New grant to explore causes of endometriosis and potential therapies

Endometriosis can cause severe chronic pelvic pain for women and around 10% of reproductive age women may experience symptoms. It’s also one of the major reasons why some women can’t get pregnant, affecting up to 50% of women with infertility, according to the U.S. Department of Health and Human Services Office on Women’s Health.

Formal portrait of Kanako Hayashi
Kanako Hayashi

A research team led by Washington State University’s Kanako Hayashi will study the disease, trying to better understand why endometriosis happens and then develop a new non-hormonal therapy to lessen symptoms. The work is funded by a five-year, $2.3 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health (NIH).

Endometriosis occurs when the uterine lining (endometrium) grows outside the uterus. For most women, menstrual blood and uterine tissues flow out of the pelvic cavity during their period. For women with endometriosis, tissues remain and grow in the pelvic cavity around the ovaries, uterus, and fallopian tubes. Those tissues can build up and form lesions that cause severe pain.

“The menstrual flow should be cleared out by the immune system,” said Hayashi, an associate professor in WSU’s Department of Animal Sciences and associate director of the Center for Reproductive Biology. “So we think one of the main drivers of endometriosis is the immune system not working correctly.”

The research team will look at a drug, niclosamide, that’s already approved by FDA and was originally designed to treat tapeworms.

“We’re trying to get more knowledge of this drug, we think it is targeting abnormal inflammation and its associated immune cells,” Hayashi said.

Endometriosis is an estrogen-dependent disorder, and hormonal therapies like oral contraceptives are available to reduce symptoms, as those medications inhibit estrogen production and function. The only other current treatment option is surgery.

Because these strategies only temporarily relieve endometriosis symptoms, repeated courses of surgical or drug therapy are required. Total direct costs associated with this chronic disease are estimated at over $12,000 per patient per year in the U.S., Kanako said. Endometriosis imposes costs on society similar to those of other chronic diseases, such as type 2 diabetes, Crohn’s disease, and rheumatoid arthritis.

The team will study niclosamide in the pre-clinical setting, and hopes to perform clinical trials to examine its effectiveness for endometriosis patients.