Endometriosis is a chronic, estrogen-dependent gynecological disorder affecting 10-15% of reproductive age
women which is characterized by the presence of endometrial tissue outside the uterus, predominantly in the
pelvic peritoneum, and resulting in pelvic pain and infertility. The long-term goal of this research is discovery of
molecular mechanisms governing the pathogenesis of endometriosis, particularly fibrosis, for development of
non-invasive diagnostics and fertility-sparing treatments. Lesion etiology is difficult to study in women because
of the significant delays of 8-11 years from the onset of disease to diagnosis and variations in disease
progression. Over the past 25 years the Fazleabas lab has developed the baboon as an appropriate model to
examine the establishment and progression of endometriotic lesions. FOXC1 was identified as a major upstream
regulator of differentially expressed genes in lesions compared to matched endometrium from transcriptomic
analyses. FOXC1 gain-of-function is associated with tissue remodeling and mechanisms of fibrosis, a hallmark
of endometriotic lesions hypothesized to be crucial to the underlying pathogenesis of lesions. Thus, increased
expression of FOXC1 may be an important contributor to the development of fibrosis in endometriotic lesions.
We hypothesize that increased FOXC1, as a consequence of transcriptional and post-transcriptional regulation,
alters the function of epithelial and stromal cells to promote fibrosis in the ectopic endometrium. We will determine
the transcriptional and post-transcriptional mechanisms that regulate the increased expression of FOXC1 in
endometriotic lesions (Aim 1), and the effects of FOXC1 expression on epithelial to mesenchymal (EMT) and
fibroblast to myofibroblast (FMT) transitions, two components that contribute to fibrosis in endometriotic lesions.
The proposed studies will provide key insight into the regulation and downstream effects of increased FOXC1
expression to uncover critical mechanisms in the pathogenesis of fibrosis in endometriotic lesions. The technical
experience from these studies and career training from my sponsor and co-sponsors will prepare me for a
successful independent research career for investigating endometriosis and disorders of the female reproductive
tract to improve human health.