Endometriosis-like lesions induced by phthalates: new phytotherapic applications to complement traditional cares: a PNRR 2023 project.

backgroundEndometriosis (E) is an oestrogen-dependent, multifactorial, inflammatory disease causing pelvic pain and infertility. Several concerns have been raised about the role of food contaminants, in particular Bis(2-ethylhexyl) phthalate (DEHP), potentially involved in the onset and propagation of E. Conventional therapies- which have considerable side effects - focus on reducing levels of oestrogens and counteracting inflammation. The potential preventive/protective role of plant extracts (PEs) on phthalate (PH) -induced E is studied by a stepwise approach.

methods(i) raw material identification, extraction and phytochemical characterization; (ii) in vitro tests to evaluate pharmacokinetics and organotropism; (iii) in vitro screening on 2 human endometrial cell lines and in vivo toxicokinetic to select the PEs/BCs in comparison with non-steroidal anti-inflammatory drugs; (iv) in vivo juvenile toxicity study to test the PE/BC activity on DEHP induced E-like lesions and (v) ex vivo and in vitro studies on human E primary cells obtained by patients with E to be subjected to scheduled surgical procedures and human non-cancerous cells, to investigate the DEHP and metabolite concentration and PE/BC effects, respectively. DISCUSSION: The project aims to provide data and tools to develop a new strategy based on herbal medicine- especially polyphenolic compounds for their pleiotropic activities - to mitigate the E symptoms and to prevent and/or to protect population - including susceptible sub-groups - from the onset of E. The outcomes of the project will support the Italian National Health System in the development of complementary alternative/preventive strategies for E and to set clinical studies on humans also considering the potential role of environmental contaminants in E pathogenesis. CLINICAL TRIAL NUMBER: Not applicable.