As an estrogen-dependent pro-inflammatory disease, endometriosis is defined as the colonization and growth of endometrial tissues at anatomic sites outside of the uterine cavity, primarily on the pelvic peritoneum and ovaries. Up to 5-10 percent of reproductive-aged women worldwide chronically suffer from endometriosis symptoms, such as pelvic pain and infertile.

Due to the severe chronic morbidity associated with this gynecological disorder, our study has attempted to identify the distinguishing molecular features of endometriotic lesions and endometrial dysfunction to develop more effective prognostic, diagnostic, and/or treatment strategies for the clinical management of this debilitating disease and the amelioration of endometriosis-associated infertility.

Project 1: Estrogen/Estrogen Receptor Beta Axis in Endometriosis

Endometriosis is an estrogen-dependent disease. Therefore, the estrogen/Estrogen Receptor (ER)s axis has a critical role in endometriosis progression. Among ERs, the ER-beta level is significantly elevated in endometriotic tissues as compared with normal endometriosis. Now, we will investigate the role of ER-beta in endometriosis progression with the OMICs data set.

Project 2: Dysregulation of Immune in Endometriosis

Retrograde menstruation is the main driving factor to initiate the endometriosis progression. To shedding endometrial fragments is developed into endometriotic lesions, the immune system should be dysregulated compared to normal women. However, it is not elucidated how the immune system is changed in endometriosis patients to allow endometriotic lesions. Now, we investigate how endometriotic lesions dysregulate and then generate an endometriosis-competent immune environment to enhance endometriosis. 

Project 3: Endocrine Disruptor in Endometriosis Progression  

The central hypothesis of endometriosis is retrograde menstruation. Most of the reproductive-aged women (90%) have experienced retrograde menstruation, but 10% of women suffer from endometriosis symptoms.  In addition to retrograde menstruation,  however, other factors should involve in the initiation of endometriosis. Our hypothesis is the exposure of the environment hormone causes endometriosis progression along with retrograde menstruation. Now, we will investigate the molecular etiology of environmental hormone in endometriosis initiation. 

Project 4: Alteration of Epigenetic Regulation in Endometriosis

In addition to genetic variation, the altered epigenomic pattern is also associated with the endometriosis progression. For example, the DNA methylation pattern is quite difference between normal endometrium versus endometriotic tissues. Therefore, our project aims to define how DNA methyltransferase involves endometriosis
progression with various animal models and human endometriotic lesions.

Project 5: Genetic Mutation Causing Endometriosis

Previous studies revealed exon specific gene mutations are defined in endometriosis patients. However, it is not clearly elucidated whether these genes mutation causes endometriosis progression. Using the CRISPR/Cas9 system, we  will determine whether these gene mutations initiate and progress the endometriosis.      

Project 6: Diet therapy for the endometriosis

Our studies revealed that ER-beta has an essential role in endometriosis progression. However, most ER-beta antagonists also inhibit ER-alpha activity in vivo and cause side effects by suppressing ER-alpha activity. To effectively suppress endometriosis without side effects, we have screened natural ligands that effectively inhibit ER-beta activity but not ER-alpha activity. Now, we will investigate whether foods that contain high levels of ER-beta inhibiting natural ligands suppress the endometriosis progression.