The concept of invasion in deep nodular endometriosis

Endometriosis is a benign estrogen-dependent gynecological disease, known to occur in 7-10% of women of childbearing age. Despite its prevalence and severity of symptoms, the pathogenesis of deep nodular endometriosis has not yet been elucidated. In 2013, our team successfully developed the first experimental induction model of deep nodular endometriosis in baboons, allowing to investigate the pathogenic evolution of these lesions. The present work aimed to study the mechanisms of invasion and innervation of deep nodular endometriotic lesions induced in a baboon model and in deep nodular endometriotic lesions observed in women. Our study clearly indicates that the mechanism that supports gland invasion in deep endometriotic lesions is dominated by collective cell migration. Moreover our results shed further light on the mechanism of innervation of deep nodular endometriosis, suggesting that innervation of these lesions may be a consequence of nerve recruitment from surrounding organs.