Non-invasive tests for endometriosis are here; how reliable are they, and what should we do with the results?

A reliable non-invasive biomarker for endometriosis is highly likely in the coming years. In the lead-up to this, clinicians need to be aware of commercially available tests as they become accessible, be aware of the level of evidence to support them and be prepared to counsel and manage patients who present with the results of such tests. One such test gaining popularity in Europe was developed using a machine-based learning algorithm to analyse thousands of microRNAs based on a 200-patient cohort with suspected endometriosis in France. We explore the background science for this commercially available test; outline the questions that remain to be answered; and caution against its use outside of a research setting.

Comparison of cervicovaginal fluid extracellular vesicles isolated from paired cervical brushes and vaginal swabs.

Endometriosis is a common gynaecological condition, with a long diagnostic delay. Surgery is required to confirm a diagnosis, highlighting the need for a non-invasive biomarker. Extracellular vesicles (EVs) may have a role in endometriosis pathogenesis, yet there is limited EV biomarker literature available. This study aimed to investigate the feasibility of isolating cervico-vaginal fluid EVs sampled using cervical brushes and vaginal swabs and to compare these methods. After providing informed consent, patients undergoing surgery for suspected endometriosis had cervical brush and vaginal swab samples collected under general anaesthetic. Isolated EVs were characterised through negative stain transmission electron microscopy (TEM), Western blotting (TSG101, CD63, Calnexin, ApoB, Albumin), tunable resistive pulse sensing (TRPS), microBCA assays and RT-qPCR of miRNAs. PCR was performed on samples prior to EV isolation to assess bacteria present in samples. Cervical brush and vaginal swab EVs were intact vesicles with limited co-isolated contaminants. Cervical brushes had higher concentrations of particles compared to match vaginal swabs, although both samples had low concentrations. Protein and miRNA yield were similar between matched samples. PCR demonstrated only a small amount DNA within samples was bacterial (>0.5%). Cervico-vaginal fluids EVs were successfully isolated from cervical brushes and vaginal swabs, demonstrating a new method of sampling reproductive EVs. EV yield from both sample types was low. Similar protein and miRNA levels suggest either sampling method may be suitable for biomarker studies.

Is semantic processing impaired in individuals with high schizotypy?

Semantic processing deficits are present in schizophrenia. However, this research has often been criticized for methodological artifacts and confounds, including long hospitalizations and medication of patient samples. Utilizing high schizotypes (psychosis-prone individuals) can overcome these confounds. Previously, similar deficits have been reported in high schizotypes and schizophrenia on semantic priming tasks. In contrast to schizophrenia research, no other types of semantic processing have been examining in high schizotypes. Semantic processing is multifaceted, thus, deficits on semantic priming can not answer whether high schizotypes have difficulty with explicit semantic processing, that is, on tasks that require the conscious recollection of semantic information. In the current study, 24 high and 30 low scorers on the O-LIFE schizotypy scale were administered a battery of semantic processing measures. The high schizotypy group did not show global semantic processing impairments (as has been shown in schizophrenia), only impairments on a task designed to examine subtle categorization processing. Such deficits can be equated to those found on semantic priming tasks, in that both require quick and accurate access to semantic networks.