# Harnessing biomarker and phenotypic diversity among adolescents and women with endometriosis to advance personalized medicine for diagnosis and pain remediation

> **NIH NIH R21** · MICHIGAN STATE UNIVERSITY · 2020 · $213,974

## 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. Currently laparoscopic
surgery is the only means for providing a definitive diagnosis of endometriosis. The average delay to diagnosis
from symptom onset is 7 years, potentially leading to unchecked endometriotic lesion progression and
increased risk and severity of morbidity later in adulthood. While numerous studies have investigated non-
invasive screening tests for diagnosing endometriosis, none have proven to have sufficient specificity and/or
sensitivity to replace laparoscopic surgery. Further, once an adolescent or woman has been diagnosed with
endometriosis she often faces a struggle to find the most effective treatment modality to relieve endometriosis-
related symptoms. While the revised American Society for Reproductive Medicine endometriosis staging and
the Endometriosis Fertility Index have been used to predict prognosis after endometriosis diagnosis; neither is
specific to predicting if adolescents and women will experience pain remediation. Additionally, a subset of
endometriosis patients will develop central sensitization leading to treatment refractory chronic pelvic pain. The
lack of discovery for a non-invasive screening test for endometriosis diagnosis and for monitoring disease
progression may be due to considering endometriosis as a single entity and not including the full heterogeneity
in symptom profiles and patient characteristics to assess diagnosis and pain remediation after treatment. Our
proposal fills this scientific gap by (1) investigating a non-invasive diagnostic for endometriosis combining
patient symptoms and characteristics with inflammatory, oxidative stress and central sensitization biomarkers;
(2) assessing changes in inflammatory, oxidative stress and central sensitization biomarkers before and after
surgery; and (3) determining the optimal set of patient symptoms and characteristics in addition to
inflammatory, oxidative stress and central sensitization biomarkers to advance personalized treatment
selection. We will assess inflammatory and oxidative stress biomarkers as an aberrant immune response and
increased oxidative stress have been implicated in endometriosis etiology and progression. Collectively, these
aims have the potential to advance our understanding of phenotypic diversity among adolescents and women
with endometriosis; diversity that will be the foundation for successful personalized, precision medicine to
shorten diagnostic delay and 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:** 9921458
- **Project number:** 5R21HD096358-02
- **Recipient organization:** MICHIGAN STATE UNIVERSITY
- **Principal Investigator:** STACEY ANN MISSMER
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $213,974
- **Award type:** 5
- **Project period:** 2019-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9921458

## Citation

> US National Institutes of Health, RePORTER application 9921458, Harnessing biomarker and phenotypic diversity among adolescents and women with endometriosis to advance personalized medicine for diagnosis and pain remediation (5R21HD096358-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9921458. Licensed CC0.

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