- Pathophysiology of endometriosis and associated pain
- Pathophysiology of gynaecological cancers
Endometriosis is an extremely prevalent condition that is accompanied by chronic pain, reduced fecundity and an increased risk of ovarian cancer later in life all of which can be related to inflammation. The most widely accepted theory of endometriotic lesion development is retrograde menstruation, a process by which viable endometrial cells are refluxed backwards into the peritoneal cavity. These cells attach to the underlying tissue and via a hormonal and inflammatory stimulation continue to grow. As retrograde menstruation has been shown to occur in almost 90% of women additional factors must be involved that support the attachment of the endometrial tissue in those patients who suffer from endometriosis. To date, these factors are still not fully identified. Endometriosis is as such a benign condition but, unfortunately, it is associated with specific ovarian cancer subtypes such as clear cell and endometrioid carcinoma subtypes (also named endometriosis-associated ovarian cancers, EAOC). Direct transformation of endometriotic epithelial cells to a malignant endometrioid, or clear cell ovarian cancer has been documented, although what stimulates this transformation is unclear.
In our studies, we are analysing samples such as endometrial tissues (eutopic and ectopic), body fluids (blood, peritoneal fluid) to better elucidate the biological bases sustaining endometriosis itself but also endometriosis associated pain, fertility loss and oncogenesis. The strength of our research is the large number of samples obtained from the Department of Obstetrics and Gynaecology at the University of Berne and constantly accumulated in our biobank with the great involvement of the physicians and the generous consent of the patients. Through our approach, we hope that these studies ultimately, amongst other scientific benefits, improve the diagnosis and reduce the symptoms for the overall benefit of the patient quality of life.