Endometriosis is a chronic inflammatory disease that affects 10% of all women of reproductive age. It is characterized by the ectopic growth of endometrial tissue outside the uterus and is a major cause of pelvic pain and disability. Endometriosis also has an adverse effect on fertility, with almost one third of patients failing to conceive. The aetiology of endometriosis is unknown; a definitive diagnosis of endometriosis requires invasive laparoscopic surgery, and treatment options are limited in number and efficacy. The aim of this project is to characterise the glycans that are expressed in blood and uterine tissue and fluids in patients with endometriosis and to investigate the role of these glycans in mediating dysbiosis. We will adopt an integrated, systems biology approach to finely characterize how circulating and local uterine glycans from glycoproteins and the uterine microbial ecosystem are altered in endometriosis. We will investigate how altered glycans affect pathogenic bacteria binding to the endometrial cells, focusing on microbes specific for this disease. Using our combined multidisciplinary expertise in glycomics, microbiology and gynaecology, we will use findings from this study to define changes in glycosylation associated with endometriosis that may be used as non-invasive biomarkers for this disease and also how these changes might affect microbiome which may provide insight into disease pathogenesis. More effective diagnosis and treatment of endometriosis has the potential to significantly reduce the healthcare cost burden associated with current strategies and may increase success rates of pregnancy and live births in these patients.
