May it be a new non-hormonal treatment option for endometriosis patients?

Women with endometriosis are in need of new treatment options due to disease-related pain that seriously affects their quality of life.

Key Points

Highlights:

• The pathophysiology of endometriosis is multifactorial and diagnostic non-invasive markers are not yet available.
• In a mouse model, inhibiting the CGRP pathway not only alleviated pain but also diminished the growth of endometrial lesions.
• Repurposing FDA-approved migraine drugs might offer a non-hormonal treatment option for endometriosis.

Importance:

• The study uncovers a dual role of pain-sensing nerves in both transmitting pain and promoting lesion development in endometriosis.
• This research paves the way for clinical trials, potentially filling a critical gap in treatment options for millions affected by the disorder

What’s done here?

• This is a news article summarizing an original study published in Science Translational Medicine.
• Although there are several management methods including non-hormonal/hormonal and surgical options, each has limited healing effect on pain.
• Additionally, these options may not provide much benefit for women who want to become pregnant
• The above study developed a mouse model that mimics key features of endometriosis.
• Investigated the interplay between pain-sensing nerves and immune cells , specifically macrophages.
• Evaluated the effects of several FDA-approved CGRP inhibitors on pain and lesion size. 

 Key results:

• Like many other problematic diseases, immunologic and inflammatory dysfunction plays a role in the development of endometriosis.
• Experiments in mice with endometriosis-like condition have shown that damage to pain-sensing nerves may lead to a significant reduction in endometriosis-related pain.
• Disabling these nerves also may contribute to the reduction of endometriotic lesions’ sizes.
• A protein named as CGRP, providing the communication between the nervous system and macrophages may be responsible for the development of endometriosis and pain.
• Newly developed drugs that block CGRP have been shown to reduce pain and shrink lesions significantly.
• CGRP-inhibiting drugs see to be safe and effective for women who want to become pregnant.

Lay Summary

Heidi Ledford published a news in Nature, entitled “How understudied endometriosis causes pain for hundreds of millions of women”. She aimed to summarize the recent status about endometriosis treatment options.

Pain-sensing nerves and immune cells interact to worsen both pain and lesion growth in endometriosis. In a study published in Science Translational Medicine, researchers found that the protein CGRP, which mediates communication between these cells, contributes to both the sensation of pain and the progression of lesions in a mouse model.

Importantly, FDA-approved migraine drugs that inhibit CGRP reduced pain and lesion size in these animals, suggesting they might be repurposed as non-hormonal treatments for endometriosis—a condition that currently offers limited options, particularly for women wishing to become pregnant.

“New non-hormonal treatments for endometriosis are desperately needed.” she added. 

Research Source: https://pubmed.ncbi.nlm.nih.gov/39506178/