09/03/2023
Two excellent articles on new discoveries in endometriosis research have appeared online: one in the Guardian, written by Gabrielle Jackson and the other in Medscape by Ann Thomas.
Excitement is growing in this field after years of stagnation. Scientists and researchers are collaborating across different disciplines to bring new ideas to the forefront. In line with the thinking of natural therapists, a shift in perspective is occurring, viewing endometriosis not merely as a pelvic disease but as a systemic condition affecting the whole body. A series of developments, including a major genetics study and breakthroughs in Australia and Japan, have ignited optimism in the community.
Quoting from the Medscape article: “In 1927, American gynaecologist John Sampson published his theory of the aetiology of endometriosis, postulating that retrograde flow of endometrial debris flows backward through the fallopian tubes during me**es into the peritoneal cavity. Sampson's notion remains the main paradigm today, mentioned still in recent articles on the topic, but it has a flaw: Although the theory may account for how endometrial tissue escapes the uterus, a 1984 study revealed that this phenomenon occurs in 90% of women. Why, then, do only 10% of women suffer from endometriosis?”
In March, the largest ever study on the genetics of endometriosis was published in Nature Genetics, which found genetic links to 11 other pain conditions as well as other inflammatory conditions. The study, involving DNA from more than 760,000 women, also found ovarian endometriosis is genetically distinct from other types and indicated there may be a genetic predisposition to excessive inflammation in people with the condition.
Shortly after, Japanese researchers discovered a common form of bacterium (found in gum disease) may be contributing to the growth of endometriosis via generating inflammation and abnormal cellular behaviour. In a cohort of women, 64% of patients with endometriosis but fewer than 10% of healthy controls were found to have Fusobacterium infiltration in the endometrium (mainly Fusobacterium nucleatum). Analyses revealed that activation of transforming growth factor-β (TGF-β) signaling resulting from the Fusobacterium infection of endometrial cells led to the transition of quiescent fibroblasts to myofibroblasts, which gained the ability to proliferate, adhere and migrate in vitro. Myofibroblasts are not found in normal endometrial tissue but are present in endometriosis.
These developments have reinvigorated the research world and have led to new ideas about the disease's mechanisms. A growing focus on the neuroimmune system and chronic inflammation is gaining traction, with researchers recognising endometriosis as more than just a reproductive system disorder.
Australian gynaecologist, Dr Susan Evans believes that the “uterus-brain axis” plays a significant role in endometriosis, influencing chronic inflammation and its impact on various bodily systems. “I personally believe the reason why women are so much more affected by immune conditions than men is that there’s also a uterus-brain axis, and the uterus talks to the brain via inflammation,” Evans says.
While scientists are now investigating new treatment avenues, such as immunomodulatory drugs and antibiotics, these discoveries both validate and further inform the approaches already used by natural therapists to manage this complex and challenging disorder. For more information see:
https://www.theguardian.com/society/2023/aug/10/its-really-only-the-beginning-are-we-on-the-cusp-of-a-breakthrough-in-endometriosis
https://www.medscape.com/viewarticle/993862 #:~:text=They%20found%20many%20of%20the,development%20of%20new%20blood%20vessels