Endometriosis treatment: Nanoparticles may help avoid surgery

• Endometriotic lesions are the source of pain and numerous medical complications for many people, and there is currently no cure for endometriosis.
• Until now, the only remedy has been surgical removal of lesions, which often return, requiring repeated lesion-removal surgeries.
• A new study finds that injected nanoparticles can both find and, when heated remotely, eliminate endometriotic lesions in mice.

“Endometriosis is a debilitating, systemic disease, and the need for an efficient, non-surgical method of removing the lesions is urgent,” Professor Oleh Taratula of Oregon State University tells the school’s Newsroom.

Prof. Taratula is the corresponding author of a new study investigating the possibility of removing endometriosis lesions non-surgically through the use of magnetic nanoparticles.

With endometriosis, lesions form on the outside of the uterus with tissue similar to that of the organ’s inner layer, the endometrium. This tissue can involve the fallopian tubes and ovaries, as well as the pelvis. On rare occasions, this tissue may spread beyond the pelvic region.

According to study co-author associate professor Olena Taratula, “Endometriosis is a non-malignant condition, but the lesions sometimes perforate organs, resulting in a life-threatening situation.”

Endometriosis occurs in about 10% of reproductive-age women and girls, or roughly 190 million women. It is chronic and can be extremely painful. Endometriosis is linked to pain during periods, bowel movements and urination, and sexual intercourse. It can be the cause of pelvic pain, nausea, abdominal bloating, fatigue, depression, anxiety, and infertility.

It has been reported that 35 to 50% of women with endometriosis have pain, infertility, or both.

There is currently no cure for endometriosis. Surgery can remove lesions to alleviate pain and infertility, though about half of the lesions grow back in time, necessitating multiple surgeries for about 25% of patients.

“We invented,” says Prof. Taratula, “targeted nanoparticles with extraordinary heating capabilities that enable the use of magnetic hyperthermia for the safe and efficient elimination of endometriosis lesions.”

The study is published in the journal NANO • MICRO small.

Nanoparticles remove lesions they have found

Study co-author, doctoral candidate Ananiya A. Demessie, told Medical News Today:

“Magnetic hyperthermia therapy has been explored in the clinic as an alternative cancer treatment approach. Capitalizing on that knowledge, we were able to treat endometriosis in small animal models utilizing our newly developed nanoparticles without the need for surgical removal of lesions.”

The nanoparticles are treated with a chain of multiple linked amino acids — a peptide — drawn to a receptor in endometriosis cells. After injection, they accumulate within endometriotic lesions.

Working with Khashayar Farsad of Oregon Health & Science University’s Dotter Interventional Institute, the authors of the study found that the nanoparticles gathered in lesions serve as an MRI contrast agent. Says associate professor Taratula, “This feature of the nanoparticles can aid in the diagnosis of endometriotic lesions by MRI before their exposure to the external alternating magnetic field,” or AMF.

Conventional nanoparticles can only maintain temperatures of less than 114.8° F, or 46° C, not quite enough to directly kill lesion cells according to previous research. However, Prof. Taratula, together with Youngrong Park, Abraham Moses, Peter Do, and Demessie, developed new hexagonal magnetic particles of iron oxide. They are 6.4 times more heat-efficient than conventional nanoparticles.

Co-author, post-doctoral scholar Dr. Youngrong Park, explained to MNT: “We employed endometriosis-targeted nanoparticles, which accumulate more efficiently in endometriosis lesions than in normal tissues.”

“As a result, only endometriosis lesions can reach temperatures above 50 degrees Celsius [122° F]. We also showed that the tissue around the endometriosis grafts had a negligible temperature increase when exposed to AMF.”​

“With the emerging development of technologies like the HYPER system,” said Demessie, “the AMF delivery to target tissue can be very precise with millimeter accuracy, thus reducing the potential for off-target heating.”

​The researchers were able to eradicate lesions of macaque endometriotic tissue transplanted into mice in a single non-surgical session.

“According to the literature and our observations,” Demessie noted, “injected nanoparticles are eventually collected and eliminated from the body by the spleen and liver. But this needs more investigation.”

A less invasive approach to treatment

The study concludes:

“The obtained results suggest that nanoparticle-mediated magnetic hyperthermia can potentially provide an efficient non-surgical approach to eradicate endometriotic lesions and shift the paradigm for endometriosis treatment.”

– Oleh Taratula et al.

“Validation of the developed systemically delivered magnetic hyperthermia in large animal models is important for advancing this therapy to women.”

Before trials with humans, the researchers plan to verify the safety and effectiveness using “old-world non-human primates that spontaneously develop endometriosis and are functionally similar to women.”

“Although these results are preliminary,” said Demessie, “I am hopeful that they will provide the framework for a potentially safe and effective endometriosis treatment that does not require surgery.”

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