EH: The breakthrough you made was taking an adult human bone marrow cell and turning it into a healthy endometrial cell?
SB: Endometriosis in its current form is a very complex chronic disease. There is no known cure. Anovulation and frequent menstrual cycles are significant risk factors and are therefore harmful for endometriosis. They can actually induce it.
The treatment today is to give hormones to suppress ovulation and menstruation. If these endometriotic lesions are deposited in different locations in the lower abdomen, we can also perform laparoscopy or surgery to remove them. But this is not a cure because these lesions can come back through additional bouts of retrograde menstruation.
In these women, these cells in retrograde menstrual tissue are originally improperly programmed to be able to survive and cause pelvic inflammation. It makes sense to try to replace the endometrial cells within the uterus with cells appropriately programmed to be a cell therapy for endometriosis.
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Thus, we can take a skin biopsy or isolate blood cells from a woman, erase the DNA program of these cells via Yamanaka factors, and then reprogram these induced pluripotent stem (iPS) cells. We were able to treat these pluripotent stem cells with a series of hormones to convert them into an endometrial cell. They resemble mature endometrial cells that contain receptors for progesterone, which is essential, so they can function as normal endometrial cells.
EH: How to proceed with this discovery in relation to endometriosis?
SB: These inappropriately programmed cells in endometriotic patients are resistant to progesterone. Our simple concept is to perform a skin biopsy on a patient with endometriosis, and create a pluripotent cell from the patient’s cell. Now the cell is responding appropriately to progesterone. Then, through advanced technology that has not yet been created, we hope to replace the cell back in the endometrial cavity, so that diseased cells are replaced by healthy cells normally.
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EH: How can this knowledge be used?
SB: This technique can be applied to other critical problems, such as infertility that occurs in some women with endometriosis. Diseased cells do not respond appropriately to progesterone, but these reprogrammed cells will.
Another potential use may be in patients with Asherman’s syndromeIntrauterine adhesions have destroyed parts of the uterine lining, and the uterine lining cannot be regenerated.
Finally, the same technology can be modified to make other types of cells in the uterus, such as uterine muscle cells, or combined with uterine vascular stem cells to engineer a full uterus, which can be transplanted.
Since the uterus was created with its own cells, there will be less risk of rejection than the donated uterus.
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EH: How long have you been working on this?
SB: We have worked on this stage for four years. Scientists all over the world are working on the same idea in different ways. We chose a very simple method. We have simply tried different external hormonal therapies, but we had to find the right treatment, the right dose, and the right amount of treatment time. We had to demonstrate that these cells were molecularly suitable. Ultimately, we were able to differentiate these cells into an endometrial stromal cell type over a time period of 14 days.
EH: Do you see that happening any time soon?
SB: Every potential therapeutic application I describe now is really my future. We need a lot of new technology to make these things happen because it’s a very complex process. But this is a good step towards these goals. opening the door.