Researchers at the University of Edinburgh have shown that the painful symptoms of endometriosis could potentially be alleviated using a drug that has so far been investigated as a treatment for cancer.
They found that treating endometrial cells with the drug reduced production of the potentially harmful waste product lactate and prevented aberrant cell growth.
Endometriosis is a chronic, painful condition that affects approximately 176 million women globally. It is characterized by the growth of endometrium-like tissue (lesions) outside of the womb, usually on the pelvic peritoneum.
Currently, there is no cure for endometriosis, and treatment is difficult. All drugs that have been approved are contraceptives, which limits their use among women of child-bearing age. The drugs are also associated with unpleasant side effects. Lesions can be surgically removed, but recurrence rates post-surgery are as high as 50% after five years.
The University of Edinburgh researchers found that human peritoneal mesothelial cells (HPMCs) taken from the pelvic peritoneum of women with endometriosis exhibit a different metabolism, compared with women who do not have the disease.
The authors say the cells "exhibit significantly higher glycolysis, lower mitochondrial respiration, decreased enzymatic activity of pyruvate dehydrogenase (PDH), and increased production of lactate compared to HPMCs from women without disease."
This resembles the behavior of cancer cells, which are programmed to use aerobic glycolysis to increased lactate secretion.
"In tumors, lactate is considered a key factor in driving cell invasion, angiogenesis, and immune suppression, changes that are also implicated in the establishment and survival of endometriosis lesions," writes Andrew Horne and team.
As reported in the Proceedings of the National Academy of Sciences, the researchers treated HPMCs from women who had endometriosis with a PDH activator that has previously been investigated as a cancer drug.