Steroïde hormonen en eaLocal steroid production (intracrinology) in endometriosis – inter & intra patient variabilityndometriose

Endometriosis is characterised by the presence of endometrial tissue outside the uterine cavity. This condition affects 10% of women of reproductive age and is associated with a number of distressing symptoms such as dysmenorrhoea, dyspareunia, pelvic pain and sub-fertility, with important economic impacts on the society.

In a recent study, we showed the endometriotic tissue (ectopic) is capable of producing local higher levels of 17β-estradiol than the endometrium located inside the uterus (eutopic) because of high level of the enzyme 17β-hydroxysteroid-dehydrogenase type 1 (17β-HSD-1) that converts the low-potent estrone into the high-potent 17β-estradiol. In addition to our findings, also others showed that 17β-HSD-1 can be a potential drug target for endometriosis.



Compounds targeting the 17β-HSD type 1 enzyme are close to the first human trials.

To best design future human trials it is important to characterise the intra & inter patient variability of 17β-HSD-1 and other enzymes involved in the local generation of estrogens (e.g. intracrinology).



Objectives: 1) Chart the intracrine metabolism in women with endometriosis, e.g.: determine the steroid content in endometriosis lesions and in the serum; assess the levels of the intracrine enzymes (mRNA and protein) in endometriosis lesions. 2) Chart the intracrine metabolism (as described in Objective 1) in lesions from distinct location in the same patient.

3) Chart the intracrine metabolism (as described in Objective 1) in the normal endometrium of patients with endometriosis and controls. As secondary objectives, intracrine features will be correlated with additional clinical and radiology characteristics (obtained through standard care) and metabolite profile (such as steroids, inflammatory mediators) in urine and peritoneal fluid. Three hundreds (300) patients and 100 control subjects will be recruited for a total of 400 study subjects.

there exist intra & inter patient variability of 17β-HSD-1 and other enzymes involved in the local generation of estrogens

non applicable

Blood (10 mL), urine (10 mL) and peritonel fluid sampling (10 mL) prior to standard care (e.g. surgery, medical treatment). Completing a questionnaire about life-style. Obtaining an eutopic endometrial sample and a control (without disease) peritoneal sample from both patients and controls (sample from endometriosis tissue will be obtained from rest surgical material).