Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Endometriosis (EM) is a chronic disease where tissue similar to the uterine lining grows outside the uterus, often on the ovaries, bowel, and bladder. EM affects ~10% of reproductive-age women, impacting 190 million worldwide. Symptoms include pelvic pain and infertility, though severity varies widely. Some patients with severe EM may be symptom-free, while others with mild disease suffer debilitating pain. This variability contributes to misdiagnosis and diagnostic delays, averaging 4-11 years. Diagnosis remains challenging and invasive, relying on direct visualization of lesions through laparoscopic surgery. Yet ~50% of procedures yield negative findings, subjecting patients to unnecessary trauma and delays. Despite its prevalence and impact on quality of life, effective diagnostic and therapeutic strategies remain limited, with no non-invasive or fertility-sparing options. EM disproportionately affects females, intersecting with societal and gender biases that contribute to disparities in care. The cause of endometriosis is not fully understood, but emerging evidence points to improper functioning of the body's immune system and suggests a potential role for small extracellular vesicles (sEVs). sEVs are tiny particles released by cells that carry influential cargo from their cells of origin. sEVs circulate in body fluids, transferring these altered signals to other cells/tissues, which can drive disease progression. Their unique properties make them promising biomarkers for EM. We propose the first in-depth analysis of sEVs in EM, providing a comprehensive molecular profile and exploring their functional roles in disease mechanisms. Using patient samples, cell culture models and mechanistic studies in mice, our study will reveal the utility of these sEVs to identify novel biomarkers specific to EM. This will help prioritize candidates for surgical reconfirmation, reduce unnecessary procedures and ultimately shorten diagnostic delays to improve patient outcomes.