Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions

In the first experimental model of deep nodular endometriosis, lesions similar to endometriotic nodules were induced, and they invaded surrounding organs in more than 40% of cases.

Olivier Donnez, M.D., Anne Van Langendonckt, Ph.D., Sylvie Defrère, Ph.D., Sébastien Colette, Ph.D., Olivier Van Kerk, Jean-Paul Dehoux, D.V.M., Ph.D., Jean Squifflet, M.D., Ph.D., Jacques Donnez, M.D., Ph.D.

Volume 99, Issue 3, Pages 783-789.e3, 1 March 2013


To establish an experimental model for the study of deep nodular endometriosis.

Induction of nodular endometriosis in baboons by grafting different uterine specimens to the peritoneal cavity.

Institute of Primate Research, Nairobi, Kenya, and Catholic University of Louvain, Brussels, Belgium.

Ten baboons were used to develop a model of induced deep nodular endometriosis.

Biopsies of endometrium, endometrium plus the JZ, full uterine thickness and myometrium were grafted to the peritoneum.

Main outcome measure(s):
Macroscopic descriptions were recorded for observed induced lesions. Staining with hematoxylin-eosin was performed for histological evaluation and specific antibodies (CK22, CD10) for immunohistochemical studies. Surface area and volume of lesions, glandular density and surrounding organs invasion were also analyzed.

The incidence of induced nodular endometriosis was 100%, but the extent depended on the tissue grafted. Lesions induced after grafting specimens containing the JZ were significantly (p<0.05) larger than those not containing the JZ. Surrounding organ invasion was reported in more than 40% of lesions after grafting specimens containing the JZ. Conclusion:
Here we describe the first experimental model of nodular endometriosis. This new model now allows investigation of deeper nodular lesions, as well as invasion phenomena associated with nodular lesions.

  • This study follows up on a previous paper by the same group from 2011 (“Is the baboon model appropriate for endometriosis studies?”, F+S Sept 2011). In these articles the induction of endometriosis is demonstrated with impressive histologic, and laparoscopic images. The model holds great promise to study endometriotic lesions, including nodular lesions and their invasiveness. The caveat to the model is that the induction of endometriosis in the baboon is costly and time-consuming, as well as relatively inefficient (Induction of endometriosis in 20.7% in the 2011 study). It will also be interesting to see if the induction of endometriosis is confirmed in more detail on a molecular level. Nevertheless this model is a great addition to the experimental tools to study endometriosis.

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