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Winning Startup Village project seeks to simplify endometriosis diagnosis

Whoopi Goldberg’s got it. Susan Sarandon has it. So has Dolly Parton, and they’re far from alone. An estimated 176 million women around the planet suffer from endometriosis, a condition in which tissue that normally grows inside the uterus (endometrium) grows outside of it, often causing great pain and leaving up to half of its sufferers infertile. One of the problems associated with endometriosis is difficulty and delays in diagnosing it. Now Russian biomed startup Endometrics is developing a minimally invasive testing system that could save millions of women years of frustration and false diagnoses.

Yana Garazha, head of Endometrics, pictured at the Startup Tour in Arkhangelsk. Photo: Sk.ru.

The Moscow-based Endometrics won 1 million rubles ($17,000) earlier this month in the final of the Ideas Contest at Skolkovo’s Startup Village. The project has been a resident startup of the Skolkovo Foundation since last December, and has been awarded a microgrant to help fund its research.

Endometriosis can be a devastating condition. Nearly half of the women who suffer from it endure chronic pelvic pain, and endometriosis is notoriously difficult to diagnose. It is not known what causes the condition, and there is no cure, but symptoms can be alleviated with surgery or hormone treatment. Despite ongoing efforts to identify biomarkers that would enable non-invasive diagnosis, currently, the only surefire diagnosis method is a laparoscopy – a surgical procedure in which a camera is inserted through an incision in the belly to look at the abdominal or female pelvic organs.

The Endometrics project aims to develop a test for the early and minimally invasive diagnosis of endometriosis based on intracellular processes.

“Endometriosis is a multifactorial illness, at the basis of which lie an array of molecular abnormalities,” said Yana Garazha, head of Endometrics.

“For this reason, our research is based on a comprehensive approach: we’re not looking for a particular mutation or a specific protein biomarker, we’re assessing the whole pool of intracellular abnormalities that occur in cells in endometriosis patients.”

In 2015, the group analysed 14 samples of the eutopic (inside the womb) and ectopic (outside the womb) endometrium from six patients, and found a strong correlation between the activation of intracellular signaling pathways in the cells of both kinds of endometrium. The results of that analysis were then presented at the 17th World Congress of Gynecological Endocrinology in March 2016 in Italy, and at the 45th AAGL (American Association of Gynecologic Laparoscopists) Global Congress in Florida in November 2016. The following month, Endometrics became a resident of the Skolkovo Foundation, and in January its application for a microgrant to carry out the next series of analysis was approved.

Endometrics won first prize in the biomed category of the Ideas Contest at the Startup Village earlier this month. Photo: Sk.ru.

Endometrics is currently conducting analysis of biosamples from a larger group of patients than it studied before, and is collecting samples both from women who have been diagnosed with endometriosis and from those who do not suffer from it, as a control group. The startup plans to create a prototype test system this autumn.

“The Endometrics project became a Skolkovo resident relatively recently, but thanks to the team’s active work, it is moving forward from one goal to another,” said Vladimir Egorov, Endometrics’ project manager within Skolkovo’s biomed cluster.

Film star Marilyn Monroe is believed to have suffered from endometriosis. Photo: Wikimedia Commons.

“The move over to non-invasive screening is a worldwide trend, so we are optimistic about the project’s prospects. We are eagerly awaiting the results of clinical lab tests of a ready testing system, which the project will be ready for next year. Right now, the formulation of a list of markers that this system will detect is nearly complete. We plan to finance the creation of a commercial prototype with a mini-grant,” he said, adding that an application was already being drawn up.

Although in recent years, endometriosis has been the focus of more attention in the West (the condition now has its own designated global awareness month: March), Endometrics believes its precise research focus is unique.

“Professor Linda Guidice at the University of California, San Francisco is studying the transcription of cells, but only in eutopic endometrium, while we are studying both eutopic and ectopic endometrium, and are determining the correlation of abnormalities in the endometrial tissues in different locations,” said Garazha. Scientists at the Medical University of Vienna are also studying biomarkers as a potential way of diagnosing endometriosis.

The spotlight on endometriosis in the West was not just prompted by a series of high-profile actresses and other celebrities talking about their struggle with the condition. In the U.K., the average time taken to diagnose the debilitating illness – seven-and-a-half years – has prompted calls for change. Members of parliament there have called the treatment of endometriosis “unacceptable.” More than 2,600 women spoke to the All Parliamentary Group on Women’s Health in the U.K., with 40 percent saying they had seen a doctor 10 times before being diagnosed. In some cases, diagnosis took up to a decade, despite the fact that up to 10 percent of women in the U.K. are believed to suffer from the illness.

In Russia, there are fewer statistics available for incidence rates and diagnosis times, said Garazha.

“The last data available for endometriosis is state statistics service (Rosstat) data from 2010, which showed that its occurrence had grown 72.9 percent in the previous 10 years,” she said. 

“Treatment of patients is decided on an individual basis and depends on factors such as the severity of the symptoms, the patient’s age, the type of endometriosis, the patient’s desire to become pregnant, and the existence of concurrent conditions. But the main treatment methods are the same in Russia as in most other countries: hormone therapy and surgery to remove endometriosis and cysts,” said Garazha.

Earlier this year, Endometrics won first prize in the biomed category of the Startup Tour pitching competition in the northern city of Arkhangelsk. Endometrics is partnered with clinics operating in the Arkhangelsk region.