How did you get interested in endometriosis research?
My studies have in the past always been focused on cancer, and in the last 10 years or so, specifically on clear cell and endometrioid ovarian cancers. Women with endometriosis are known to be at higher risk for these cancers, and recently my work has shown that endometriosis may, in rare cases, evolve into these cancers. My interest in endometriosis has changed from wanting to know why some become cancerous, while the majority do not.
For your study, you collect saliva and tissue samples from women with endometriosis who undergo surgery. What do you use that for?
Part of the work we do looks at changes in the DNA of endometriosis cells. We want to know if the cells that makes up the endometriosis has acquired specific mutations, and if these mutations are what allow it to grow, cause pain, or turn into cancer. We use the DNA in a patient’s saliva as a reference for that patient. All human DNA is pretty similar, but there are still a lot of differences that make each one of us a little bit different. We want to be sure we look at what makes endometriosis different in each patient, not what makes each patient different from each other. We could also use blood for this, or surrounding normal tissue, but the saliva is convenient to collect and we can be sure there’s no trace of endometriosis DNA!
Congrats on your grant! Can you tell us a little about the project you’ll be working on?
This new project is looking at how endometriosis that has “cancer mutations” might cause different kinds of immune reactions than endometriosis without cancer mutations. We’ll be looking specifically at the kinds of immune cells that are attracted to endometriosis, in different places in the body, and comparing the number, type and response of these immune cells. Immune cells can control a lot of reactions related to inflammation and pain, they can kill off infections and cancers, and they can also tell your body not to fight an infection or cancer. By looking at which mutations affect the immune response we hope to figure out why different women get more vs less pain, and if endometriosis may even be protected or destroyed by the immune system.
A lot of your research happens in the lab – how will the work you’re doing now help people with endometriosis in the future?
There is a lot going on!! Looking at the changes in the DNA of endometriosis is relatively new. In fact, we are the first group to have launched major studies to examine mutations in endometriosis DNA that are not associated with cancer. I hope my experience in cancer research can bring a new perspective to this disease.
My lab’s connection with clinical specialists – like the doctors at the BC Women’s Centre for Pelvic Pain and Endometriosis – may bring real change in the near future. First, we need to find out how cancer-mutations in endometriosis contribute to pain, fertility, or risk of cancer. Having this knowledge could immediately change the way we treat the disease even without new drugs. Depending on the mutations, immune response, and symptoms, a women might be directed to specialist centre for surgery, medical or hormonal therapies, and some women might need long-term monitoring (for example if cancer risk is elevated). As DNA sequencing technologies advance we may also be able to rapidly diagnose endometriosis and provide the proper management to women earlier. Knowing what to look for will make a world of difference!