EFA Medical Conference 2017 "Breast, Ovary and Endometriosis" October 28, 2017 - Lotte New York Palace Hotel
Hormone and Cytokine Sensitivity in Endometriosis
Robert Taylor, MD, PhD
Interviewer: Dr. Robert Taylor, thank you so much for being here. You're with the Wake Forest University Health Sciences. Thank you again for coming to the conference.
Dr. Taylor: It's a pleasure.
Interviewer: We just want to talk to you a little bit about your talk in the conference a little bit ago about hormone and cytokine sensitivity in endometriosis. If you can, just kind of give us a brief overview. And unfortunately, all of us have not been to medical school, so if you could do so in layman's terms for us, that'd be great.
Dr. Taylor: Sure. So hormones and cytokines. Hormones are molecules, compounds, that are released from endocrine glands, travel throughout the body and have effects on various cells including cells of endometriosis. Estradiol, or estrogen, and progesterone are two of the common female sex hormones that actually have these influences. Both of those come predominantly from the ovary.Cytokines are like hormones too, they're actually secreted products from immune cells, inflammatory cells, lymphocytes, and the kind of cells that really give us immunity to protect us from various infections and other diseases. Cytokines are made from these cells and they circulate as well, and they can have effects on endometriosis cells, endometriosis lesions. But rather than coming from endocrine glands or from the ovary, they come from the immune cells that actually kind of surround those.
So we've been interested both in how hormones and cytokines influence the growth and potentially the shrinkage of endometriosis cells.
Interviewer: Why is it so important to study this relationship between the two?
Dr. Taylor: Well, we know that surgical therapy for endometriosis is really primary, but there aren't lots and lots of really excellent endometriosis surgeons, nationally or internationally. And often times, there will be failures of surgical treatment. And we can either subject women to further surgeries, or we can attempt to use medical therapies to try to help with their symptoms. Medical treatments have been used for quite a few years now, really since the '50s with not the greatest results in the past, in part because we think that we need to have more targeted treatments that would work better than the kid of treatments that we currently have available to us.
Interviewer: Okay, thank you. And I do have a question here from an audience member who is watching via the livestream, and they want to know, "What are some of the side effects patients experience when using hormone therapies?"
Dr. Taylor: So there are significant side effects. The predominant hormone therapies that are being used currently are ones that really suppress the hypothalamic pituitary ovarian access. They suppress estrogen production from the ovaries and create almost a pseudo-menopausal state. We happen to know that when women enter the menopause, their endometriosis symptoms tend, in the majority of cases, to get better. So we can kind of replicate that state with medical therapies. Unfortunately, those are associated with hot flashes, vaginal dryness, discomfort with intercourse, some mood changes, and bone loss, which is silent but can be quite dangerous.
So there definitely are limitations to the medical therapies as a result of these side effects that you're describing. So that's, again, one of the reasons why we're hoping that perhaps by understanding cytokine biology a little bit better, we might be able to develop new drugs that would target the inflammatory aspects of the disease, allowing some of the ovarian hormones to do their naturally functioning things to maintain good bone health, good mental health, good mood, and probably cardiovascular effects as well.
Interviewer: Well thank you so much Dr. Taylor for your time and for being here at the conference.
Dr. Taylor: No, you bet. Thank you.
Interviewer: Thank you.