There is often a delay in diagnosing endometriosis, and women with endometriosis can wait 7 to 10 years to receive a correct diagnosis. A keyhole surgical procedure called a laparoscopy is the main method used to diagnose endometriosis. However, some types of endometriosis may be diagnosed through an ultrasound or MRI. Endometriosis is often classified as minimal, mild, moderate or severe, or from stage I to stage IV. There is no early detection test currently used to diagnose all types of endometriosis.
Our scientists are working to better understand the biology underlying endometriosis to help reduce the diagnostic delay. By detecting subtle differences in tissues or body fluid samples donated by women with endometriosis, our scientists are hoping to find genetic signatures, also called biomarkers, to inform diagnostic tools or tests. There is no biomarker currently available for endometriosis. Discovering biomarkers for endometriosis may help to inform an early diagnostic test.
Developing non-invasive diagnosis of endometriosis
Team: Dr Jemma Evans, Prof Lois Salamonsen, Dr Tracey Edgell
On average, it takes 7 to 10 years for a woman to be diagnosed with endometriosis because the symptoms can be non-specific and may be ignored as being ‘just part of life’. Often, by the time endometriosis is diagnosed, usually by a surgical procedure called laparoscopy, the endometriosis is well established and is significantly affecting the woman’s life. This project hopes to uncover protein biomarkers for endometriosis by comparing samples from women who have endometriosis and those who don’t, with the aim of developing a non-invasive early diagnostic test for endometriosis that can be easily applied to any woman presenting with potential symptoms.
Most women menstruate - so why do only some get endometriosis?
Team: Professor Lois Salamonsen, Dr Tracey Edgell, Dr Jemma Evans
Almost every woman menstruates throughout their reproductive years, yet only around one in ten women have endometriosis. We still don’t know what causes endometriosis, or why only some women have the condition. One explanation for endometriosis is that it is caused by retrograde menstruation, where menstrual fluid containing endometrial cells flows back into the pelvic cavity instead of out of the body. This project plans to examine specific proteins present in the fallopian tubes, which may help to either block or enable menstrual fluid to travel into the pelvic cavity to form lesions, in order to explain why endometriosis only occurs in some women.
Could an early bleed be a biomarker for endometriosis?
Team: Professor Caroline Gargett
A small number of newborn girls (one in 20) will experience a small ‘menstrual’ bleed in the first week of life, known as neonatal uterine bleeding. Unlike a girl getting her period, this event was never thought to be significant – in fact, it has been largely ignored by the medical community for the last 40 years. Working with international collaborators, Prof Caroline Gargett’s team has now developed a hypothesis that neonatal uterine bleeding may be linked to the development of early-onset endometriosis at puberty. The team believes this small bleed may cause endometrial stem cells to implant in the pelvic cavity of newborn girls, where they remain dormant until a girl reaches puberty. Then, estrogen is generated and activates the stem cells to grow into endometriosis lesions. Prof Gargett’s team is now interested in developing a register for neonatal uterine bleeding at major hospitals, to determine if this event could be a biomarker of early-onset endometriosis.
New tricks: Could revisiting an ‘old’ protein be the key to controlling endometriosis?
Team: Dr Tracey Edgell
Endometriosis is an inflammatory condition, and research shows inflammation is present in the reproductive tracts of women with endometriosis. A protein called ORM1 is implicated in controlling inflammation in chronic conditions, and our researchers are now examining its role in endometriosis. ORM1 has a large number of sugars attached to it, which help to determine whether this protein will promote or reduce inflammation. Unlike dietary defined sugars, these are complex sugars that are generated by the body. Many decades ago, the technology available to explore the roles of these sugars was limited, but research showed that at least one form of ORM1 was present in women with endometriosis. With today’s improved technologies, the team will re-examine ORM1 in women with endometriosis to identify unique sugar forms that may determine how they regulate inflammation. Understanding how this protein works could lead to a new test to non-invasively diagnose endometriosis.