Short Wave – "A Surprising Cause Of Endometriosis Could Lead To Cure"

Podcast: Short Wave (NPR)
Episode Date: September 26, 2025
Host: Regina Barber
Guests: Katie Burns (endometriosis researcher), Meredith Wadman (science journalist)

Episode Overview

This episode explores groundbreaking research shifting our understanding of endometriosis—a common, debilitating gynecological disease—from hormonal causes to the critical involvement of the immune system. Through the story of researcher Katie Burns and insight from science journalist Meredith Wadman, listeners learn about recent scientific advances, the limitations of existing treatments, and a hopeful path towards more effective therapies and diagnostics.

Key Discussion Points & Insights

1. Katie Burns’ Personal Journey with Endometriosis

• (00:28-01:22) Katie recounts a childhood filled with illness and severe pain, often dismissed by adults and attributed to "growing pains."
  • Quote: “You would get your period and it would hurt and you move on with life. And that's what I did. I don't know if they understood the magnitude of the pain.” — Katie Burns (01:29)
• She describes missing out on normal teenage experiences due to pain and fatigue.

2. From Patient to Researcher

• (01:39-02:12) Burning curiosity and the drive to find relief led Katie to become a researcher, focusing her work on endometriosis after finding few effective therapies.
• Her research garnered attention, especially from MIT’s Linda Griffith, and soon, science reporter Meredith Wadman.

3. Challenging the Hormonal Model of Endometriosis

• (02:28-04:43) Early theories blamed hormones—particularly estrogen—for driving endometriosis. Hormonal treatments, however, only alleviate symptoms without curing the disease.
  • Quote: “You can quiet disease, but you don't cure it, you don't get rid of it.” — Katie Burns (02:45)
• Katie’s experiments with mice lacking key estrogen receptors showed endometriosis lesions could still develop, even in the near absence of estrogen:
  • Quote: "Something is helping these get established that does not have to do with estrogen." — Meredith Wadman on Katie’s discovery (07:32)

4. The Immune System: A New Suspect

• (06:21-08:55) Burns found that immune cells, not hormones, were the critical factor in lesion formation in the earliest stage.
  • Details:
    • Innate immune cells (neutrophils and macrophages) flooded the pelvic cavity, seemingly nurturing rather than eradicating the misplaced tissue.
    • Only after 72 hours did estrogen become necessary for lesions to thrive.
• Quote: “It really showed that the immune system seems to be that important starting piece and not the hormone receptors.” — Katie Burns (03:04)

5. Supporting Research into Immune Dysfunction

• (09:02-10:21) Wadman explains that subsequent research supports the immune involvement:
  • Natural killer cells that should destroy “errant” tissue are too few or inactive.
  • Neutrophils and macrophages contribute to chronic inflammation and help endometriosis tissue establish itself.
  • Genetics may account for about half of endometriosis cases, but there’s no single gene.
• Quote: “Neutrophils are hanging around the scene and getting, being inflammatory instead of quick zooming in and doing their hoovering up function and disappearing.” — Meredith Wadman (09:34)

6. Therapeutic Implications: Moving Beyond Hormones

• (10:21-11:54) New treatments could target the immune system:
  • Antibody therapies may block inflammatory immune substances (cytokines), reducing pain and disease progression.
  • University of Edinburgh is preparing human trials of “nibrozetone,” a drug to improve macrophage function in cleaning up misplaced tissue.
  • Recognizes individual variability: endometriosis is not the same in every patient, so personalized immune-based treatments may be more effective.

7. Prospects for Early, Non-Invasive Diagnosis

• (11:54-12:43) Scientists are developing diagnostic tests using menstrual fluid, which could replace surgical diagnosis:
  • The Feinstein Institutes pioneered this research despite initial skepticism.
  • Quote: “Right now, the only way you can get an ironclad diagnosis of endometriosis is by having surgery and having it visualized. And that really needs to change.” — Meredith Wadman (12:17)

8. The Funding Gap and Future Outlook

• (12:57-14:28) Despite scientific progress, research is underfunded:
  • The National Institutes of Health allocated only 0.03% of its 2024 budget to endometriosis.
  • Quote: “The uncertainty with NIH is palpable. I have never felt such stress from everybody around me. If I don't get grants approved, then the lab shuts down... for the sake of the young girls that are trying to avoid living the life that I did. That's what drives me.” — Katie Burns (13:54)
• Meredith Wadman points out that a cure will require sustained funding and attention.

Notable Quotes & Memorable Moments

• Katie Burns’ frustration and motivation:
  • “I didn't live, I don't think as a normal teenager.” (01:16)
  • “If I don't get grants approved, then the lab shuts down for the sake of endometriosis... That's what drives me.” (13:54)
• Scientific breakthrough:
  • “These mice developed rudimentary endometriosis lesions... something is helping these get established that does not have to do with estrogen.” — Meredith Wadman (07:49)

Important Timestamps

| Time | Segment / Topic | |-----------|--------------------------------------------------------------| | 00:28 | Katie's early experience with pain and illness | | 01:39 | Path to diagnosis and her decision to pursue research | | 02:45 | Limitations of hormonal treatments | | 03:04 | First discoveries: immune system's role | | 04:57 | Historical overview of endometriosis research | | 06:21 | Katie’s pivotal mouse experiment | | 09:13 | Evidence linking immune dysfunction to endometriosis | | 10:21 | Potential for immune-targeted therapies | | 11:54 | Search for non-invasive diagnosis via menstrual fluid | | 12:57 | Funding challenges and outlook | | 13:54 | Katie’s personal drive and worry about research continuity |

Takeaways

• Cutting-edge studies show that abnormal immune cell activity is likely central to endometriosis origins—challenging decades of hormone-dominated thinking.
• Immune-targeted therapies and simple diagnostic tests using menstrual blood could revolutionize care for millions—pending greater research funding and awareness.
• Personal stories like Katie’s highlight both the real-world impact of the disease and the persistent gaps in understanding, treatment, and care.