Extracellular vesicles as biomarkers of endometriosis.

Abstract

We propose an origin of endometriotic lesions akin to the ‘seed and soil’ hypothesis in cancer, with extracellular vesicles (EVs) interacting with the intraperitoneal environment and the prospective lesion site, preparing the ground for attachment and growth of endometrium ectopically. EVs contain specific cargo from the cell of origin and would be good biomarkers of endometriosis, if found in the blood. We have shown that EVs can be directly isolated from PF and are now investigating blood samples in parallel to PF samples to see if we can trace the same EVs in both sample types. Conclusion: Extracellular vesicles are present in the peritoneal fluid and can be isolated directly. Women with endometriosis show endometriosis-specific vesicles in their PF. Whether the same vesicles can be traced in blood samples remains to be confirmed. Additional sample collection sites (Epworth) will speed up the discovery and validation work.