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ENACT

Our UCSF-Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement (“ENACT”) is a new collaborative program comprised of an accomplished group of investigators and clinicians in multiple disciplines, as well as educators, trainees, and community representatives who are all committed to improve the lives of adults and teens with endometriosis.The overall goals of our Center are to understand endometriosis pathogenesis and pathophysiology, develop accurate disease classifications, identify novel therapies, improve patient outcomes, train the next generation in endometriosis research, and engage our community in these efforts to enrich research and to empower those affected.

About Our Center

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 people 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.

 

Our UCSF Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement (“ENACT”) takes a comprehensive systems biology and precision medicine approach to endometriosis. We 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 research projects and 2 Cores, focused on the central theme of Endometriosis Precision Medicine.

Our long-standing Human Endometrial Tissue and DNA Bank and REDCap database and ongoing accruals with our collaborating network of surgeons are a major resource for this Center's project. The Center has an Administrative Core and an Education and Community Outreach Core that engages 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 adults and teens 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.

Our Team

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Linda Giudice, MD, PhD (UCSF)

Principal Investigator

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Marina Sirota, PhD (UCSF)

Principal Investigator

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Brice Gaudilliere, MD, PhD (Stanford)

Principal Investigator

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David K. Stevenson, MD (Stanford)

Core Director

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Jessica Opoku-Anane, MD, MS  (Columbia)

Core Director

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Traci Ito, MD (UCSF)

Core Director

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Synthia Mellon, PhD (UCSF)

Core Director

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Susan Fisher, PhD (UCSF)

Project Director

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Tracey Woodruff, MD, MPH (UCSF)

Project Director

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Stacey Missmer, ScD (MSU)

Contributor

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Nima Aghaeepour, PhD (Stanford)

Project Lead

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Stacy McAllister, PhD (Emory)

Project Lead

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Joshua Robinson, PhD (UCSF)

Project Lead

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June-Soo Park, PhD (DTSC)

Project Lead

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Joseph T. Rabban III, MD, MPH (UCSF)

Contributor

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Juan Irwin, MD, PhD (UCSF)

Investigator

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Tomiko Oskotsky, MD (UCSF)

Investigator

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Camran Nezhat, MD

Investigator

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Azadeh Nezhat, MD

Investigator

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Diana Atashroo, MD (Stanford)

Investigator

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Deirdre Lum, MD
(Stanford)

Investigator

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Alexis Combes, PhD
(UCSF) 

Investigator

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Jeannette Lager, MD
(UCSF)

Investigator

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Noémie Elhadad, PhD  (Columbia)

Investigator

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Jingjing Li, PhD  (UCSF)

Investigator

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Vivian Siu (UCSF) 

Admininstrator

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Edna Rodas (UCSF)

Admininstrator

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Zaida Esquivel (Stanford)

Admininstrator

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Member

Role

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Member

Role

Image by National Cancer Institute
Science Lab
Image by Myriam Zilles

Project 1

Leveraging Single-Cell Technologies to Elucidate Niche Environments and Immune Mechanisms Involved in Endometriosis Pathogenesis, Pathophysiology, and Disease Stratification. Project 1 focuses on underlying immunological mechanisms in endometriosis pathogenesis and pathophysiology.

Project 2

Mass Spectrometry-based Global Molecular Approaches and Computational Tools to Determine Phenotypic and Environmental Signatures of Endometriosis. Project 2 addresses developing a multi-omic disease classification to inform diagnostic strategies.

Project 3

Integrating Omics Based Computational Approaches to Identify and Validate Novel Therapeutic Candidates for Endometriosis. Project 3 leverages existing and newly generated large-scale omic data to identify and validate new therapeutic interventions.

ENACT Publications

Oskotsky TT, Bhoja A, Bunis D, Le BL, Kosti I, Li C, Houshdaran S, Sen S, Vallvé-Juanico J, Wang W, Arthurs E, Mahoney L, Lang L, Gaudilliere B, Stevenson DK, Irwin JC, Giudice LC, McAllister S, Sirota M.
Applying a computational transcriptomics-based drug repositioning pipeline to identify therapeutic candidates for endometriosis.
medRxiv. 2022;2022.12.20.22283736.
DOI: 10.1101/2022.12.20.22283736

Giudice LC, Horne AW, Missmer SA.
Time for global health policy and research leaders to prioritize endometriosis.
Nat Communications. 2023;14(1):8028.
DOI: 10.1038/s41467-023-43913-9.

Giudice LC, Oskotsky TT, Falako S, Opoku-Anane J, Sirota M.
Endometriosis in the era of precision medicine and impact on sexual and reproductive health across the lifespan and in diverse populations.
The FASEB Journal. 2023;37(9):e23130.
PMID: 37641572. DOI: 10.1096/fj.202300907.

Hédou J, Marić I, Bellan G, Einhaus J, Gaudillière DK, Ladant FX, Verdonk F, Stelzer IA, Feyaerts D, Tsai AS, Ganio EA, Sabayev M, Gillard J, Amar J, Cambriel A, Oskotsky TT, Roldan A, Golob JL, Sirota M, Bonham TA, Sato M, Diop M, Durand X, Angst MS, Stevenson DK, Aghaeepour N, Montanari A, Gaudillière B.
Discovery of sparse, reliable omic biomarkers with Stabl.
DOI: 10.1038/s41587-023-02033-x

Hugging a Pillow

Participation and Eligibility

We invite you to consider participating in our study about gynecological and reproductive health, being conducted by Drs. Linda Giudice and Marina Sirota at UCSF and Dr. Brice Gaudilliere at Stanford. The study’s aim is to advance understanding about the uterine lining (endometrium) and health. The study is funded by the National Institutes of Health (NIH).

You may be eligible if you:

  1. Are between the age of 18-40 with regular periods

  2. Are not currently using any form of hormonal contraceptive (birth control pill, patch, IUD, implant, ring, etc.), GnRH analog (e.g., Buserelin, Goserelin, Leuprorelin, Naferelin, or Triptorelin), or aromatase inhibitor (e.g., letrozole and anastrozole)

  3. Are HIV negative

  4. Are generally healthy with no significant medical conditions (e.g., cancer)

  5. Not currently pregnant

 

If you are interested in learning more about the study, please contact our study coordinator directly (UCSF: endo-research@listsrv.ucsf.edu. Stanford: gynresearch@stanford.edu) before your gynecologic surgery/appointment and indicate your availability for a zoom or phone call with our study coordinator to review the study in more detail.

 

Participating in this study is entirely voluntary. It will not affect your medical care if you decide not to reply or decide not to participate in the study.

We hope that you will consider participating in our study as we strive to further understand the biological impacts of the endometrium in health.
 

Thank you,
The Endometrial Tissue Bank Study Team

FAQs

What are my rights if I take part in this study?

Taking part in this study is your choice. You may choose either to take part or not to take part in the study. If you decide to take part in this study, you may leave the study at any time. No matter what decision you make, there will be no penalty to you and you will not lose any of your regular benefits. Leaving the study will not affect your medical care. You can still get your medical care from our institution.

How will I know that my confidentiality will be protected?

This research is covered by a Certificate of Confidentiality from the National Institutes of Health. This means that the researchers cannot release or use information, documents, or samples that may identify you in any action or suit unless you say it is okay. They also cannot provide them as evidence unless you have agreed. This protection includes federal, state, or local civil, criminal, administrative, legislative, or other proceedings. An example would be a court subpoena. The Certificate does not stop reporting that federal, state or local laws require. Some examples are laws that require reporting of child or elder abuse, some communicable diseases, and threats to harm yourself or others. The Certificate cannot be used to stop a sponsoring United States federal or state government agency from checking records or evaluating programs. The Certificate does not stop disclosures required by the federal Food and Drug Administration (FDA). The Certificate also does not prevent your information from being used for other research if allowed by federal regulations.

Can I stop being in the study?

Yes. You can decide to stop at any time. Tell the study doctor or co-investigators if you are thinking about stopping or decide to stop. If you decide to stop before the procedure, no specimen will be obtained and no blood sample will be taken for this study, and no information will be collected from your medical records. If, in the future, you decide that you don’t want to have your tissue or blood used for research, inform the UCSF investigators in writing and all of your specimens and data will be destroyed if they have not been used or unlinked.

Female patient suffering form abdominal

Resources

  1. endometriosis.org - a global platform for news and information which links all stake holders in endometriosis and provides a comprehensive list of national endometriosis organizations

  2. endometriosisassn.org - The Endometriosis Association is a self-help organization of people with endometriosis and their families, doctors, scientists, and others interested in exchanging information about the endometriosis disease

  3. endomarch.org - Worldwide EndoMarch is an internationally-coordinated endometriosis coalition, representing over 100 organizations, groups, and medical societies

    • 2024 EndoMarch Virtual Conference - a two-day virtual gathering of renowned endometriosis pioneers and specialists. March 23 · 10am - March 25 · 2:59am EDT. Register (free).

  4. endofound.org - The Endometriosis Foundation of America strives to increase disease recognition, provide advocacy, facilitate expert surgical training, and fund landmark endometriosis research

  5. endocenter.org - The Endometriosis Research Center addresses the ongoing need for international endometriosis awareness, advocacy, support, education, legislative efforts and research facilitation

  6. ESHRE guideline: endometriosis - The European Society of Human Reproduction and Embryology's endometriosis guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. (Published in Human Reproduction Open. 26 February 2022)

  7. citizenendo.org - Citizen Endo: a research project led by researchers in partnership with patients to better understand, and better manage, endometriosis

  8. endometriosis.ca - the World Endometriosis Society (WES) advances evidence-based standards and innovations for education, advocacy, clinical care, and research in endometriosis and adenomyosis, in collaboration with its stakeholders and global partners to improve the lives of those affected and their families. This year, the 15th World Congress on Endometriosis was in Edinburgh, Scotland from 3 to 6 May in 2023.

  9. Society for Women’s Health Research (SWHR): dedicated to promoting research on biological sex differences in disease and improving women’s health through science, policy, and education.

  10. Below the Belt - a film through the lens of endometriosis featuring the personal stories of four patients.

  11. Endo What? - a documentary about endometriosis featuring interviews with endometriosis experts, researchers, and advocates.

Contact Us

University of California, San Francisco

513 Parnassus Ave, HSE 1600.
San Francisco, CA 94143

Phone: 415-476-2695
Email: Endo-research@listsrv.ucsf.edu

Stanford University
Address: 453 Quarry Road, OBGYN 5317.
Palo Alto, CA 94304
Phone: 650-724-7826
Email: gynresearch@stanford.edu

Center For Special Minimally Invasive and Robotic Surgery
1775 Woodside Road.
Woodside, CA 94601
Phone: 650-327-8778
Email: Office@camrannezhatinstitute.com

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