Feinstein Institute discovery promises improved diagnosis, understanding of endometriosis

Feinstein Institute discovery promises improved diagnosis, understanding of endometriosis
Dr. Peter Gregersen, left, and Christine Metz recently announced a new, non-invasive procedure to diagnose endometriosis. (Photo courtesy of Northwell Health)

Northwell Health’s Feinstein Institute for Medical Research ended Endometriosis Awareness Month in March with a new possibility for the diagnosis of an illness affecting about 176 million women worldwide.

Dr. Peter Gregersen and Christine Metz, both professors at the Feinstein Institute, announced last month an experimental, rapid and non-invasive way to diagnose endometriosis, which is a chronic condition where tissue from the uterus grows outside itself, typically in the abdominal cavity, and causes significant pain.

Metz said the disease could also cause infertility as many women with endometriosis are also infertile.

“I’ve been working on endometriosis for more than a decade, and it’s a very understudied condition that affects a large number of people,” Metz said. “It’s not a rare disease; it affects 6 to 10 percent of women of reproductive age, and it’s an invisible disease that people suffer with that I’m totally dedicated to as a woman to improve human health, including women who are suffering from menstrual misery.”

Gregersen said the cause of endometriosis is unknown and is most commonly diagnosed through surgery. The pair’s new experimental procedure, however, would diagnose women through an analysis of menstrual blood.

Metz said while many doctors were unsure if women would donate their menstrual blood, collected in a menstrual cup instead of a traditional pad or tampon, but said many women reached out for the study both with and without endometriosis.

Feinstein Institute researchers also established the Research OutSmarts Endometriosis program to study the genetic basis of endometriosis and what is occurring at the cellular level.

Volunteers in the program provide menstrual blood samples, stored in a biobank, so they can be examined for current and future studies.

Gregersen said the team’s recently published study in “Molecular Medicine” focused on the role of stromal fibroblasts, a type of stem cell found in menstrual blood and the immune system.

Laura Warren, a medical student at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell also led the research effort with Metz and Gregersen.

Metz said other groups who have studied the disease, which is funded by the National Institute of Health with less than $1 per patient, have done invasive procedures, such as studying lesions surgically removed.

Metz said the menstrual blood of endometriosis patients contained a significantly smaller number of uterine natural killer cells compared with healthy participants.

In addition to this decrease, the team observed that endometriosis patients’ stem cells showed impaired decidualization, a process that prepares the uterus from embryo implantation.

The scientists are using these observations to develop a non-invasive diagnostic for endometriosis and to learn more about the biology of this devastating disease.

“I think a lot of people don’t know what’s normal,” Metz said. “It has a genetic component, so some young women who start menses and have a lot of problems are told by their mothers, sisters and aunts that’s just the way it is, and they don’t understand necessarily there’s something not right. People don’t always seek help. People feel uncomfortable talking about it. Sometimes, they seek help from their primary care physicians who aren’t the ideal caregiver and information provider regarding endometriosis.”

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