[Endometriosis pain research in Germany : ENDO-PAIN and StEPP-UPP-two new research consortia on endometriosis pain]

Renata Voltolini Velho, Velho RV, Bruno Pradier, Pradier B, Werner F, Franziska Werner, Pogatzki-Zahn EM, Esther M Pogatzki-Zahn, Sylvia Mechsner, Mechsner S
Schmerz (Berlin, Germany) · 2026 · doi:10.1007/s00482-026-00958-1 · PMID:42474512 · W7169778937
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Abstract

Endometriosis is one of the most common causes of chronic pelvic or lower-abdominal pain, yet mechanisms, predictors, and patient-centered treatment pathways remain insufficiently defined. This article summarizes the situation in Germany and presents two complementary research consortia: StEPP-UPP and ENDO-PAIN.StEPP-UPP addresses the clinical heterogeneity of endometriosis pain via a prospective multicenter cohort, standardized patient-reported outcomes, quantitative sensory testing, and multi-omics from blood, stool, and lesions. Explainable artificial intelligence and machine-learning models aim to estimate risk and trajectories of persistent pain, define mechanism-informed subgroups, and support treatment decisions. Preclinical mouse models with non-evoked behavioral metrics plus multiparametric MRI and single-cell analyses provide mechanistic anchoring for clinical signatures.ENDO-PAIN focuses on neuroinflammation and fibrosis as drivers of pain and chronification. Using patient samples, cell cultures, and 3D organoids, it maps immune-stroma interactions, syndecan signaling, and hormone-inflammation axes (for example P4-TGFβ-NFκB-COX-2) to derive biomarker networks and therapeutic targets.Both consortia integrate patient advocacy structurally to ensure patient-relevant endpoints and accessible information. Together they point to three priorities: standardization of data collection and biobanking; stratification along bio-psycho-social profiles and molecular signatures; and interdisciplinary shared decision-making across research, clinics, and people with endometriosis, aiming for mechanistically grounded, data-driven, patient-centered pain medicine.

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