Endometriosis Research Provides New Origin Clues, Potential Diagnostic and Possible Treatment Avenues

Feinstein Institutes researchers expand menstrual effluent study to better understand the complex disorder of endometriosis

MANHASSET, N.Y.--(BUSINESS WIRE)--Endometriosis is a common, chronic and often misdiagnosed disorder that affects 6-10 percent of women. Today, researchers at the Feinstein Institutes for Medical Research published new data in the journal Frontiers in Reproductive Health which helps validate the hypothesis that menstrual effluent (ME), or menstrual blood, may be used to diagnose the disorder and revealed new clues into its potential causes.

Accompanied by chronic pelvic pain and often infertility, endometriosis diagnosis is typically delayed by 6-10 years after symptoms first appear and requires invasive surgery for diagnosis. In 2013, to better understand the disorder and explore new non-invasive diagnostic methods, Professors Christine N. Metz, PhD, and Peter K. Gregersen, MD, formed the “Research Out-Smarts Endometriosis” (ROSE) initiative to collect and study menstrual effluent. To date, over 500 women from across North America have joined the clinical study.

With the collection of ME, researchers examine the genetic basis of endometriosis and what is occurring at the cellular level, specifically the analysis of menstrual effluent-derived stromal fibroblast cells (or ME-SFCs). The research announced today marks two milestones for the ROSE initiative.

First, the new research explores the hypothesis that it is inflammation in the uterine lining which promotes the disease, not just in the pelvic cavity, which is a common premise. To test this, the ROSE team took healthy women’s ME-SFCs and introduced them to inflammatory cytokines (TNF and IL-1β) in a laboratory dish (in vitro). They then observed the cells develop the same characteristics as ME-SFCs from endometriosis subjects which resulted in altered gene and protein expression, as well as increased cell migration.

These observed results are consistent with the hypothesis that chronic intrauterine inflammation influences the development of endometriosis lesions in the pelvic cavity following retrograde menstruation, which delivers endometrial cells found in menstrual effluent to the pelvic cavity where most endometriosis lesions are found. This finding sheds new light on the pathogenesis, or formation, of the disease.

“To be able to mimic the development of endometriosis-like cells in a controlled environment is a significant breakthrough to better understand how this disorder develops in a woman’s body,” said Dr. Gregersen, a co-leading author on the study. “Observing the formation of endo-like cells opens up the door for developing new, more effective, and better-tolerated treatments and new hope for millions of women suffering from this condition.”

Additionally, the new research confirms and extends the results of the biomarker study published by the ROSE team in 2018, showing the development of a promising non-invasive diagnostic method for endometriosis based on menstrual effluent. This study also expanded its patient population to include women who have symptoms of endometriosis – but who have not yet undergone surgery to confirm their diagnosis. By using this patient population, researchers can check before and after diagnosis to validate that menstrual effluent may be used to identify the disorder with accuracy and good sensitivity.

“Endometriosis diagnosis is often delayed up to 10 years because of misdiagnosis, social pressure, and the need for invasive surgery,” said Dr. Metz, a co-leading author on the paper. “By expanding the study to include symptomatic women waiting for an official diagnosis, we can cross-check our results, and show that menstrual blood could provide the key to non-surgically identify this debilitating disorder much earlier than in the past.”

The study of ME can reduce the burdens of endometriosis by eliminating the diagnostic delay, improving the understanding of the disease, and promoting earlier treatments.

“Drs. Metz and Gregersen are pioneers and leaders in endometriosis research,” said Kevin Tracey, MD, president and CEO of the Feinstein Institutes. “Their efforts reveal new strategies to diagnose and treat this devastating syndrome.”

To learn more about the ROSE study click the link here. Women with endometriosis or symptoms of endometriosis – like abdominal bloating, chronic pelvic pain, painful menses, pain during intercourse, and/or pain going the bathroom – who wish to enroll and donate their menstrual effluent samples can fill out an interest form here.

About the Feinstein Institutes

The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York State. Home to 50 research labs, 3,000 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit http://feinstein.northwell.edu and follow us on LinkedIn.