Nerve clue to endometriosis pain

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http://news.bbc.co.uk/2/hi/health/3887365.stm

 

Nerve clue to endometriosis pain

New nerve growth may explain why the condition

endometriosis is painful, US scientists believe.

 

Endometriosis occurs when the tissue which normally

lines the uterus is found elsewhere in the body,

causing pain and sometimes infertility.

 

Professor Karen Berkley and colleagues at Universities

in Florida and Ohio say this 'trespassing' lining

grows its own nerve supply which transmits pain.

 

The study appears in Proceedings of the National

Academy of Sciences.

 

Doctors have known that endometriosis is a painful

condition, which usually involves the pelvis.

 

It's an interesting lead and it's good news

Sanjay Vyas, consultant obstetrician and gynaecologist

at Southmead Hospital, Bristol

 

The pain occurs during a woman's period, when the

endometrial lining in her womb breaks down and sheds

off.

 

Each month the tissue outside of the uterus, under

normal hormonal control, also breaks down and bleeds

in the same way as the womb lining but has no way of

leaving the body.

 

This leads to inflammation and pain.

 

But the exact mechanism behind the pain is poorly

understood.

 

To study this, the US team operated on rats to give

them a condition mimicking endometriosis by

transplanting endometrial tissue from the womb into

the abdomen.

 

They later removed the transplanted tissue to see what

had happened to it.

 

The tissue had grown its own nerve supply that could

transmit information about injury and pain to the

brain.

 

New nerves

 

The researchers believe this nerve supply might also

help the abnormally-located tissue survive and grow by

setting up its own blood supply.

 

They cautioned that the findings only apply to rats,

but said the same might be true in women.

 

If it is, this might lead to new treatments, they

said.

 

Professor Berkley said: " It opens up a whole new way

of thinking about how the disease comes about and is

maintained and how its symptoms come about.

 

" It's bringing about the possibility of treating with

something other than hormonal treatment or surgical

treatment, " she said.

 

The researchers are now doing studies looking at human

tissue.

 

Sanjay Vyas, consultant obstetrician and gynaecologist

at Southmead Hospital in Bristol, said: " It's an

interesting lead and it's good news.

 

" If you can understand how the disease causes symptoms

it can help target treatment.

 

" The downside is it is in rats not humans and within

the rats this is not spontaneous endometriosis so

there might be subtle differences, " he said.

 

Jeremy Wright, president of the British Society for

Gynaecological Endoscopy, said it was an " elegant "

study but he doubted the nerves could regulate the

growth of blood vessels in endometriosis.

 

He had similar concerns to Mr Vyas about whether the

findings would apply to humans.

 

Chief executive of the National Endometriosis Society

Robert Music said: " This sounds interesting, although

obviously it is only on rats. There is a real need for

research into endometriosis, which affects two million

women in the UK. "