# Diagnosis and Treatment of Endometriosis: A Translational Approach

> **NIH NIH P01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $402,938

## Abstract

Project 1 (Young) Diagnosis and Treatment of Endometriosis: A Translational Approach
ABSTRACT
The Collaborative Center to Develop Improved Diagnostic and Therapeutic Approaches to Endometriosis has
the overarching goal of developing advanced tools and insights for improved understanding of the
pathophysiology of endometriosis. We pursue this goal to enhance the diagnosis, assessment, and treatment
of women suffering from this common and devastating disease. Progress in understanding the etiology and
pathophysiology of endometriosis has been significantly compromised by limits to disease assessment, and
current therapeutic approaches prevent fertility and are minimally effective. The dependence on surgical
assessment delays diagnosis and limits clinicians and researchers from confirming endometriosis lesion
recurrence or response to therapies. Thus, a better paradigm is needed to scientifically address this disorder.
Chronic inflammation underlies both infertility and pain in the disease. While resolution of inflammation
throughout the body requires specialized pro-resolving mediators (SPMs), including derivatives of arachidonic
acid, eicosapentaenoic acid, and docosahexaenoic acid, these mediators have not been closely examined in
women with endometriosis. Some SPMs require SIRT1, a histone deacetylase that epigenetically regulates
many disease processes and is overexpressed in the eutopic endometrium of individuals with endometriosis in
humans, baboons, rhesus macaques, and mouse endometrium. However, inflammation persists in
endometriosis, suggesting that SIRT1 induction of SPM resolving activity is compromised. Our preliminary data
indicate that a change in receptor expression results in a shift from anti-inflammatory to pro-inflammatory actions
of SPMs. Therefore, SIRT1 and SPMs may represent novel therapeutic targets for endometriosis.
Our specific aims address the gaps in endometriosis diagnosis and therapy as follows:
In Aim 1, we approach the problem of diagnosis by refining a novel imaging technique that takes advantage of
both steroid hormone expression in endometriosis lesions and the associated inflammation: we propose imaging
endometriosis using a progestin-based tracer 21-[18F]fluoro-furanyl-nor-progesterone (FFNP) for positron
emission tomography (PET) combined with simultaneous gadolinium(Gd)-contrast, magnetic resonance imaging
(GMRI), to allow anatomic localization of endometriosis lesions and highlight areas of inflammation.
In Aim 2, we directly address the issue of treatment by investigating why endometriosis-related inflammation is
not resolved by SPMs, including evaluation of post-translational modifications of SIRT1 and expression of SPM
biosynthetic enzymes and receptors in women with and without endometriosis; and the correlation of these
parameters with inflammation and metabolic alterations in human and non-human primate tissue.
This project exhibits clear synergy with both Project 2 (Jeong and Lessey) and Project 3 (S...

## Key facts

- **NIH application ID:** 10309092
- **Project number:** 1P01HD106485-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** STEVEN L YOUNG
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $402,938
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10309092

## Citation

> US National Institutes of Health, RePORTER application 10309092, Diagnosis and Treatment of Endometriosis: A Translational Approach (1P01HD106485-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10309092. Licensed CC0.

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