International Medical Conference Endometriosis 2025:
Endometriosis 2025: Your Mother Should Know, Your Doctor Should Know Better!
Discussion: Endometriosis For all: Anatomy -DIE- Peritoneal Profibrotic Disease
Speaker 1:
Thank you, Mario. If I can ask the other speakers to come up. We have Dr. Mazzone and Dr. Gali on video. Let me check and make sure we can talk to them.
Speaker 2:
Oh, hi there. I have a question for Andrew. On the Endo 1000 projects, I think one of your stated aims there was to find better responders of existing treatments. I'm just interested to know whether going in you have any hypotheses around which methods of data collection might prove the most revealing there? So whether the genetic side of things or whether you think it'll be more driven by symptomatic presentation. And I guess the same question goes to your repurposing trial as well, whether there you have hypotheses on which likely subpopulations of highest response.
Speaker 3:
Yeah, so thanks very much for the question. We don't have any set hypothesis. We have done some preliminary work looking at the smart, whether the smart watches can predict response to treatment, particularly with concern to fatigue that patients respond suffer from with endometriosis. So that's one aspect. The same with some of the microbiome analysis that we've done. Again, that's very much related back to fatigue as well. So interestingly, less predictive of painful symptoms. So I think, I mean we're going into it very much with an open mind and hoping that combining all of these approaches will help us identify patterns. But yeah, not sure yet time will tell.
Speaker 4:
Hi, my question is for Professor Horn, you mentioned that in the peritoneal fluid there was lactate. How does that relate to, for example, high intensity exercise that increases lactate production? Is that something that would be harmful done in that case?
Speaker 3:
Yeah, I suppose the lactate, you see the buildup is more in muscles. I hadn't really thought about it in the context of whether it changes within the pelvis itself. I mean obviously when we've been collecting the lactate, it's been at a time of surgery when patients have been bastard, but the comparison has been between groups of patients with and without disease, but also patients that suffer from pain. I think I hadn't thought of it in that context. I think we're probably given the two groups that we're looking at, it's unlikely to be a confounder in this. Is that what you're suggesting or
Speaker 2:
Yeah, that if high exercise patient
Speaker 3:
Exercise, that would increase. Yeah, I think in this instance that's unlikely.
Speaker 1:
Speaker 5:
I want to thank all the speakers. All were wonderful, but I want to ask Dr. Horn about interaction between BN F1 and Zain. Have you tried to use both on the same patient and have you checked the interaction between,
Speaker 3:
Sorry, I couldn't hear your
Speaker 5:
Speaker 3:
D, C and
Speaker 5:
Speaker 3:
So to answer your first question, we haven't tried a combination. The second drug treatment, obviously we haven't started that study, but it's a good idea. I mean, I suppose they all both work by different mechanisms, so be helpful. And then in terms of the duration for the second study that I showed, obviously in the mice we looked up to 21 days, but you're absolutely right and I mean looking at the mouse isn't necessarily going to help us. We need to look at any kind of longer term effects from those treatments, but in patients, yeah.
Speaker 6:
Thank you. Good morning. We've watched extensive surgery done on these patients and I'm wondering once we put the patients through all these wonderful work that we're doing, what is your view on the post-surgical management of the patients? Given that some of them of course will come back to occur in endometriosis at some point, the goals of therapy, meaning at some point do you recommend the hysterectomy in these patients? What medical management you recommend the patients for after the surgery? Just trying to get your views on this. Let's
Speaker 1:
Address those. Dr. Malone first. So Dr. Malone, what is your postoperative management? How do you approach patients postoperative, and what is your long-term follow up?
Speaker 7:
Hi, good evening everybody. Everyone. It's a pleasure to be part of this event. So yes, usually we suggest medical treatment after surgery depends from the desire of pregnancy. Of course, if there is no desire for pregnancy, we put the patients under medical therapy. Using the d NIST medical therapy is the first choice that we have.
Speaker 1:
Thank you. And Dr. Ali, your answer,
Speaker 8:
Hello and lovely to be with you. So yes, I always tell my patients that surgery is just the start. It's not the end of the journey. We not only suggest medical treatment, but women's health, physiotherapy and also intervention in terms of dietary intervention is going to be very useful. Also, I just want to pick up on the word hysterectomy that was mentioned in the question. We only consider a hysterectomy if there is an indication for hysterectomy, not as part of treatment for endometriosis. If there is adenomyosis, then a hysterectomy could be indicated. Otherwise, no, we don't do a hysterectomy.
Speaker 1:
Thank you. We appreciate the speakers this morning and we'll take a short break and start the next session at about five after 10. Thank you.
Speaker 8:
Thank
Speaker 1:
You very much.
Speaker 7:
Thank you
Speaker 8:
So much. Hi
Speaker 7:
