Cellular mechanisms involved in cyclic stromal renewal of the uterus. II. The albino rat

Presence of the P2X(7) purinergic receptor on immune cells that invade the rat endometrium during oestrus

Eosinophils, macrophages and other leucocytes invade the uterine endometrium during oestrus and play a role in the tissue remodeling and immune responses that occur prior to implantation of the fertilized ovum. Adenosine 5'-triphosphate (ATP) and its metabolites influence uterine function via ATP receptors. In this study, we investigated the presence and localisation of the P2X(7) nucleotide receptor in the cells that infiltrate the uterine endometrium of adult female rats during oestrus at the electron microscope level, using gold-silver pre-embedding immunocytochemical techniques. P2X(7) receptor expression was found in the cytoplasm and the cell membrane of eosinophils, macrophages and fibroblasts in the endometrium during oestrus. These results suggest that ATP-mediated responses may be important in uterine preparation and remodeling before implantation and that this may involve several types of cells. In particular, the presence of P2X(7) receptors on endometrial stromal cells may indicate their involvement in apoptosis and immune and inflammatory responses.

Inflammatory triggers of lymphangiogenesis

Inflammation is the common denominator to the postnatal events that overlap with lymphatic vessel growth, or lymphangiogenesis. Undoubtedly, inflammation and accompanying fluid overload are cardinal factors in wound healing, lymphedema, the pathogenesis of some forms of lymphangiomatosis, and solid tumor lymphangiogenesis. The assertion that inflammation actually triggers lymphangiogenesis lies in the evidence set forth below that inflammation is the usual precursor to tissue repair and regeneration. Moreover, the panel of pro-inflammatory and anti-inflammatory molecules that orchestrates the inflammatory response abounds with cytokines and chemokines that foster survival, migration, and proliferation of lymphatic endothelial cells. Finally, both interstitial fluid overload and increased demand for removal of leukocytes can benefit from lymphangiogenesis, although the mechanisms controlling the exit of leukocytes from tissues via the lymphatics are practically unknown. The pertinent question actually is how and why inflammation presents with formation of new lymph vessels in liver fibrosis but not in rheumatoid arthritis. One possible explanation is that organ-specific histological and functional properties of the lymphatic endothelium gauge their response to death, survival, and proliferative factors. Alternatively, the decision to remain quiescent, proliferate or regress resides within the stroma microenvironment.

Detection of Luse bodies, spiralled collagen, dysplastic collagen, and intracellular collagen in rheumatoid connective tissues: an electron microscopic study

BACKGROUND

Rheumatoid arthritis is a chronic inflammatory disease leading to alterations of the extracellular matrix in tendons, ligaments, and cartilage. The structural changes of the collagenous systems in rheumatoid connective tissues are largely unknown, however.

METHODS

Thirty four samples of menisci, 36 cruciate ligaments, and four tendons were taken during joint surgery in patients with rheumatoid arthritis. Eighteen menisci, 35 ligaments, and 30 tendons obtained at necropsy served as a control group. The extracellular matrix in the two groups was analysed by the combined use of transmission and scanning electron microscopy, immunohistochemistry with monoclonal antibodies recognising collagen types IV and VI, and ultramorphometry.

RESULTS

Normal tendons and ligaments predominantly showed a unidirectional fibril arrangement. Whereas type IV collagen showed a positive staining pattern along all basement membranes, type VI collagen formed fine, filaments aligned in parallel. In patients with rheumatoid arthritis a significant reduction of the mean diameter of the collagen fibrils was found owing to the presence of thin collagenous fibrils 20-60 nm in diameter. Most of these fibrils showed considerable changes in their arrangement with irregular courses (so-called interfibrillar dysplastic collagen). Up to 410 nm thick frayed fibrils with irregular outlines (spiralled collagen) and intracellular collagen forms were found in rheumatoid tissues. In addition, atypical thick collagenous structures with 41 nm periodicity (Luse bodies) were detected in the matrix. The upregulation of type IV collagen in rheumatoid arthritis was associated with an increase in the vascular density. The expression of type VI collagen was upregulated in fibrotic zones.

CONCLUSIONS

The dramatic ultrastructural collagen changes lead to a structural and functional insufficiency of the extracellular matrix in rheumatoid connective tissues. The results suggest that collagen alterations may contribute to the development of tendon and ligament ruptures in rheumatoid arthritis.

Immunohistochemical localization of the eosinophil major basic protein in the uterus horn and cervix of the rat at term and after parturition

Distribution of the eosinophil major basic protein (MBP) was studied in the rat uterus horn and cervix by means of immunohistochemistry using an antiserum raised against rat MBP. Various hormonal contexts were investigated: pre- and post-parturition, the estrous cycle, and ovariectomy followed by hormonal treatment or without treatment. MBP was detectable in the cervix as early as 12 h post-partum, appearing in the stroma close to the myometrium. The MBP had spread throughout the stroma toward the luminal epithelium after a few days. In contrast, no MBP was seen in sections of the corresponding pre- and post-partum uteri and in the pre-partum cervix. In cycling rats, MBP was distributed equally in the cervix and uterus and was more abundant during proestrus and estrus. In ovariectomized rats subsequently treated with progesterone, no MBP was detected in the cervix or uterus. In the cervix of ovariectomized rats treated with estradiol, MBP first appeared in the muscle layer situated between the two cervical lumina and then reached the stroma; within a few days only the stroma was stained. Inversely, in the uterus MBP-staining first appeared in the stroma. In conclusion, analysis of the distribution of MBP in rat uterus revealed a marked difference in the response of the cervix and horn to a hormonal environment.

Phagocytosis of collagen by mouse decidual cells

Collagen fibrils were present within membrane-bound vacuoles in the cytoplasm of mouse decidual cells on the 7th day of pregnancy. The space between the vacuole membranes and the fibrils was narrow and frequently filled with a granular electron-dense material. The loss of banding of the collagen fibrils, their association with lysosomelike bodies, and the demonstration of acid phosphatase activity in the vacuoles indicate that the fibrils were internalized by the decidual cells and were being digested. It is suggested that phagocytosis of collagen is a mechanism of remodeling of the mouse decidua.

Removal of collagen bundles in murine uterus during postpartum involution

The localization of collagenolytic activity within the tissue compartments of the mouse uterus was investigated during postpartum involution. The rate of collagenase activity was measured by analysis of tissue levels of hydroxyproline from the day of parturition to the 10th postpartum day. Collagen bonding was analyzed by viewing birefringence induced by the picrosirius red-binding technique. An attempt was made to interrelate quantitative analysis with the histologic distribution of collagen during postpartum days 1-10. Histologic and quantitative evidence indicated the following: 1) The collagenous compartments of the endometrium and myometrium differ in their response to the postpartum rise in collagenase activity; collagen degradation occurs primarily in the endometrium, that is, the myometrial collagen remains, but much of the endometrial collagen is removed. 2) Endometrial collagen is degraded particularly in the immediate subluminal compartment.

Effect of estrophilic platinum complex on the mouse uterus

Resistance of hormone-dependent mammary carcinoma to cisplatin as a potent antitumor agent led to the synthesis of other estrophilic platinum complexes. In this investigation, the effects of a newly synthesized estrogen-receptor affine platinum complex on the mouse uterus were studied using light and electron-microscopy. The results have been compared with Tamoxifen, cisplatin and the estrophilic ligand. Both estrophilic ligand and estrophilic platinum complex produced strong estrogenic effects as well as features characteristic of the uterine epithelial cell in the luteal phase of the cycle, corresponding to a massive stimulation of the surface and glandular epithelial cells. The uteri showed large glandular lumina. An increase in the number of multivesicular and residual bodies, accompanied by a proliferation of eosinophilic granulocytes, was also seen. The appearance of inter- and intracellular lumina and the activation of smooth muscle cells represent further characteristic effects of the estrophilic ligand and estrophilic platinum complex. Anticipated increases in the incidence of cell death and/or deviant cyto-nuclear architecture in the uteri treated with cisplatin or platinum complex, were not observed.

Activation of the vascular system: a main mediator of periodontal fiber remodeling in orthodontic tooth movement

The behavior and role of blood vessels and blood-borne cells in the process of the remodeling of the periodontal ligament (PDL) incident to experimental tooth movement was studied in rats. Particular interest was focused on areas of tension and of pressure with frontal bone resorption but without overt hyalinization. An increase of vascular activity occurred in the above mentioned situations. Extensive breakdown of collagen was observed in pressure areas with frontal resorption and in areas of tension concomitant with vascular invasion. Two patterns of fiber and bone remodeling were seen in areas of tension: intense vascular activity within the periodontal membrane and intense vascular activity inside the alveolar bone. Macrophages occurred consistently near blood vessels both in areas of tension and in areas of resorption. These are multipotent cells that obviously influence the remodeling process.

Penetration of the basal lamina of the uterine luminal epithelium during implantation in the rat

During early stages of implantation in the rat, as in other species that form a hemochorial placenta, there is a progressive increase in intimacy between blastocyst and endometrium. After initial invasion of the uterine luminal epithelium by trophoblast cells and displacement of epithelial cells, the trophoblast comes to lie adjacent to the residual basal lamina of the displaced epithelium but does not penetrate it. After a pause at the basal lamina, this temporary barrier is breached. To study the interrelations of trophoblast, uterine epithelium, and decidual cells with the epithelial basal lamina during the time of penetration of the basal lamina, implantation sites collected on day 7 of pregnancy were oriented so that the implantation chamber could be sectioned either longitudinally or transversely. Neither trophoblast nor uterine epithelial cells have processes that extend through the basal lamina. However, flange-like processes from the decidual cells penetrate the basal lamina and underlie both trophoblast and, more rarely, epithelium. Smaller folds of the surface of decidual cells partially surround bundles of collagen fibrils oriented parallel to the long axis of the implantation chamber. Initially the area of penetration of basal lamina by decidual cell processes is quite restricted; as implantation proceeds the basal lamina becomes displaced and is sometimes not discernible, extracellular materials accumulate, and the relationships become more difficult to follow. It is concluded that the initial breaching of the basal lamina is an activity of the decidual cells, and that contact of basal lamina with trophoblast is not necessary to permit this penetration.

Rat uterine tissue and cell responses to the presence of plain and indomethacin-delivering IUDs

Plain silastic intrauterine devices or those containing 270 micrograms of indomethacin were inserted into the caudal portion of one uterine horn of mature Wistar rats. After a 3-week period animals were fixed by perfusion on the morning of day 2 after estrus. Segments of uterine tissue corresponding to regions adjacent to and cranial to the devices as well as an equivalent portion of the contralateral horn were embedded in glycol methacrylate. A group of control animals without any form of device were treated in an identical manner. Sections cut from these segments were evaluated by grid-point stereology to ascertain changes in tissue volumes and cell populations. It was found that the presence of plain devices induced hypertrophy in the stroma and myometrium of the portion of the uterus adjacent to the device. The presence of indomethacin in such devices prevented stromal hypertrophy. No changes in populations of fibroblasts or areas of glandular or vascular tissue were evident in any treatment group. Cell populations of neutrophils, eosinophils, and mononuclear cells, however, were elevated in the superficial stroma of the horns bearing either type of device; this feature was more pronounced for neutrophils in the presence of the indomethacin devices. Neutrophils, rather than eosinophils, predominated in the epithelia of the uterus bearing either type of IUD. Conversely, eosinophil populations were reduced in the superficial tissues cranial to the devices delivering indomethacin. Neutrophils and mononuclear cells were also found to be elevated in the deep stroma of tissues adjacent to both the plain and medicated device.

Phagocytosis in the uterus: A review

Phagocytosis is an important non-specific defense mechanism. Uterine phagocytosis is reviewed emphasizing factors which may alter the uterine phagocytic responses including the estrous cycle, pregnancy and the puerperium, and the presence of an intrauterine device. Implications of phagocytosis in therapy of and recovery from intrauterine infections are considered.

Etiology of DES-induced uterine tumors in the Syrian hamster

This paper describes a new experimental model system for the induction of endometrial adenocarcinoma in hamster uterus following diethylstilbestrol (DES) treatment of the newborn female. We propose that DES acts as an initiator during early development and that other estrogens act as promoters to stimulate tumor development in the adult uterus. DES directly affects the uterus as was shown by the failure of neonatal ovariectomy to prevent early DES-induced uterine growth. Subsequently, ovarian estrogen secretion from anovulatory, polyfollicular ovaries modifies the DES-altered uterus starting between 20 and 30 days of age and continuing into adult life. Early DES effects on the uterus include stimulation of endometrial cellular differentiation and progesterone receptor production. Permanent changes in uterine collagen, DNA and progesterone receptor content were noted, but the responsiveness of the DES-altered uterus to estrogen and progestin action was not impaired. Morphogenetic changes included an increase in extracellular connective tissue elements and striking alterations in endometrial cell composition such as hyperplasia of luminal and glandular epithelia and a massive inflammatory response in the stroma. Endometrial adenocarcinomas occurred in DES-treated animals in association with exposure to either endogenous estrogen from anovulatory ovaries or exogenous estrogen treatment of the ovariectomized animal. Endometrial tumors had relatively high concentrations of estrogen and progesterone receptors, suggesting a sensitivity to hormone action. Thus, these studies (a) demonstrate the utility of this animal model for the preparation of experimental endometrial tumors, and (b) suggest that DES acts as an initiator to transform uterine cells during early development, and estrogen exposure later in life acts as a promotor to stimulate growth and proliferation of DES-transformed cells.

A stereologic analysis of collagen phagocytosis by fibroblasts in three soft connective tissues with differing rates of collagen turnover

The purpose of this study was to assess the importance of the phagocytic mechanism of collagen resorption in the normal turnover and remodelling of soft connective tissues. Collagen phagocytosis by fibroblasts in rat skin, attached gingiva, and periodontal ligament was quantitated using the methodology of electron microscopic stereology. Periodontal ligament contained five and 15 times as much phagocytosed collagen as attached gingiva and skin respectively. Also, for each tissue examined, a positive correlation was observed between the amount of collagen phagocytosed and the known rate of mature collagen turnover.

Degradation of connective tissue matrices by macrophages. I. Proteolysis of elastin, glycoproteins, and collagen by proteinases isolated from macrophages

We have investigated the ability of neutral and lysosomal enzymes of mouse macrophages to degrade the insoluble extracellular matrices secreted by smooth muscle cells, endothelial cells, and fibroblasts. Matrices produced by smooth muscle cells contained glycoproteins, elastin, and collagens, but matrices of endothelial cells and fibroblasts contained no elastin. Sequential enzyme digestion of residual matrix revealed that plasmin, a product of macrophage plasminogen activation, degraded 50-70% of the glycoprotein in the matrices but did not degrade the elastin or the collagens. Purified macrophage elastase degraded glycoprotein and elastin components but had no effect on the collagens. The rate of elastin degradation by macrophage elastase was decreased in the presence of the glycoproteins. In contrast, human granulocyte elastase effectively degraded the matrix glycoproteins, elastin, and, to a lesser extent, collagens, Mammalian collagenase degraded only collagens. Conditioned medium from resident and inflammatory macrophages, containing mixtures of the secreted proteinases, degraded the glycoprotein and elastin components of the matrices. However, conditioned medium was less effective in degrading matrix than comparable amounts of purified macrophage elastase because > 90% of the elastase in the medium was in a latent form. Inclusion of plasminogen in the assays accelerated degradation. In the presence of plasminogen, glycoproteins were degraded readily by medium from P388D1, pyran copolymer-, thioglycollate-, and periodate-elicited macrophages and, to a lesser extent, by medium from endotoxin-elicited and resident macrophages; medium from P388D1, thioglycollate-, and periodate-elicited macrophages was most effective in elastin degradation, and resident, endotoxin-elicited and pyran copolymer-elicited macrophages degraded almost no elastin. The macrophage cathepsins D and B degraded all the matrix components at an optimum pH of 5.5 and acted with the secreted neutral proteinases to degrade the connective tissue macromolecules to amino acids and oligopeptides. These data indicate that macrophages at inflammatory sites contain and secrete proteolytic enzymes that could degrade the extracellular matrix.

The corpus luteum of the guinea pig. IV. Fine structure of macrophages during pregnancy and postpartum luteolysis, and the phagocytosis of luteal cells

Little information is available on the ultrastructure of macrophages in the corpus luteum or their importance in the regression of luteal tissue. In the present study, the fine structure of activated luteal macrophages during pregnancy and the postpartum period was examined by electron microscopy of guinea pig ovaries fixed by vascular perfusion. In these corpora lutea, macrophages can readily be distinguished from luteal cells. Activated macrophages typically display three prominent inclusions in their cytoplasm: (1) heterophagic vacuoles, (2) distinctive large dense inclusions, and (3) large and small electron-lucent vacuoles. In addition, they contain numerous smaller lysosome-like dense bodies. Activated macrophages in corpora lutea also characteristically show many surface protrusions, such as processes, folds or pseudopodia, which often occur in close contact with nearby luteal cells. Generally, nuclei of macrophages are irregular in shape and display a dense border of heterochromatin, thus differing from those of luteal cells. Macrophages seem to be most abundant in regressing corpora lutea, where they commonly display heterophagic vacuoles containing recognizable luteal cell fragments, evidence that these phagocytes ingest senescent luteal cells. The digestion of luteal cell components in heterophagic vacuoles presumably gives rise to the distinctive large dense inclusions typically seen in macrophages. The findings of this study indicate that macrophages play a central role in luteolysis by phagocytizing luteal cells or their remnants. They therefore appear to bring about the reduction in volume of the corpus luteum that occurs as this tissue regresses. These results taken together with those previously published (Paavola, '78) further indicate that breakdown of the corpus luteum during postpartum luteolysis in guinea pigs involves both autophagy and heterophagy.

The occurrence of uterine stromal and intraepithelial monocytes and heterophils during normal late pregnancy in the rat

The steady decline in plasma progesterone level that occurs during the last week of pregnancy in the normal rat (Wiest, '70) provides good opportunity to study the effect of withdrawal of progesterone on uterine differentiation. Evidence is presented that tissue monocytes, heterophils, and eosinophils are regular components of the normal late gestational uterus and that their number increases as term approaches. Uterine monocytes and heterophils are located in the endometrial and myometrial stroma as well as within the basal intercellular compartment of the luminal epithelium. Stromal monocytes are distributed throughout the attenuated endometrium of late gestation, but are more common immediately beneath the luminal epithelium. In the myometrium, monocytes and heterophils occur, often as perivascular, clusters in the connective tissue septum that separates the two layers of smooth muscle. Eosinophils are present especially in the deep endometrial and myometrial stroma, and increase in number as plasma estrogen rises immediately before parturition. A small population of lymphocytes is regularly present. An important feature of the prepartum uterine stroma is the sparseness of macrophages. Near term, however, the beginnings of monocytic-macrophagic transformation are noticeable as the cell surface becomes more irregular and organelles associated with endocytic activity arise. The prepartum monocytes are positioned in the same histological sites that during the postpartum period of regression will be occupied by macrophages (Padykula and Campbell, '76). Since it is generally accepted that monocytes are precursors of macrophages, this spatial correlation raises the possibility that cellular preparations for regression commence before birth. The possible significance of prepartum monocytic infiltration is discussed in relation to the effect of changing plasma and uterine concentrations of progesterone on uterine collagenase activity. The steady increase in uterine leucocytes which occurs concomitantly with decreasing uterine binding capacity for progesterone supports the hypothesis by Siiteri et al. ('77) that progesterone in high local concentrations has an anti-inflammatory effect.

Ultrastructural changes in the rat metrial gland in the latter half of pregnancy

The ultrastructural changes occurring in the metrial gland in the latter half of pregnancy in the rat have been studied. Typical palely stained granulated cells are present in the metrial gland up to day 20 but many granulated cells show variations in appearance which may be associated with degeneration. In some the cytoplasm is more darkly stained and such cells often have apparently empty areas of cytoplasm adjacent to the granules. From day 14 onwards many areas of the gland show cellular debris, apparently resulting from lysis of the granulated cells. However, occasionally normal granulated cells are present in blood vessels and have been observed apparently penetrating the vascular endothelium. A variety of changes was also noted in the stromal cell population. Inclusions became apparent in many of these cells; some of these consisted of lipid while others resembled granules from the typical granulated cells. Other cells with numerous inclusions appeared to be macrophages. Lysis of granulated cells in situ is compatible with suggestions that the metrial gland produces a holocrine secretion, though some normal granulated cells enter blood vessels. The stromal cells may have a phagocytic role in late pregnancy but evidence for this was inconclusive.

The percentage of granulocyte-like cells in human oviduct epithelium

The ratio of granulocyte-like cells to epithelial cells was examined in the fimbriae, ampullary, and isthmic regions of oviducts obtained from normal women of reproductive age, from postpartum women, from menopausal women, from women on combined oral contraceptives and from women with adnexal pathology. Only patients on oral contraceptives had a significantly high percentage of granulocyte-like cells as did one patient with acute salpingitis.

Cellular mechanisms involved in cyclic stroma renewal of the uterus. III. Cells of the immune response

The principal cell types associated with the humoral immune response (monocyte-macrophages, lymphocytes, and plasma cells) are numerous in the endometrial stroma of the uterus during the first four postpartum days in two types of mammals, the marsupial North America opossum and the eutherian albino rat. This transietn cellular differentiation coincides with the physiologic period of rapid uterine regression which includes massive reduction in the amount of extracellular stromal material. In addition, heterophils and eosinophils, cell types also known to be associated with phagocytic and immunologic activity, appear in the stroma during the first two postpartum days; their presence may, however, be associated more directly with the postpartum estrus that occurs on day 1 postpartum than with endometrial regression. Thus, the five cell types, which are known in pathologic conditions to be components present in the inflammatory response to a foreign antigen, are conspicuously present in the normal regressing endometrium. Furthermore, there is ample ultrastructural evidence of frequent macrophagic-lymphocytic interaction, transformation of lymphocytes, and active secretion by plasma cells during this early postpartum period. An hypothesis has been derived by uniting this new description of endometrial stromal cell differentiation with the existing literature on uterine collagenase activity, an important feature of postpartum regression (reviews of Gross, '74; Harris and Krane, '74). It is based on the assumption that during regression the extracellular action of neutral collagenase (and possibly other extracellular proteases) release new antigenic sites in proteins located in the ground substance. In the case of collagenase, these transient antigenic sites would arise at the locus of enzymic cleavage as well as from the subsequent denaturation of the fragments of the collagen molecule. This endogenous antigenic stimulus would be strong and temporary, and would lead to the cellular manifestations of the transient humoral immunologic response which are evident in the regressing stroma of these two mammals. This humoral immune reaction may be one of the regulatory mechanisms involved in the cyclic renewal of the extracellular compartment of the uterine stroma.

Cellular mechanisms involved in cyclic stromal renewal of the uterus. I. The opossum, Didelphis virginiana

At the close of a uterine cycle, the remodelling of the endometrial stroma of the North American opossum involves removal of extracellular material by macrophages. This study provides cytochemical and ultrastructural evidence which indicates that the laden macrophages are eliminated from the endometrium through emigration across the glandular and luminal epithelia. During diestrus or the early postpartum period, the abundant uterine glands relinguish their secretory function to acquire a transient function in the transportation of emigrating stromal cells. During the first three postpartum days endometrial regression in the stroma is marked by sudden appearance of monocytes, macrophages, lymphocytes, and plasma cells. Ultrastructural and cytochemical evidence indicates that the macrophages engulf the extracellular macromolecular material which, in the opossum, consists primarily of ground substance. Macrophages filled with ingested extracellular material aggregated beneath the glandular and luminal epithelia, where they acquire an extracellular coat that resembles the material of the basal lamina elsewhere. A fibroblast-like cell closely invests the macrophage at the time the extracellular material appears. Simultaneously, the secretory glandular epithelium is being converted to a highly ciliated one. Macrophages, often accompanied by lymphocytes, acquire intraepithelial positions in the glands. From here these stromal cells gain entrance to the glandular lumens. At this time the luminal contents are rich in acid phosphatase activity which most likely reflects the high lysosomal content of the emigrating macrophages. Evidence suggests that these intraluminal macrophages and lymphocytes are swept, by the recently differentiated ciliary lining, toward the glandular orifices and into the uterine cavity. It is hypothesized that this cyclic appearance and transepithelial elimination of macrophages is a cellular mechanism for removing large amounts of extracellular material without disruption of the endometrium.