New tests set to dramatically speed up diagnosis for endometriosis
Women with suspected endometriosis will no longer have to spend years trying to get a diagnosis thanks to new “game-changer” tests approved for use in the GP surgery.
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Endometriosis is a painful condition where cells similar to those in the lining of the womb (uterus) grow in other parts of the body.
These cells can grow and change in response to hormones, leading to inflammation, pain and the development of scar tissue.
The condition is driven by female hormones oestrogen and progesterone, linked to the menstrual cycle, but research into the role of androgens, such as testosterone, has been limited.
A team led by researchers at the University of Edinburgh found those with endometriosis have differences in a group of androgens – so-called “male” hormones – compared with those without the condition.
They said the findings could lead to a simple, non-invasive route for diagnosis of the condition, which currently takes an average of nine years in the UK and is confirmed through surgery.
In a bid to dramatically cut the time it takes for women to be told whether they have the condition, the National Institute for Health and Care Excellence (Nice) has given the green light to EndoSure and Endotest on the NHS.
With Endotest, women give a saliva sample which is then sent off to the lab to check for tiny biological markers called microRNAs. This indicates the presence of endometriosis.
Meanwhile, EndoSure can detect the condition by measuring electrical signals in the gut using sensor pads on the abdomen.
Women fast for six to eight hours beforehand and then drink water for 45 minutes during this test.
The latest study saw scientists look at hormone levels in the blood of 159 women with confirmed endometriosis and 57 women without the condition.
Their analysis focused on androgens, including 11-oxygenated androgens – a group of hormones produced by the adrenal glands – and found those with endometriosis have a distinct hormone “fingerprint”.
This includes high levels of an 11-oxygenated androgen called 11-ketotestosterone.
By using the unique hormone “signature”, the researchers were able to correctly identify more than 95% of endometriosis patients taking part in the study.
Endometriosis is thought to affect around one in 10 women of reproductive age in the UK.
The study’s principal investigator, Dr Douglas Gibson – from the University of Edinburgh’s Centre for Reproductive Health, said: “These findings mark a significant breakthrough in our understanding of endometriosis.
“Traditionally seen as an oestrogen-driven disorder, our research challenges this view by showing different androgen levels in the condition.
“We are optimistic that this new insight will lead to earlier diagnosis and the development of innovative new treatments for those affected by endometriosis.”
The team is looking for industry partners to help develop a diagnostic blood test for endometriosis, based on the study’s findings.
They also said the study’s insights into the role of androgens could offer a route for future therapeutic targets for the condition.
'Exciting discovery'
Dr Susan Bodie, director of innovation development and licensing at Edinburgh Innovations – the university’s commercialisation department, said: “This is an exciting discovery that addresses an important unmet need in the field of women’s health.
“Edinburgh Innovations would encourage partners who can help develop this proprietary technology, so it can reach women who currently wait years for an endometriosis diagnosis, to get in touch.”
'Long-awaited'
Emma Cox, CEO of the charity Endometriosis UK, said: “Endometriosis affects one in 10 women and those assigned female at birth, yet has historically been under-researched and under-funded.
“For too long, those with endometriosis have faced unacceptably long waits for diagnosis, and it currently takes an average of over 9 years to get a diagnosis in the UK. Without a diagnosis, treatment cannot be accessed and the disease may progress.
“A reliable, non-surgical diagnostic test is much needed, long-awaited, and could help drive down diagnosis times to just a few months.
“These early results are promising, however larger trials will be essential to validate these findings.
“This is exactly why investment in endometriosis research matters – and why we will be following the progress of this research with interest.”
The study is funded by Wellcome and the Medical Research Council and is published in the European Journal of Endocrinology.
The research team included scientists from the Universities of Liverpool, Glasgow and Birmingham.