A research team from the Wayne State University School of Medicine has proposed a new hypothesis about the factors involved in the progression of endometriosis and the potential reasons it leads to infertility.
Professor of Obstetrics and Gynecology and of the C.S. Mott Center for Human Growth and Development Husam Abu-Soud, Ph.D., led the review and related project, with support from Department of Physiology master’s student Olivia Camp; Wayne State School of Medicine student David Bai; Pravin Goud, M.D., Ph.D., University of California - Davis; and Michael Diamond, M.D., Augusta University. The group compiled current research in the field, while adding a new outlook for future research.
Camp is the lead author of “A novel theory implicating hypochlorous acid as the primary generator of angiogenesis, infertility, and free iron in endometriosis,” included in the May issue of the journal Fertility and Sterility Reviews, which reveals the first evidence that hypochlorous acid, or HOCI can be a primary modulator promoting the growth of endometriosis. She and her colleagues examined the morphology and color of endometriotic lesions, and observed that local high inflammation and oxidative stress also can contribute to infertility by diminishing egg quality.
“We believe chronic inflammation, caused by the body reacting to the tissue and cells outside of the uterus, can generate free radicals and reactive oxygen species that cause the tissue to grow in the abdomen through promoting new blood flow, or angiogenesis,” Dr. Abu-Soud said. “Specifically, we believe myeloperoxidase, or MPO, an inflammatory enzyme that produces hypochlorous acid, or HOCI, a reactive oxygen species, are key players in this process, and our previous studies have shown these substances produce detrimental effects to oocyte (egg) quality.”
The result allows a comprehensive understanding of what they know and how to proceed. It also provides the potential for future new therapeutic treatments that target MPO and reactive oxygen species to alleviate symptoms and progression, such as supplementation with antioxidants like melatonin and lycopene.
Endometriosis is a common disorder in gynecology that can cause complications with trying to get pregnant or maintain pregnancy, and may lead to infertility. It can cause chronic pain and may require surgery because the tissue that is supposed to grow inside the uterus each menstrual cycle instead grows throughout the abdomen.
“It is important for us to continue studying this disorder and get a good understanding of how it begins and progresses, because it affects about 10% of reproductive-age women worldwide, yet we still do not know enough about it to efficiently diagnose or treat it,” Dr. Abu-Soud said.