A Transcriptomics-Based Computational Drug Repositioning Pipeline Identifies Simvastatin And Primaquine As Novel Therapeutics For Endometriosis Pain.

INTRODUCTION AND METHODS

Endometriosis has limited treatment options, prompting the search for novel therapeutics. We previously used a transcriptomics-based computational drug repositioning pipeline to analyze public bulk transcriptomic data and identified several drug candidates. Fenoprofen, our top in silico candidate, was validated in a rat model. Building on this, we now evaluate two additional candidates, simvastatin (a cholesterol-lowering drug) and primaquine (an antimalarial), based on strong gene expression reversal scores and favorable safety profiles. Using a validated rat model of endometriosis and pain, we conducted behavioral testing, bulk RNA sequencing, and differential expression analysis to assess their therapeutic potential.

RESULTS

Of 299 drugs identified computationally, simvastatin and primaquine ranked highly for reversing gene expression signatures associated with endometriosis. In vivo validation using a rat model of endometriosis demonstrated that both drugs significantly reduced vaginal hyperalgesia, a surrogate marker of endometriosis-associated pain. RNA-seq of uteri and lesions confirmed reversal of disease-associated gene expression signatures following treatment.

CONCLUSION

Simvastatin and primaquine attenuated pain behaviors and reversed endometriosis-related gene expression changes in an animal model. These findings highlight their potential as repurposed therapeutics for endometriosis-related pain and support the effectiveness of computational drug repositioning strategies in identifying new treatment strategies.