Dr Paulina Nunez-Badinez
Judy Birch B.Ed
Lydia Coxon BA
Endometriosis and interstitial cystitis affect millions worldwide. The causes of both diseases remain unknown, there is no cure and pain frequently persists and can worsen.
Status of the conditions
The recently updated International Classification of Diseases, ICD 11 includes the category “chronic visceral pain from persistent inflammation in the pelvic region”, hence recognising the pain associated with Endometriosis and Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) . The public-private partnership Innovative Medicines Initiative, IMI-PainCare, aims to improve the management of chronic pain. Specifically, Chronic Pelvic Pain is the focus of their subproject TRiPP (Translational Research in Pelvic Pain) which is committed to improving the translation of laboratory and clinical findings into treatment for Endometriosis Associated Pain (EAP) and IC/BPS.
Diagnosis and treatment of endometriosis and IC/BPS
Endometriosis and IC/BPS are difficult to diagnose, with laparoscopic surgery and histology required for endometriosis diagnosis and IC/BPS being diagnosed when all other possible diseases causing bladder pain and increased urinary urgency and/or frequency are excluded. Whilst there are guidelines for treatments to improve pain symptoms, any symptom improvement is generally short-term and treatments have associated side-effects. Preclinical research in animal models for EAP and IC/BPS are at different developmental stages with a lack of consensus, which hinders the development of new medicines.
Disease understanding is essential
improving patient management is challenging because of the complexity of the
disorders and our limited understanding of them. The TRiPP strategy is based on
obtaining information, including biomarkers, directly from patients in order to
identify the relevant biological pathways affected in these disorders. This
information will be used to refine the existing preclinical models, with a
particular focus on translational aspects so that they better reflect the
symptoms seen in EAP and IC/BPS. One of TRiPP’s hypotheses is that the pain
symptoms in EAP and IC/BPS are generated and maintained by mechanisms which are
similar to those seen in other chronic pain conditions and that they occur
alongside specific pathological lesions and symptoms. The project also aims to
establish whether women with EAP and BPS can be stratified into subgroups and
to explore whether these subgroups relate to treatment response.
 Aziz, Q., et al., The IASP classification of chronic pain for ICD-11: chronic secondary visceral pain. Pain, 2019. 160(1): p. 69-76.
Disclaimer: This work has received support from the EU/EFPIA/Innovative Medicines Initiative  Joint Undertaking (IMI-PAINCARE) grant No 777500 www.imi.europa.eu