Grant: Project Grant

Endometriosis (EM) is a disease where normal lining of the uterus, called endometrium, grows outside on the organs in pelvic cavity. It is estimated to affect ~200 million women worldwide and more than 50% of them experience infertility and disease recurrence. Pain during intercourse and chronic non-menstrual pelvic pain are the predominant clinical features of EM. Current treatments include hormone therapy and anti-inflammatory drugs that provide only temporary relief and have significant side effects. In this context, cannabinoids has attracted significant attention given their well-established anti-inflammatory and pain relief properties. Further, endocannabinoids are associated with EM development, and pain mechanisms. Although there is no concrete data on numbers, significant proportion of EM patients are taking cannabinoids to relive pain. However, there is little evidence on the mechanisms of whether and how cannabinoids affects EM lesion growth and associated pain. Keeping in view different stages and types of endometriosis, we will evaluate endocannabinoids and their receptors in EM patient samples and associate the findings with pain scores. We will then conduct studies in cannabinoid receptor knock out mice and our established mouse model of EM to understand whether stringent relationship exist between endocannabinoids and their receptors and if so, which of the two receptor(s) or both contribute in lesion development and associated pathology. Finally, we will evaluate therapeutic efficacy of synthetic and plant based cannabinoids in mouse model of endometriosis. This "triple hit" strategy targeting EM-associated angiogenesis, inflammation and pain in one shot will potentially curb EM lesion growth. Outcome of this research may potentially provide real life solution that likely will lead to change in practice for the management of EM in future.