Laboratory Tests Indicate Potential of Dichloroacetate for Endometriosis Treatment
Understanding Endometriosis
Endometriosis is a gynecological condition that impacts over 176 million women globally. This disorder occurs when endometrial tissue grows outside the uterus, typically on the pelvic wall, fallopian tubes, and ovaries. The accumulation of blood and tissue from the breakdown of this misplaced endometrial tissue leads to inflammation, swelling, and scarring of surrounding tissues. Consequently, affected women suffer from chronic pain, fatigue, and infertility.
Current Management Challenges
At present, there is no cure for endometriosis, and treatment options are primarily limited to surgical interventions and hormonal medications. Surgical removal of endometrial growths remains the preferred method; however, approximately 50% of patients experience regrowth within five years. Additionally, current hormone-based therapies often serve a contraceptive purpose and come with limitations in efficacy and undesirable side effects.
Innovative Research Approach
To explore new, non-invasive treatment options, researchers from the University of Edinburgh investigated the cancer-like characteristics of endometrial cells. They observed that endometrial tissue may utilize a similar energy production mechanism as tumors. Specifically, cells from the pelvic wall of women with endometriosis were found to produce elevated levels of lactate, a by-product of anaerobic glycolysis commonly associated with cancer cell metabolism. This increase in lactate may contribute to the formation of endometrial lesions, akin to its role in tumor progression.
Experimental Findings with Dichloroacetate
To test their hypothesis, the researchers administered the small-molecule cancer drug dichloroacetate in both cell and mouse models of endometriosis. Human peritoneal mesothelial cells were sourced from the pelvic cavities of women diagnosed with endometriosis at a pain clinic. The results indicated that treatment with dichloroacetate led to a decrease in lactate secretion and reduced cell proliferation, suggesting a correction in abnormal cellular metabolism.
Furthermore, when oral dichloroacetate was administered to a preclinical mouse model of endometriosis, the researchers noted a significant reduction in the size of endometriosis lesions. These findings were published in the Proceedings of the National Academy of Sciences.
Future Clinical Applications
Andrew Horne, the study’s lead author and a professor at the MRC Centre for Reproductive Health at the University of Edinburgh, emphasized the potential clinical implications of this research: “Endometriosis can be a life-changing condition for so many women. Now that we understand better the metabolism of the cells in women that have endometriosis, we can work to develop a non-hormonal treatment. Through a clinical trial with dichloroacetate, we should be able to see if the conditions we observed in the lab are replicated in women.”
References
Horne, A. W. et al. Repurposing dichloroacetate for the treatment of women with endometriosis. Proc Natl Acad Sci USA 201916144 (2019) doi:10.1073/pnas.1916144116.
Canning, S. Endometriosis could be treated with cancer drug, study suggests. EurekAlert! (2019).
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