Open Access
CC BY-NC-ND 4.0 · Semin Reprod Med 2020; 38(02/03): 179-196
DOI: 10.1055/s-0040-1719084
Review Article

Physiomimetic Models of Adenomyosis

Juan S. Gnecco
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
,
Alex T. Brown
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
,
Ellen L. Kan
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
,
Lauren Baugh
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
,
Clara Ives
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
,
Megan Loring
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
3   Endometriosis and Adenomyosis Care Collaborative, Center for Minimally Invasive Gynecologic Surgery, Newton Wellesley Hospital, Newton, Massachusetts
,
Linda G. Griffith
1   Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
2   Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
› Author Affiliations

Funding National Institutes of Health http://dx.doi.org/10.13039/100000002 EB029132 National Science Foundation http://dx.doi.org/10.13039/100000001
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Abstract

Adenomyosis remains an enigmatic disease in the clinical and research communities. The high prevalence, diversity of morphological and symptomatic presentations, array of potential etiological explanations, and variable response to existing interventions suggest that different subgroups of patients with distinguishable mechanistic drivers of disease may exist. These factors, combined with the weak links to genetic predisposition, make the entire spectrum of the human condition challenging to model in animals. Here, after an overview of current approaches, a vision for applying physiomimetic modeling to adenomyosis is presented. Physiomimetics combines a system's biology analysis of patient populations to generate hypotheses about mechanistic bases for stratification with in vitro patient avatars to test these hypotheses. A substantial foundation for three-dimensional (3D) tissue engineering of adenomyosis lesions exists in several disparate areas: epithelial organoid technology; synthetic biomaterials matrices for epithelial–stromal coculture; smooth muscle 3D tissue engineering; and microvascular tissue engineering. These approaches can potentially be combined with microfluidic platform technologies to model the lesion microenvironment and can potentially be coupled to other microorgan systems to examine systemic effects. In vitro patient-derived models are constructed to answer specific questions leading to target identification and validation in a manner that informs preclinical research and ultimately clinical trial design.



Publication History

Article published online:
09 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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