UC scientist battles disease up close and in the laboratory

Katherine “Katie” Burns was a Pennsylvania State University doctoral student studying liver toxicology when she became the subject of a National Institutes of Health clinical trial. She had endured the symptoms of endometriosis since adolescence and researchers were now removing lesions from her abdomen for study.

“I was the research. This was so inspiring to me because I saw firsthand the clinical and translational aspect of the disease,” says Burns, PhD, now an assistant professor of environmental and public health sciences in the University of Cincinnati College of Medicine. 

The experience changed the trajectory of science for Burns, who knew little about endometriosis except for her own experience. Endometriosis affects up to 10% of women in childbearing age and is a disorder where the tissue that makes up the lining of the womb grows outside the uterus. The condition can cause extreme pain with periods, lower abdominal pain, painful sexual intercourse and infertility.

As a young scientist, Burns was determined to find a researcher who could mentor her interest in finding a better treatment and eventual cure for endometriosis. “I emailed anyone in the country who had a grant with the word ‘uterus’ on it,” says Burns. “I got a lot of no responses and I kept at it for a year.”

She eventually ended up working with a researcher at the National Institute of Environmental Health Sciences. Burns described the experience as a “Disney World” for scientists as those in this group were given the freedom to explore and push the boundaries of scientific discovery.  Today, Burns has her own laboratory in UC’s Kettering Building and has been on the UC faculty for the past five years.

Scientists are still trying to figure out what causes endometriosis: genetics, the environment, maybe a combination or something more. A paper published in 2018 in the scholarly journal Environmental Health Perspectives by Burns suggests in mouse models that bisphenol A and bisphenol AF, two chemicals used in making common household and industrial plastics, may contribute to an increased incidence of endometriosis. 

“We look at how endometriosis starts and how environmental endocrine disruptors or immuno toxicants affect disease,” says Burns. “Toxicants are like toxins, but are human-made and released into our environment. We are trying to understand if or how these chemicals could be removed from our supply system to mitigate endometriosis in the future.”

Burns has received grants from the Endometriosis Foundation of America, a pharmaceutical company and the National Institutes of Health (NIH) to further her work. The NIH most recently awarded a five-year $2.1 million grant to look more closely at how the immune system may play a role in the development of endometriosis. As part of that work she is collecting menstrual fluid from women with and without endometriosis and to study what is in it and the differences between the two groups.

The process of finding a better treatment and ultimately a cure is a slow one. This is often frustrating for a scientist and especially for someone who knows the firsthand effects of a debilitating medical condition.

“I study this because I have endometriosis, and I have been through a heck of a journey,” says Burns. “It takes seven to nine years to get a diagnosis, and the journey is quite complicated by symptoms overlapping with other conditions, seeing a number of specialists and the psychological depression and stress that affects your overall well-being.” 

Glenn Talaska, PhD, interim chair of the UC Department of Environmental and Public Health Sciences, says that Burns’ dogged determination to make an impact on endometriosis is bound to bear fruit. “Katie is devoting her total energy to understanding the mechanisms of endometriosis so that she can see if and how environmental factors may be making a difference in its incidence and severity.”

Burns first felt the pain of endometriosis when she was 10 years old and it was mistaken for appendicitis.

“I had my first surgery to explore what was happening at 19, and then every two years afterward,” says Burns. “I would have another type of surgery to remove lesions for many years. I was prescribed drugs to simulate menopause, different types of oral contraceptives, multiple cocktails of medicines from pain clinics and various diet changes. I tried acupuncture and hypnosis to control the symptoms.”

Endometriosis causes scarring, and organs in the pelvic region become frozen or stuck together. “For me, I’ve done pelvic physical therapy once a week for eight years and that has really helped suppress the pain,” says Burns.

The disease is not life-threatening but it is certainly life-altering, says Burns. 

Many women with endometriosis find themselves infertile due to the disease, while others undergo hysterectomies,” says Burns. “This can be life-altering for many women. The number of women who have told me how this affects their ability to have children and their marriage is quite sad. A lot of relationships and marriages end because of this. There is so much strain on a marriage with the inability to get pregnant.”

Burns says if she could mimic the results that investigators or scientists in popular TV shows such as the CSI series are able to offer, she could be a lot further with her discoveries. Many in the public think this is the norm, when it’s far from the case.

“In those shows, they get a sequence and figure everything out in split seconds,” says Burns. “Science in the real world does not work like this. One of the things that the COVID-19 pandemic is showing all of us is that it takes time to mitigate, to understand and to really find a cure or treatment. With endometriosis we don’t know what causes it so we have to dig in deeper and we have to keep trying to find answers that will help women be healthy and reproductively competent.”

Featured image of Katherine Burns, PhD, taken by Joe Fuqua/UC Creative + Brand.