# The role of neurotrophins in chronic pelvic pain and central sensitization among adolescents and women with endometriosis

> **NIH NIH R21** · BOSTON CHILDREN'S HOSPITAL · 2022 · $255,358

## Abstract

Project Summary/Abstract
Endometriosis is a common disease among reproductive-aged adolescents and women and can lead to
debilitating pelvic pain, infertility, reduced quality of life and significant health care costs. While some patients
with endometriosis will remain asymptomatic or their symptoms will be managed with empirical treatment,
approximately 30% of women undergoing laparoscopic surgery for endometriosis will have treatment-resistant
chronic pelvic pain, meaning that while their endometriotic lesions have been excised they will not experience
pain remediation. One potential factor leading to the development of chronic pelvic pain among endometriosis
patients is through central sensitization resulting from changes in the central nervous system that amplify painful
stimuli. However, very few studies have assessed central sensitization among women with endometriosis and
none have assessed it among adolescents. Among endometriosis patients, greater innervation of endometriotic
lesions is associated with greater endometriosis-related pain and these pain levels may be further amplified by
the pro-inflammatory environment within the peritoneal cavity. Among other chronic pain conditions, two nerve
growth factors (neurotrophins) - β-nerve growth factor (β-NGF) and brain-derived neurotrophic factor (BDNF)
are thought to be involved in the development of central sensitization. Limited research has assessed the
relationship between neurotrophins within the peritoneal cavity and pain symptoms among endometriosis
patients, and no studies have prospectively assessed the peritoneal fluid levels of neurotrophins in addition to
inflammatory markers at surgery with post-surgery pain symptoms. Our proposal fills this scientific gap by
investigating whether peritoneal fluid levels of β-NGF and BDNF are (1) associated with co-morbid pain
conditions (e.g. migraine, fibromyalgia) among endometriosis patients, and (2) differentiate between
endometriosis patients who will experience pain remediation after surgery and those who will not and if this
association is modified by the inflammatory environment in the peritoneal cavity. Additionally, in exploratory
analyses, we will assess the association between neurotrophin levels in the peritoneal cavity and measures of
underlying pain sensitivity as markers of central sensitization – the first study to date to look at these associations
among endometriosis patients. Collectively, these aims have the potential to advance our understanding of
chronic pelvic pain and central sensitization among adolescents and women with endometriosis – laying
important foundational work in furthering our efforts to provide successful personalized, precision medicine to
maximize pain remediation. Success will reduce health care costs and increase long-term health and quality of
life for adolescents and women with endometriosis.

## Key facts

- **NIH application ID:** 10526863
- **Project number:** 1R21HD107515-01A1
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Amy Lee Shafrir
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $255,358
- **Award type:** 1
- **Project period:** 2022-09-19 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10526863

## Citation

> US National Institutes of Health, RePORTER application 10526863, The role of neurotrophins in chronic pelvic pain and central sensitization among adolescents and women with endometriosis (1R21HD107515-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10526863. Licensed CC0.

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