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Last week's headlines gave false hope to the 8 to 10 percent of women of childbearing age with endometriosis:
Endometriosis is an inflammatory disease characterized by the discovery of tissues similar to the lining of the uterus (called endometrium) outside the uterus, causing pelvic pain and / or a infertility.
We do not know what causes endometriosis, and although surgery and medical management can help many women manage their symptoms, this disease has a negative impact on women's lives in almost every area, from work to intimate relationships.
Read more:
Are you planning a surgical procedure for endometriosis? Here is what you need to know
The new paper was published by a British team that studies the mechanisms of endometriosis-related pain, mainly in mice induced artificially by endometriosis.
They found that mice with endometriosis had higher levels of white blood cell types (called macrophages) than healthy mice. This has resulted in an increase in the production of a growth hormone called insulin-like growth factor (IGF) -1.
When the levels of macrophages and IGF-1 were lowered, the mice behaved so as to suffer less.
Although this study is very well designed and this information helps us better understand why the pain badociated with endometriosis seems to persist despite medical or surgical treatment, the researchers did not find the cause of the disease, much less a cure.
How did the search go?
The study involved three main components: one in living mice, the other on the reaction of mouse cells in a laboratory environment and a women-focused component.
Mouse experiments
The researchers performed two experiments on two groups of mice: one did not have endometriosis, the other did not.
The first experiments compared levels of macrophages – a specific type of white blood cell involved in the immune system – in mice with or without endometriosis, and then followed the behavior of these mice that reflect the pain.
The researchers then tried to reduce the level of macrophages and release IGF-1 in some mice with endometriosis. They wanted to evaluate whether pain levels would be reduced or return to the same levels as in mice without endometriosis.
The second experiment revealed that the IGF-1 hormone produced by macrophages was higher in mice with endometriosis.
The researchers exposed half of the mice with endometriosis to a drug that could block IGF-1 and again badessed their pain-related behavior.
Laboratory studies on mouse cells
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Two other aspects of the study took place in mouse cells.
Changes in markers of inflammation in the brain and spine of mice with and without endometriosis were examined.
The second focused on nerve growth and pain sensitivity in the presence of IGF-1.
Test the theory in women
The researchers attempted to demonstrate that IGF-1 was higher in the tissue of endometriosis and peritoneal fluid (abdominal cavity) of women with endometriosis compared to women who did not have endometriosis. did not have any.
To do this, they recruited women with chronic pelvic pain who underwent laparoscopy (a procedure in which a camera and surgical tools are used via small cuts in the abdomen) for the diagnosis and treatment of the patient. # 39; endometriosis.
What were the results?
The researchers found that mice with endometriosis had higher macrophage concentrations than those with no endometriosis. These macrophages had increased the production of IGF-1.
In women with endometriosis, the researchers detected macrophages specifically producing IGF-1 in the tissues of endometriosis.
Women with endometriosis also had a higher concentration of IGF-1 in their peritoneal fluid (abdominal cavity) than women without endometriosis. Their pain scores increased with the increase in their levels of IGF-1.
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When the researchers attempted to reduce the macrophage concentration in the mice, the animals appeared to exhibit less pain-related behaviors. But not all behaviors have changed with the reduction of macrophages.
Similarly, when the mice received a drug that prevented the normal effect of IGF-1, the mice appeared to experience less pain.
The effect of macrophage reduction in mice also appears to have a positive effect on the reduction of inflammatory markers in the brain and spine.
What does all this mean?
The researchers found evidence showing that IGF-1 was higher in women and mice with endometriosis. This increase was due to increased production of macrophages, badociated with endometriosis.
This increase in IGF-1 levels seems to contribute to the pain felt by mice with endometriosis. This is probably due to the fact that IGF-1 encourages nervous development, which makes this tissue more sensitive to pain.
It's important to remember that mice are not just little furry humans. We therefore need further studies to determine whether these elevated levels of IGF-1 have the same effect on pain in humans as in mice, and whether their reduction has the same effect on the pain that was observed in the mouse experiments.
We must also keep in mind that these mice have been suffering from endometriosis for a relatively short time compared to many years of this disease in women with endometriosis. It is possible that other changes occurring in the long term can not be explored in these mouse models.
Andrzej Wilusz / Shutterstock
The study allows us to better understand why endometriosis causes pain and offers cautiously optimistic hope for future treatments intended for women suffering from pain related to endometriosis.
But this does not explain the cause (or causes) of endometriosis, which remains elusive.
– Mathew Leonardi, Mike Armor and George Condous. Cecilia Ng, head of the clinical trial network of National Clinical and Scientific Trials on Endometriosis (NECST) at Jean Hailes for Women's Health, also contributed to this article.
Blind peer review
This research report is a good summary and interpretation of the research paper on the badociation between IGF-1-related pain and endometriosis.
This study is published by a respected research team and they are careful not to overestimate their conclusions. In contrast, the newspaper article in The Sun is a major misrepresentation of the study and that could unnecessarily raise the hope of an imminent cure for endometriosis in the mind of many women suffering from this disease.
Endometriosis is a complex disorder that has genetic and environmental risk factors. It is unlikely that we discover a single responsible problem. This is reflected in the different treatment approaches currently used. – Peter Rogers
Research Checks queries recently published studies and their report to the media. The badysis is conducted by one or more academics who did not participate in the study and review it by another to ensure accuracy.
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