Women who suffer with endometriosis and endometrial cancer could be treated with a bioengineered human uterus, and scientists say their latest research could “open the door” to a raft of potential treatments.
Researchers in America have taken the first step towards adapting a damaged female sex organ by taking unhealthy stem cells, known as human pluripotent stem (iPS) cells, and reprogramming them to be healthy ones.
The study is the first of its kind to show a woman’s own stem cells can be used in this way. This type of ‘auto-transplant’ is beneficial because, unlike normal transplants, it doesn’t run the risk of rejection by the patient’s immune system.
Endometriosis is a condition where the tissue that lines a woman’s womb –known as endometrium – is found in areas outside the womb such as the ovaries and fallopian tubes.
It occurs in some women because the endometrial cells in their uterus have not responded correctly to the implantation hormone (progesterone) that stops them from moving around. The abnormal cells travel through the fallopian tubes, on to the lower abdominal tissues and ovaries. This can result in severe pelvic pain, development of adhesions, infertility and risk of ovarian cancer.
Worldwide, approximately 10 per cent of women of reproductive age (about 200 million) suffer with endometriosis. This includes 1.5 million women in the UK.
In previous attempts at uterus transplantation to treat endometriosis patients, the biggest obstacle to success was the rejection of someone else’s uterus by the patient’s immune response. This problem could be solved if the whole uterus was bioengineered by populating a scaffold with the patient’s own reprogrammed iPS cells.
While the transplant is still a long way off, Dr Serdar Bulun, who has been researching endometriosis treatments for 25 years, said these findings were “huge” and have “opened the door” to treating endometriosis.
“These women with endometriosis start suffering from the disease at a very early age, so we end up seeing young high school girls getting addicted to opioids, which totally destroys their academic potential and social lives,” said Bulun.
Details of the treatment, published in the Stem Cell Reports journal, suggest these women’s defective endometrial cells could eventually be replaced with normal cells, which would reproduce and respond properly to progesterone.
The study also opens avenues for replacing these defective cells with cells derived from a woman’s own skin or blood.
“One day we hope to make a whole uterus using this cell-based treatment employing the patient’s own iPS cells,” Bulun said.