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Researchers at Baylor College of Medicine, in collaboration with several institutions, have made significant strides in the understanding of endometriosis, a condition impacting nearly 200 million women globally. Their recent study, published in the journal Med, highlights promising advancements that could lead to a non-invasive stool test and innovative therapy options for the condition.
“Endometriosis arises when tissue similar to the uterine lining develops outside the womb, often attaching to areas such as the intestines or the abdominal cavity. This abnormal growth can result in symptoms like severe pain, internal bleeding, inflammation, and infertility,” explained Dr. Rama Kommagani, the study’s corresponding author and associate professor in the Department of Pathology and Immunology at Baylor. “Typically, it can take up to seven years for a diagnosis, during which time many women are misdiagnosed with bowel disorders, highlighting the urgent need for enhanced diagnostic and treatment strategies.”
Prior research conducted by the team indicated that the microbiome—the vast array of bacteria present in the body—and their byproducts may play a role in the progression of endometriosis. The latest study delves deeper into this relationship by contrasting the stool bacteria and metabolites of women diagnosed with endometriosis against those from healthy counterparts. The results revealed marked differences between the two groups.
The study proposes that the stool metabolites identified in women suffering from endometriosis might serve as a foundation for a novel non-invasive diagnostic test and a framework for therapies aimed at decelerating the disease’s progression.
Researchers pinpointed a distinct set of bacterial metabolites associated with endometriosis, including a specific compound known as 4-hydroxyindole. “This metabolite is generated by beneficial gut bacteria, yet its levels are notably lower in women with endometriosis compared to those without,” said Dr. Chandni Talwar, the first author and a postdoctoral researcher in Dr. Kommagani’s lab.
“The implications of our findings are quite promising,” Talwar noted. “Previous animal studies have correlated specific bacterial metabolite profiles with endometriosis, but our research is groundbreaking as it reveals a unique metabolite signature that relates to the human form of the condition, advancing our understanding and potentially improving management approaches.”
Moreover, comprehensive experiments revealed that the administration of 4-hydroxyindole in animal models effectively halted both the onset and escalation of inflammation and pain linked to endometriosis.
“Interestingly, the metabolite profile we’ve identified in endometriosis bears resemblance to patterns observed in inflammatory bowel disease (IBD), hinting at potential connections between these two medical conditions,” Kommagani remarked. “This supports the hypothesis that the microbiome may have a significant role in both endometriosis and IBD.”
The research team is dedicated to further developing the non-invasive stool test for endometriosis and is actively conducting studies to assess the safety and effectiveness of 4-hydroxyindole as a prospective treatment.
Other contributors to this research include Goutham Venkata Naga Davuluri, Abu Hena Mostafa Kamal, Cristian Coarfa, Sang Jun Han, Surabi Veeraragavan, Krishna Parsawar, Nagireddy Putluri, Kristi Hoffman, Patricia Jimenez, and Scott Biest, all affiliated with Baylor College of Medicine, University of Arizona – Tucson, and Washington University School of Medicine – St. Louis.
This significant study was supported by grants from NIH/NICHD (R01HD102680, R01HD104813) as well as a Research Scholar Grant from the American Cancer Society.
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