US$2.07 million awarded to tackle endometriosis

Hudson Institute's Professor Caroline Gargett and collaborators at the University of Queensland and Monash IVF have been awarded a three-year US$2.07 million (AU$3.05 million) grant to determine the cause of endometriosis and the physiological processes associated with the disease.

She believes the findings from this extensive research project will provide new targets for drug development that are needed for the 176 million women worldwide with endometriosis.

This is a tremendous win for all women who suffer from this incredibly debilitating disease that historically has received little funding attention, despite being as common as asthma or diabetes.

Endometriosis affects an estimated one in 10 women of reproductive age and more than 730,000 women in Australia.

Endometriosis occurs when cells from the lining of the endometrium (the inner lining of the uterus) establish growths in other areas of the body. These cells may stick to organs in the pelvic cavity, such as the ovaries, fallopian tubes, peritoneal lining, bowel or the bladder, where they grow to form lesions.

Finding the cause of endometriosis

To date, Prof Gargett's research has identified three types of adult stem cells present in the endometrium that are believed to play a significant role in menstrual disorders. Adult stem cells are highly regenerative cells with the potential to differentiate into the cells of the endometrium that support early embryo development.

Prof Gargett believes the three types of stem cells are also involved in endometriosis, but in different ways. These cells hold properties different to normal endometrial cells. For example, one of the cell types shows a gene profile indicating they resist the normal process of cell death.

The US$2.07 million in funding will go towards leading edge science that aims to understand how 'risk gene' profiles may cause abnormal endometrial stem cell behaviours in women with endometriosis.

A unique approach

Prof Gargett said: "The novelty and innovation of our approach lies in the merger of two parallel streams of endometriosis research, the identification of risk genes in endometriosis with University of Queensland collaborator Grant Montgomery and our endometrial stem cell biology research.

"Together these approaches will allow us to identify what is happening at the genomic and cellular level. This will give us insight into how endometriosis occurs, and allow us to pinpoint the cause of this disease.

"It's easier to design a specific treatment for the disorder once we know it's root cause. Therefore, we believe our approach will let us address the top two research priorities identified by women with endometriosis—the cause and a cure.

"With endometriosis, we desperately need new ways to diagnose and treat the disorder. We would like to give the millions of women with endometriosis their quality of life back."

Three leading researchers

This research will bring together three world leaders in endometrial research. Prof Gargett's team was the first in the world to discover adult stem cells in the endometrium.

Professor Grant Montgomery's team from the University of Queensland will be collaborating with Prof Gargett. His team discovered endometriosis risk genes and are world leaders in genomics and large DNA sequencing studies.

Professor Luk Rombauts is an endometriosis gynaecologist (Monash IVF) who conducts clinical endometriosis research and is the incoming President of the World Endometriosis Society.

Economic implications of endometriosis

The grant was awarded to Prof Gargett and Prof Montgomery from the US Department of Defense (DoD). This is the first year the DoD has sought to deliver funding for endometriosis research. With women comprising between 15-20 percent of the US military, it is estimated that up to two percent of the US Army population have endometriosis.

"We are extremely grateful that there is a shift in society where the economic and personal impact of endometriosis is being recognised, as this realisation will result in new research that has the potential to improve health outcomes for women.

"The cost of endometriosis to society and the healthcare system is extremely high—with each individual woman with the disorder costing US$11,300 per year. This figure represents the loss of productivity from being unable to work due to the disease, as well as the costs of healthcare.

"These figures indicate that endometriosis is a significant burden for working woman and a significant loss of productivity for the workplace. Funding research into endometriosis will not only greatly improve the lives of many women, it will also have huge beneficial economic outcomes for society."

The personal impact of endometriosis

Bridget Hustwaite, Ambassador for Endometriosis Australia, was officially diagnosed with stage four endometriosis in August 2018 through a laparoscopy after years of painful periods and countless visits to GPS.

"I didn't know anything about endo throughout adolescence, despite having the severe pain and symptoms that come with it. It wasn't anything covered in the health curriculum at high school. At the age of 22, I had a GP that recommended I see a gynaecologist. It wasn't until I got that referral that anyone had used the word endometriosis to describe my condition to me. I didn't know what that was, so I googled it.

"My own diagnosis was a long time coming, and it was a bittersweet feeling receiving it. On one hand, who wants to be dealing with a chronic illness like endo? But on the other, I was so happy and relieved to have an answer as to why I had this pain. And just the validation that came with knowing that it wasn't all in my head, and that I wasn't being a sook.

"In Australia we need faster diagnosis, better treatments, and more education and awareness about endometriosis. I think the fact this research is being funded is a great step in the right direction."

Endometriosis facts

• Endometriosis occurs when cells from the lining of the endometrium (the inner lining of the uterus) establish growths in other areas of the body, usually in the pelvic cavity or on the ovary.
• Despite being outside of the uterus, these lesions are still responsive to female reproductive hormones that trigger menstruation, and as result, may bleed during menstruation, causing inflammation, internal bleeding, scar tissue and severe pain.
• Symptoms can include severe pelvic pain, infertility, heavy periods and nausea.

Team: Professor Caroline Gargett, Professor Grant Montgomery and Professor Luk Rombauts.

For interviews, please contact (not for publication):

Tori McLennon, Communication and Media Advisor

P: (03) 8572 2511 | E: tori.mclennon@hudson.org.au

Ann Pukallus, Communications Manager

P: (03) 8572 2699 | E: ann.pukallus@hudson.org.au

More information:
1. Boling RO, R Abbasi, G Ackerman, AH Schipul, Jr., SA Chaney, Disability from endometriosis in the United States Army. J Reprod Med, 1988. 33:49-52.
2. Simoens S, G Dunselman, C Dirksen, L Hummelshoj, A Bokor, I Brandes, V Brodszky, M Canis, GL Colombo, T DeLeire, et al., The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres. Hum Reprod, 2012. 27:1292-9.
3. Nnoaham KE, L Hummelshoj, P Webster, T d'Hooghe, F de Cicco Nardone, C de Cicco Nardone, C Jenkinson, SH Kennedy, KT Zondervan, Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril, 2011. 96:366-73 e8.

Provided by Hudson Institute of Medical Research