Endometriosis tissue viewed under a microscope
BIOPHOTOGRAPHY ASSOCIATIONS/SCIENCE PHOTOGRAPHY
Low levels of a certain compound in the stool can be a sign of endometriosis, and supplementation with that compound can help control the condition.
Affecting around 200 million people worldwide, endometriosis occurs when the tissue that lines the uterus grows elsewhere in the reproductive system. There is no known cure, but the lesions can be periodically removed through surgical procedures once the condition is diagnosed. However, largely due to lack of awareness and understanding, today, on average, it takes more than six years to diagnose endometriosis.
Previous research has suggested that the gut microbiome may play a role in this condition. To research more, Ramakrishna Kommagani At Baylor College of Medicine in Houston, Texas, and colleagues collected stool samples from 18 women with endometriosis and 31 women without the disease. They investigated the bacteria in the feces as well as the metabolome, the set of chemicals produced by gut bacteria.
Women with endometriosis were found to have lower levels of the metabolite 4-hydroxyindole in their feces, likely due to alterations in the gut microbiome.
Based on this finding, commercial fecal tests could allow rapid screening of this “underdiagnosed, understudied and underappreciated” condition, leading to early and effective management, Kommagani says.
“It’s very easy to collect stool, and it’s not invasive like current diagnostic techniques like laparoscopy (a kind of keyhole surgery),” he says.
To test whether 4-hydroxyindole might have a protective effect, the team fed endometriosis-induced tissue to a group of mice fed supplemental 4-hydroxyindole. After 14 days of treatment, these mice did not have fewer lesions compared to control animals, but their lesions were significantly smaller and showed significantly less pain.
Further experiments indicated that when mice with established endometriosis received 4-hydoxyindole, their lesions were greatly improved. The results were similar in mice grafted with human endometriosis lesions, suggesting that the treatment may also be effective in humans.
“We think it’s a very good therapeutic option because it occurs naturally in the body, not a drug or something synthesized,” Kommagani says.
However, larger studies in humans will be needed to confirm whether 4-hydroxyindole can be used to diagnose endometriosis and whether the compound is effective as a treatment.
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