# SIRT1 as a Therapeutic Target in Endometriosis

> **NIH NIH P01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $385,802

## Abstract

Project 2: SIRT1 as a Therapeutic Target in Endometriosis
ABSTRACT
Progesterone resistance is now recognized as a key element in the pathophysiology of endometriosis, though
its underlying mechanism is not well understood. Using mouse and non-human primate models, as well as
human tissues, we have developed a hypothesis surrounding the histone deacetylase Sirtuin-1 (SIRT1),
which appears to play a critical role in progesterone resistance of endometriosis. Triggered by
inflammation, SIRT1 orchestrates progesterone resistance that appears to have a pathophysiological role during
endometriosis-related infertility in the mouse. Due to profound and chronic inflammation elicited by
endometriosis, SIRT1 is overexpressed during all cycle stages in women with endometriosis. By promoting
progesterone resistance, endometriosis becomes self-sustaining and progressive, with progesterone resistance
promoting estrogen action and curtailing the antagonistic effects of progestins. Understanding these principles
provides unique testable hypotheses for both the diagnosis and treatment of endometriosis in a preclinical mouse
model of endometriosis. In Project 2, we propose synergistic studies that complement the overlying goal of this
P01 to develop both diagnostic and therapeutic approaches to endometriosis. In two specific aims we will use
highly innovative engineered mouse models, including Sirt1 overexpression and endometriosis models with
bioluminescent and fluorescent reporters for non-invasive imaging; integrated bioinformatic analysis to
investigate the role of SIRT1 in the progesterone resistance of endometriosis; and preclinical assessment of a
new therapeutic approach for endometriosis using an FDA-approved drug for Huntington’s disease. In Aim 1 we
will determine the essential nature of progesterone resistance and endometriosis progression. We will examine
structural, molecular, and inflammatory features of endometriosis and define the specific transcriptomic and
epigenetic changes involved in progesterone resistance and infertility that depend on SIRT1 overexpression.
These progesterone resistance signatures will be compared in both the mouse and human endometrium. In Aim
2 we will further investigate and explore the very real and exciting possibility that a specific SIRT1 inhibitor (EX-
529; selisistat), given at the proper dose and time, can reverse progesterone resistance and infertility and treat
lesion ontogeny and progression in our mouse endometriosis model. These studies will serve to identify new
mechanistic targets and set the stage for human trials of specific SIRT1 inhibitors that could dramatically
improve therapeutic options for women with this common and devastating disease.

## Key facts

- **NIH application ID:** 10309093
- **Project number:** 1P01HD106485-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Jae-Wook Jeong
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $385,802
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10309093

## Citation

> US National Institutes of Health, RePORTER application 10309093, SIRT1 as a Therapeutic Target in Endometriosis (1P01HD106485-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10309093. Licensed CC0.

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