UCSF Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement

摘要--总体 子宫内膜异位症是一种慢性、衰弱的雌激素依赖型疾病，其组织类似于子宫内层。 (子宫内膜)主要在盆腔组织和器官中发现，在那里它会引起炎症反应，结疤， 盆腔疼痛和不孕不育。它影响数以百万计的育龄妇女，严重影响生活质量和 职业生活，在美国每年有大约690亿美元的巨大健康经济影响，而其病因是 不确定的、严重的先天免疫系统和获得性免疫系统功能障碍与低效损伤有关 清除以及盆腔和全身炎症。子宫内膜异位症病变与疾病的异质性 表型反映在不同的疼痛症状表现，不可预测的生育潜力，不确定 疾病病理生理学，对药物治疗的不可预测的反应，症状和疾病复发 手术切除后，以及合并疾病的风险。子宫内膜异位症的临床分类不适应 疾病表现的异质性，因此缺乏对相关疼痛症状的有效治疗。 在这里，我们的加州大学旧金山分校斯坦福子宫内膜异位症发现、创新、培训和社区中心 Enact提出了一种综合的系统生物学和精确医学方法，以 子宫内膜异位症。我们建议通过跨学科研究子宫内膜异位症未得到满足的需求和挑战。 协作和科技创新，整合多组学数据解剖子宫内膜异位症 疾病机制，识别表型和环境疾病特征，开发准确的疾病 分层和诊断，并确定新的和重新调整用途的药物类别，以改善疼痛症状。至 为了实现这些目标，我们的中心由3个独立和互动的项目和2个核心组成，重点是 子宫内膜异位症精准医学的中心主题。项目1将专注于潜在的免疫学 子宫内膜异位症发病机制及病理生理研究。项目2将致力于开发多个 疾病分类将为诊断战略提供信息，项目3将利用现有的和新的 产生了大规模的基因组数据，以确定和验证新的治疗干预措施。我们长久以来的人类 子宫内膜组织和DNA银行和RedCap数据库以及与我们的协作网络的持续应计 外科医生的数量将是该中心项目的主要资源。该中心将有一个管理核心和一个 教育和社区外展核心，将使湾区的学生参与我们的研究项目 并赋予我们社区的妇女权力，并解决与子宫内膜异位症相关的健康差距问题。要实现 为了实现这些目标，我们在加州大学旧金山分校和斯坦福大学组建了一个多学科的调查团队，其中许多人 他们中的许多人是子宫内膜异位症研究的新手，还有教育工作者、实习生和社区代表。 都致力于改善患有子宫内膜异位症的妇女和少女的生活。整合多个学科， 促进子宫内膜异位症新手之间的合作，培训下一代并结成伙伴 与我们社区的合作对我们子宫内膜异位症中心的结果和影响至关重要。

ABSTRACT - OVERALL Endometriosis is a chronic, debilitating estrogen-dependent disease wherein tissue similar to the uterine lining (endometrium) is found mainly on pelvic tissues and organs where it causes an inflammatory response, scarring, pelvic pain, and infertility. It affects millions of reproductive age women and severely impacts quality of life and professional life, and has a huge health economic impact of about $69B annually in the U.S. While its etiology is uncertain, profound dysfunction of the innate and adaptive immune systems is associated with inefficient lesion clearance and pelvic and systemic inflammation. The heterogeneity of endometriosis lesions and disease phenotypes is reflected in variable pain symptom presentations, unpredictable fertility potential, uncertain disease pathophysiology, and unpredictable responses to medical therapies, symptom and disease recurrence after surgical resection, and risks for co-morbidities. Clinical classifications of endometriosis are maladapted to the heterogeneity of disease expression, and thus efficient treatments for associated pain symptoms are lacking. Herein, our UCSF Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement (“ENACT”) proposes a comprehensive systems biology and precision medicine approach to endometriosis. We propose to study endometriosis unmet needs and challenges through transdisciplinary collaboration and scientific and technologic innovations, integrating multi-omics data to dissect endometriosis disease mechanisms, identify phenotypic and environmental disease signatures, develop accurate disease stratification and diagnosis, and identify novel and repurposed drug classes to ameliorate pain symptoms. To achieve these goals, our Center is comprised of 3 independent and interactive projects and 2 Cores, focused on the central theme of Endometriosis Precision Medicine. Project 1 will focus on underlying immunological mechanisms in endometriosis pathogenesis and pathophysiology. Project 2 will address developing a multi- omic disease classification that will inform diagnostic strategies, and Project 3 will leverage existing and newly generated large-scale omic data to identify and validate new therapeutic interventions. Our long-standing Human Endometrial Tissue and DNA Bank and REDCap database and ongoing accruals with our collaborating network of surgeons will be a major resource for this Center's project. The Center will have an Administrative Core and an Education and Community Outreach Core that will engage students from the Bay Area in our research programs and empower women in our community and address health disparities associated with endometriosis. To achieve these goals, we have assembled a multi-disciplinary team of investigators at UCSF and Stanford University, many of whom are new to endometriosis research, as well as educators, trainees, and community representatives who are all committed to improve the lives of women and teen girls with endometriosis. Integrating multiple disciplines, fostering collaborations among those who are new to endometriosis, training the next generation and partnering with our community are key to the outcomes and impact of our Endometriosis Center.