# Targeting cellular senescence to inhibit the development and progression of ovarian endometriomas

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2024 · $620,760

## Abstract

Ovarian endometriomas are deep endometriosis lesions on the ovary. Endometriomas are a unique form of
endometriosis in that they do not respond to hormonal therapy and carry the highest risk of developing clear
cell ovarian cancer. There is an urgent need to determine the unique pathogenesis of endometriomas to
improve the lives of women. As an alternative to retrograde menstruation, the induction theory of endometriosis
posits that a substance induces an adult cell to transdifferentiate into endometriosis, although the inductive
substances or the cells which transdifferentiate into endometriosis have yet to be identified. AKA mice
(Arid1aflox/flox; Krasflox-stop-flox-G12D; Amhr2Cre) spontaneously and reproducibly develop large, cystic
endometriomas that recapitulate human endometriomas at the histologic and molecular level. As the genetic
recombination lies in the granulosa cells of the ovary, AKA endometriomas do not develop by retrograde
menstruation. The AKA mouse model allows for the cellular and molecular interrogation of the paradigm-
shifting induction theory of endometriosis using a rigorously reproducible and easily manipulatable
model. Transcriptomic analysis of AKA endometriomas revealed enrichment in cellular senescence
genes. Cellular senescence is defined as a permanent cell cycle arrest. Senescent cells exhibit a senescence-
associated secretory phenotype (SASP) and secrete high levels of pro-inflammatory molecules, similar
to those found in the pelvic cavity of women with endometriosis. These results suggest that senescent cells in
the AKA ovary secrete factors and induce endometriosis. As for the cells induced, granulosa cells exhibit the
ability to transdifferentiate, a developmental process by which fully differentiated cells change into different fully
differentiated cells. The role of senescence in endometriomas is conceptually novel, and the ability of
granulosa cells to transdifferentiate into endometriosis through senescence signaling is a new
paradigm. The central hypothesis is that the senescent microenvironment, mediated by Arid1a loss and
oncogenic Kras, is critical for developing endometriomas through induction and transdifferentiation of
granulosa cells. The objective of Aim 1 is to characterize the unique transcriptomic profile of the senescent
cells and the endometriotic microenvironment using spatial transcriptomics. The objectives of Aim
2 are to identify the genetic changes (i.e., Kras G12D) required for senescence in granulosa
cells, validate the expression of the endometriosis SASP (from SA 1), and establish SASP-mediated
endometriosis transdifferentiation using primary murine granulosa cell cultures and a soluble Cre
recombinase. The objectives of Aim 3 are to determine if senescence is essential for endometriosis
and determine whether senotherapies restore ovarian function, fertility, and reduce endometrioma
development and progression. Targeting senescence through senotherapies is critical to developing no...

## Key facts

- **NIH application ID:** 10889117
- **Project number:** 5R01HD109707-03
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Shannon Michelle Hawkins
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $620,760
- **Award type:** 5
- **Project period:** 2022-09-15 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889117

## Citation

> US National Institutes of Health, RePORTER application 10889117, Targeting cellular senescence to inhibit the development and progression of ovarian endometriomas (5R01HD109707-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10889117. Licensed CC0.

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