detailed description
The main aim of the study will be to develop a global steroidomics analytical strategy " fit-for-purpose" to improve the knowledge of endometriosis pathophysiology and boost the identification of diagnostic biomarkers. Therefore, in a first step, a new analytical method will be developed adapting state-of-the-art liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS) approaches for steroids and its metabolites towards endometriosis research. The investigators will ensure the characterization of established steroids and its metabolites known to be relevant to endometriosis, but also expand the panel with non-targeted methods to identify phase-1 and -2 metabolites potentially informing of novel steroidogenic pathways in serum and urine. In a second phase, a case-control study will be conducted to apply the strategy in a sample of women with and without endometriosis. In a third step, the investigators will explore statistical differences in steroid profiles among endometriosis groups and evaluate the discriminative performance. The proposed method has large applications in endometriosis research and large potential to provide novel clues about the still poorly understood steroid metabolism disruption undergoing in endometriosis. Ultimately, non-invasive biomarker discovery in urine could revolutionize endometriosis diagnosis and management, allowing for earlier detection and personalized treatment strategies, ultimately improving the lives of individuals affected by this often overlooked but debilitating condition. In parallel, the role of dysbiosis of the vaginal microbiota on hormonal alterations linked to endometriosis will be studied.
Interventions
OTHERBlood test
A blood test (2 x 5 ml dry tubes) will be taken to analyze steroid profiles
OTHERurine sample
a 20 ml urine sample will be taken to analyze steroid profiles
OTHERvaginal sample
to characterize the microbiota.
Sponsors
Nantes University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Women aged 18 to 45 * Free, informed and written consent from the patient to participate in the study * Good understanding of the French language * Patient affiliated to or benefiting from a social security or similar scheme Specific inclusion criteria for each group: Group 1. Controls. * Women with no laparoscopically confirmed signs suggestive of deep endometriosis. * No clinico-biological criteria in favour of a diagnosis of endometriotic disease, nor any radiological signs (ultrasound or MRI) suggestive of endometriosis. Group 2. Cases of deep endometriosis. * Newly diagnosed women (less than 12 months). * Severe, deep endometriotic pathology with surgical indication (clinical examination, imaging tests, pre-operative findings).
Exclusion criteria
* Intercurrent diagnosis of pregnancy. * Presence of other hormone-dependent pathologies (e.g. breast cancer, PCOS). * Acute infection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Identify steroid profiles associated with endometriosis | Sampling at inclusion visit | Statistical associations between steroids and the presence of endometriosis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Identify biomarkers of environmental chemical exposure associated with endometriosis and steroid profiles. | Sampling at inclusion visit | Statistical difference between environmental chemical and steroid exposure profiles between subgroups of the study populations. |
| Identify the role of vaginal microbiota dysbiosis on hormonal alteration in endometriosis | Sampling at inclusion visit | Presence of a specific bacterial community in the vaginal microbiota |
Countries
France
Contacts
CONTACTStéphane PLOTEAU, PU-PH
Outcome results
None listed