Non-invasive theranostics for endometriosis

Endometriosis presents significant diagnostic and therapeutic challenges due to associated pain, infertility, and complex presentation and pathophysiology. The only definitive diagnostic method available to date is the histological assessment of biopsies obtained by laparoscopy. Current treatments are palliative and limited to pain management, hormonal therapy or surgery. This project addresses the need for improved diagnostics and treatment of endometriosis by focusing on two novel endothelial cell (EC) biomarkers, Endometriosis-Specific Endothelial Cell Target 1 and 2 (EMECT1/2). Preliminary data show that ECs in endometriosis lesions upregulate EMECT1 and 2.  EMECT1 is also expressed in eutopic endometrium, whereas EMECT2 is preferentially expressed in ectopic lesions. Both EMECTs are luminally expressed in blood vessels, so targeting by engineered nanobodies (NAbs) could have therapeutic and/or diagnostic utility. We are developing NAb based imaging agents that recognize these biomarkers after intravenous injection to specifically accumulate in endometriosis lesions and enable the diagnosis, localization and monitoring of endometriosis by routine medical imaging. If successful, this approach may be extended to enable selective targeting of lesions with novel therapeutics.