Endometriosis is a common and severe illness affecting women in their reproductive years. Despite the ongoing interest and intensive research of this disabling disease, its etiopathogenesis remains unknown, although the first description of endometriosis dates back 150 years ago. Endometriosis is generally considered a steroid-sensitive disease. Together with an aberrant steroidal response of endometriotic women, another possible cause of endometriosis has been identified in a defective cellular and molecular immune system response.
Endocrine-disrupting chemicals (EDCs) have been described as a general class of chemicals that induce hormone dysregulation in humans or wildlife, exerting adverse effects on reproductive, developmental, cardiovascular, neurological, metabolic, and immune process. As a result, human exposure to EDCs has aroused a wide range of health concerns, including obesity, diabetes, cancer, and decreased fertility.
Considering the close connection between EDC and immune dysregulation within endometriotic patients has been investigated, but no clear and unique available evidence,in this study,we decided to investigate its possible association in patients affected by this pathology.Therefore we hypothesize that a definitive molecular and cellular signature could be determined by combining clinical, epidemiological,environmental and immunologic data, thus defining a detailed biologic profile that can predict the onset, treatment resistance, and progression of endometriosis.Consequently, we hypothesize that a definitive molecular and cellular signature could be identified with an enrollment of 200 consecutive patients affected by endometriosis, all referring to the endometriosis outpatient setting of our Gynecology Division(Sant Andrea University Hospital in Rome),in order to define a precise biologic profile able to provide an innovative clinical and epidemiological tool to prevent, monitor and treat the population of women affected by endometriosis.
The definition of the linkage between pollutants and immune suppression could potentially lead to the definition of a precise biologic profile able to predict the onset, treatment resistance and progression of endometriosis. The widespread origin of our patients, due to our partnership with APE Onlus, will also provide new epidemiological insight into the environmental and acquired mechanisms involved in endometriosis at different latitudes of Italy. The grade of patients immune suppression is expected to be influenced by different types and levels of circulating EDC.
By combining environmental with immunological data, we expect to identify a precise biologic profile able to predict the onset, treatment resistance and progression of endometriosis. In particular, by stratifying patients for a geographical area, we aim to provide an innovative clinical and epidemiological tool to prevent, monitor and treat the population of women affected by endometriosis of high impact for the National Health System.
In case of demonstrated lack of correlation between immunosuppressive levels and EDCs levels in our cohort, we will anyway provide novel results in terms of EDCs and immunosuppression distribution within the Italian subset of endometriotic patients, which is pivotal for the definition of the reliable presence of the disease in our Country.
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