1
|
Riaz MA, Kary FL, Jensen A, Zeppernick F, Meinhold-Heerlein I, Konrad L. Long-Term Maintenance of Viable Human Endometrial Epithelial Cells to Analyze Estrogen and Progestin Effects. Cells 2024; 13:811. [PMID: 38786035 PMCID: PMC11120542 DOI: 10.3390/cells13100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
There are fewer investigations conducted on human primary endometrial epithelial cells (HPEECs) compared to human primary endometrial stromal cells (HPESCs). One of the main reasons is the scarcity of protocols enabling prolonged epithelial cell culture. Even though it is possible to culture HPEECs in 3D over a longer period of time, it is technically demanding. In this study, we successfully established a highly pure, stable, and long-term viable human conditionally reprogrammed endometrial epithelial cell line, designated as eCRC560. These cells stained positive for epithelial markers, estrogen and progesterone receptors, and epithelial cell-cell contacts but negative for stromal and endothelial cell markers. Estradiol (ES) reduced the abundance of ZO-1 in a time- and dose-dependent manner, in contrast to the dose-dependent increase with the progestin dienogest (DNG) when co-cultured with HPESCs. Moreover, ES significantly increased cell viability, cell migration, and invasion of the eCRC560 cells; all these effects were inhibited by pretreatment with DNG. DNG withdrawal led to a significantly disrupted monolayer of eCRC560 cells in co-culture with HPESCs, yet it markedly increased the adhesion of eCRC560 to the human mesothelial MeT-5A cells. The long-term viable eCRC560 cells are suitable for in vitro analysis of HPEECs to study the epithelial compartment of the human endometrium and endometrial pathologies.
Collapse
Affiliation(s)
- Muhammad Assad Riaz
- Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (M.A.R.); (F.L.K.); (F.Z.); (I.M.-H.)
| | - Franziska Louisa Kary
- Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (M.A.R.); (F.L.K.); (F.Z.); (I.M.-H.)
| | - Alexandra Jensen
- Institute of Radiooncology and Radiotherapy, Clinic Fulda, 36043 Fulda, Germany;
| | - Felix Zeppernick
- Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (M.A.R.); (F.L.K.); (F.Z.); (I.M.-H.)
| | - Ivo Meinhold-Heerlein
- Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (M.A.R.); (F.L.K.); (F.Z.); (I.M.-H.)
| | - Lutz Konrad
- Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (M.A.R.); (F.L.K.); (F.Z.); (I.M.-H.)
| |
Collapse
|
2
|
Moriyama M, Nakamura K, Nagata H, Wada I, Nagira K, Azuma Y, Sato E, Harada T, Taniguchi F. Role of tenascin C in lesion formation in early peritoneal endometriosis. F&S SCIENCE 2024; 5:69-79. [PMID: 38092313 DOI: 10.1016/j.xfss.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To identify cytokines or extracellular matrix components that contribute to adhesion to, and invasion of, the peritoneum, proximal to lesions in the early phase of endometriosis. DESIGN Laboratory-based study. SETTING University Hospital and Laboratory of Animal Science. PATIENTS AND ANIMALS Five women with ovarian endometrioma, 138 wild-type (WT) C57BL/6N mice, and 48 Tenascin C (Tnc) knockout (TncKO) mice. INTERVENTIONS To establish a murine endometriosis model, 20 pieces of minced uterine tissue fragments from each horn were administered intraperitoneally to syngeneic mice. Three days later, endometriotic lesions and peritoneal tissues were collected. Separately, we transfected human peritoneal mesothelial cells (HMrSV5) or human endometrial stromal cells (hESCs) with Tnc small interfering ribonucleic acid. MAIN OUTCOME MEASURES We employed a polymerase chain reaction array to profile gene expression in the murine peritoneum, in both peritoneum distal to lesions and peritoneum surrounding lesions (PSL). The expression of upregulated genes in the PSL was verified in the peritoneal samples by real-time reverse transcription-polymerase chain reaction. TncKO mice were used to investigate the role of Tnc in the development of endometriosis. We evaluated the proliferative activity or inflammatory state of lesions by Ki67 or CD3 immunostaining. Intraperitoneal distribution of macrophages was assessed by fluorescence-activated cell sorting. Using Tnc small interfering ribonucleic acid, we examined the invasive capacity of hESCs in a coculture system with HMrSV5. RESULTS Tnc gene expression was significantly higher in PSL than in peritoneum distal to lesions. The weight and number of TncKO lesions in TncKO hosts were lower than those of WT lesions in WT hosts. In contrast, the weight and number of nonattached TncKO lesions in TncKO hosts were higher than those of nonattached WT lesions in WT hosts. We observed decreased Ki67-positive cells or H-scores for CD3, a lower proportion of M1 macrophages, and a higher proportion of M2 macrophages in TncKO lesions in TncKO recipients. Silencing of Tnc expression in hESCs and HMrSV5 diminished the invasivity of hESCs. CONCLUSION Tnc may be a crucial factor in the development of early peritoneal endometriosis.
Collapse
Affiliation(s)
- Maako Moriyama
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Kazuomi Nakamura
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Yonago, Tottori, Japan
| | - Hiroki Nagata
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Ikumi Wada
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Kei Nagira
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Yukihiro Azuma
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Eri Sato
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Tasuku Harada
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Fuminori Taniguchi
- Division of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
| |
Collapse
|
3
|
Nazri HM, Greaves E, Quenby S, Dragovic R, Tapmeier TT, Becker CM. The role of small extracellular vesicle-miRNAs in endometriosis. Hum Reprod 2023; 38:2296-2311. [PMID: 37877421 PMCID: PMC10694411 DOI: 10.1093/humrep/dead216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
Endometriosis is defined by the presence of extrauterine endometrial-like tissue, which can cause pain and infertility in 10% of reproductive-age women. To date, the pathogenesis is poorly understood resulting in significant diagnostic delays and poor therapeutic outcomes in many women. Small extracellular vesicles (sEVs) (<200 nm) are cell-derived vesicles containing molecules that can influence gene expression and behaviour in target cells. One such cargo are microRNAs (miRNAs), which are short, non-coding RNAs mostly 19-25 nucleotides in length that regulate post-transcriptional gene expression. This mini-review focuses on the role of sEV-miRNAs, which are conceivably better biomarkers for endometriosis than free miRNAs, which reflect the true pathophysiological state in the body, as sEV-encapsulated miRNAs are protected from degradation compared to free miRNA and provide direct cell-to-cell communication via sEV surface proteins. sEV-miRNAs have been implicated in the immunomodulation of macrophages, the proliferation, migration and invasion of endometrial cells, and angiogenesis, all hallmarks of endometriosis. The diagnostic potential of sEV-miRNA was investigated in one study that reported the sensitivity and specificity of two sEV-miRNAs (hsa-miR-22-3p and hsa-miR-320a-3p) in distinguishing endometriosis from non-endometriosis cases. Only three studies have explored the therapeutic potential of sEV-miRNAs in vivo in mice-two looked into the role of sEV-hsa-miR-214-3p in decreasing fibrosis, and one investigated sEV-hsa-miR-30c-5p in suppressing the invasive and migratory potential of endometriotic lesions. While early results are encouraging, studies need to further address the potential influence of factors such as the menstrual cycle as well as the location and extent of endometriotic lesions on miRNA expression in sEVs. Given these findings, and extrapolating from other conditions such as cancer, diabetes, and pre-eclampsia, sEV-miRNAs could present an attractive and urgently needed future diagnostic and therapeutic target for millions of women suffering from endometriosis. However, research in this area is hampered by lack of adherence to the International Society for Extracellular Vesicles 2018 guideline in separating and characterising sEVs, as well as the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project protocols.
Collapse
Affiliation(s)
- Hannah M Nazri
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Erin Greaves
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Siobhan Quenby
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rebecca Dragovic
- Nuffield Department of Women’s & Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, UK
| | - Thomas T Tapmeier
- Nuffield Department of Women’s & Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, UK
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Christian M Becker
- Nuffield Department of Women’s & Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, UK
| |
Collapse
|
4
|
Gołąbek-Grenda A, Olejnik A. In vitro modeling of endometriosis and endometriotic microenvironment - Challenges and recent advances. Cell Signal 2022; 97:110375. [PMID: 35690293 DOI: 10.1016/j.cellsig.2022.110375] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/26/2022]
Abstract
Endometriosis is a chronic condition with high prevalence in reproductive age women, defined as the growth of endometrial tissue outside the uterine cavity, most commonly on the pelvic peritoneum. The ectopic endometrial lesions exist in a unique microenvironment created by the interaction of epithelial, stromal, endothelial, glandular, and immune cell components, dominated by inflammatory, angiogenic, and endocrine signals. Current research is directed at understanding the complex microenvironment of the lesions and its relationship with different endometriosis stages, phenotypes, and disease symptoms and at the development of novel diagnostic and therapeutic concepts that minimalize the undesirable side effects of current medical management. Recreating pathophysiological cellular and molecular mechanisms and identifying clinically relevant metrics to assess drug efficacy is a great challenge for the experimental disease models. This review summarizes the complete range of available in vitro experimental systems used in endometriotic studies, which reflect the multifactorial nature of the endometriotic lesion. The article discusses the simplistic in vitro models such as primary endometrial cells and endometriotic cell lines to heterogeneous 2D co-cultures, and recently more common, 3D systems based on self-organization and controlled assembly, both in microfluidic or bioprinting methodologies. Basic research models allow studying fundamental pathological mechanisms by which menstrual endometrium adheres, invades, and establishes lesions in ectopic sites. The advanced endometriosis experimental models address the critical challenges and unsolved problems and provide an approach to drug screening and medicine discovery by mimicking the complicated behaviors of the endometriotic lesion.
Collapse
Affiliation(s)
- Agata Gołąbek-Grenda
- Department of Biotechnology and Food Microbiology, Poznan University of Life Sciences, 48 Wojska Polskiego St., 60-627 Poznan, Poland
| | - Anna Olejnik
- Department of Biotechnology and Food Microbiology, Poznan University of Life Sciences, 48 Wojska Polskiego St., 60-627 Poznan, Poland.
| |
Collapse
|
5
|
Lin LL, Makwana S, Chen M, Wang CM, Gillette LH, Huang TH, Burney RO, Nicholson BJ, Kirma NB. Cellular junction and mesenchymal factors delineate an endometriosis-specific response of endometrial stromal cells to the mesothelium. Mol Cell Endocrinol 2022; 539:111481. [PMID: 34624439 DOI: 10.1016/j.mce.2021.111481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
Endometriosis is a debilitating gynecologic disorder that affects ∼10% of women of reproductive age. Endometriosis is characterized by growth of endometriosis lesions within the abdominal cavity, generally thought to arise from retrograde menstruation of shed endometrial tissue. While the pathophysiology underlying peritoneal endometriosis lesion formation is still unclear, the interaction between invading endometrial tissue and the peritoneal mesothelial lining is an essential step in lesion formation. In this study, we assessed proteomic differences between eutopic endometrial stromal cells (ESCs) from women with and without endometriosis in response to peritoneal mesothelial cell (PMC) exposure, using single-cell cytometry by time-of-flight (CyTOF). Co-cultured primary eutopic ESCs from women with and without endometriosis with an established PMC line were subjected to immunostaining with a panel of Maxpar CyTOF metal-conjugated antibodies (n = 28) targeting cell junction and mesenchymal markers, which are involved in cell-cell adhesions and epithelial-mesenchymal transition. Exposure of the ESCs to PMCs resulted in a drastic shift in cellular expression profiles in ESCs derived from endometriosis, whereas little effect by PMCs was observed in ESCs from non-endometriosis subjects. The transcription factor SNAI1 was consistently repressed by PMC interactions. ESCs from endometriosis patients are unique in that they respond to PMCs by undergoing changes in adhesive properties and mesenchymal characteristics that would facilitate lesion formation.
Collapse
Affiliation(s)
- Li-Ling Lin
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Simran Makwana
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Meizhen Chen
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Chiou-Miin Wang
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | - Tim H Huang
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | - Bruce J Nicholson
- Department of Biochemistry and Structural Biology, University of Texas Health San Antonio, Texas, USA.
| | - Nameer B Kirma
- Department of Molecular Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
| |
Collapse
|
6
|
Li X, Xiong W, Long X, Dai X, Peng Y, Xu Y, Zhang Z, Zhang L, Liu Y. Inhibition of METTL3/m6A/miR126 promotes the migration and invasion of endometrial stromal cells in endometriosis. Biol Reprod 2021; 105:1221-1233. [PMID: 34382070 DOI: 10.1093/biolre/ioab152] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/17/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
N6-methyladenosine (m6A), one of the most abundant RNA modifications, is involved in the progression of many diseases, but its role and related molecular mechanisms in endometriosis remain unknown. To address these issues, we detected m6A levels in normal, eutopic and ectopic endometrium and found the m6A levels decreased in eutopic and ectopic endometrium compared with normal endometrium. In addition, we proved that methyltransferase-like 3 (METTL3) downregulation accounted for m6A reduction in endometriosis. Furthermore, we observed that METTL3 knockdown facilitated the migration and invasion of human endometrial stromal cells (HESCs), while METTL3 overexpression exerted opposite effects, suggesting that METTL3 downregulation might contribute to endometriosis development by enhancing cellular migration and invasion. Mechanistically, METTL3-dependent m6A was involved in the DGCR8-mediated maturation of primary microRNA126 (miR126, pri-miR126). Moreover, miR126 inhibitor significantly enhanced the migration and invasion of METTL3-overexpressing HESCs, whereas miR126 mimics attenuated the migration and invasion of METTL3-silenced HESCs. Our study revealed the METTL3/m6A/miR126 pathway, whose inhibition might contribute to endometriosis development by enhancing cellular migration and invasion. It also showed that METTL3 might be a novel diagnostic biomarker and therapeutic target for endometriosis.
Collapse
Affiliation(s)
- Xiaoou Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xuefeng Long
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xin Dai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yuan Peng
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Ying Xu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Zhibing Zhang
- Department of Physiology, Wayne State University, 275E Hancock Street, Detroit, 48201, Michigan
| | - Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| |
Collapse
|
7
|
Stejskalová A, Fincke V, Nowak M, Schmidt Y, Borrmann K, von Wahlde MK, Schäfer SD, Kiesel L, Greve B, Götte M. Collagen I triggers directional migration, invasion and matrix remodeling of stroma cells in a 3D spheroid model of endometriosis. Sci Rep 2021; 11:4115. [PMID: 33603041 PMCID: PMC7892880 DOI: 10.1038/s41598-021-83645-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/29/2021] [Indexed: 01/31/2023] Open
Abstract
Endometriosis is a painful gynecological condition characterized by ectopic growth of endometrial cells. Little is known about its pathogenesis, which is partially due to a lack of suitable experimental models. Here, we use endometrial stromal (St-T1b), primary endometriotic stromal, epithelial endometriotic (12Z) and co-culture (1:1 St-T1b:12Z) spheroids to mimic the architecture of endometrium, and either collagen I or Matrigel to model ectopic locations. Stromal spheroids, but not single cells, assumed coordinated directional migration followed by matrix remodeling of collagen I on day 5 or 7, resembling ectopic lesions. While generally a higher area fold increase of spheroids occurred on collagen I compared to Matrigel, directional migration was not observed in co-culture or in 12Z cells. The fold increase in area on collagen I was significantly reduced by MMP inhibition in stromal but not 12Z cells. Inhibiting ROCK signalling responsible for actomyosin contraction increased the fold increase of area and metabolic activity compared to untreated controls on Matrigel. The number of protrusions emanating from 12Z spheroids on Matrigel was decreased by microRNA miR-200b and increased by miR-145. This study demonstrates that spheroid assay is a promising pre-clinical tool that can be used to evaluate small molecule drugs and microRNA-based therapeutics for endometriosis.
Collapse
Affiliation(s)
- Anna Stejskalová
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Victoria Fincke
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Melissa Nowak
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany ,grid.411327.20000 0001 2176 9917Present Address: Institut für Molekulare Medizin III, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany
| | - Yvonne Schmidt
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Katrin Borrmann
- grid.16149.3b0000 0004 0551 4246Department of Radiotherapy-Radiooncology, Münster University Hospital, 48149 Münster, Germany
| | - Marie-Kristin von Wahlde
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Sebastian D. Schäfer
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Ludwig Kiesel
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| | - Burkhard Greve
- grid.16149.3b0000 0004 0551 4246Department of Radiotherapy-Radiooncology, Münster University Hospital, 48149 Münster, Germany
| | - Martin Götte
- grid.16149.3b0000 0004 0551 4246Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer Campus 1, D11, 48149 Münster, Germany
| |
Collapse
|
8
|
Knudtson JF, McLaughlin JE, Sultana M, Santos MT, Sureshkumar MA, Tekmal RR, Schenken RS. CD44 variant 6 is involved in the attachment and invasion of endometrial cells to peritoneum. F&S SCIENCE 2020; 1:188-194. [PMID: 35559927 DOI: 10.1016/j.xfss.2020.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/23/2020] [Accepted: 08/26/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To study the effects of CD44 standard (CD44s), CD44v3, and CD44v6 overexpression (OE) on immortalized human endometrial epithelial (iEECs) and stroma cells (human endometrial stromal cells [hESCs]) using in vitro assays and a nude mouse xenograft model. Menstrual endometrial cells from women with endometriosis have increased adhesion and also express higher levels of CD44 variant 6 (v6), but not v3, compared to menstrual endometrial cells from women without endometriosis. DESIGN In vitro studies and in vivo xenograft model. SETTING Academic center. PATIENTS(S) Deidentified immortalized endometrial epithelial tissue samples of a reproductive-age woman. INTERVENTION(S) Overexpression of CD44s, CD44v3, and CD44v6 was carried out using lipofectamine, and their expression was verified with mRNA and protein in iEEC and hESCs. The OE cells were used in in vitro studies and an in vivo xenograft model compared to plasmid control. MAIN OUTCOME MEASURE(S) The effect of CD44s, CD44v3, and CD44v6 OE on attachment and invasion assays and a xenograft model with immortalized human stromal and epithelial cells. RESULT(S) Expression of mRNA and protein confirmed appropriate OE of CD44s, CD44v3, and CD44v6 in the different cell types. CD44v6 OE increased attachment of hESCs compared with controls. CD44v6 OE did not change the attachment of iEECs. There was no difference in attachment in iEECs or hESCs with OE of CD44s or CD44v3. CONCLUSION(S) Overexpression of CD44v6 increases attachment of hESCs to peritoneal mesothelial cells in an in vitro assay and an in vivo xenograft model. Menstrual endometrial cell type and CD44 variants play a complex role in the development of the early endometriotic lesion.
Collapse
Affiliation(s)
- Jennifer F Knudtson
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
| | - Jessica E McLaughlin
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Coastal Fertility Specialists, Charleston, South Carolina
| | - Mubeen Sultana
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Marlen Tellez Santos
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - M A Sureshkumar
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Rajeshwar R Tekmal
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Robert S Schenken
- Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| |
Collapse
|
9
|
Topdagi Yilmaz EP, Topdagi YE, Al RA, Kumtepe Y. The relationship between C-reactive protein, carbohydrate antigen 125, and hematological parameters to endometriotic nodule localization in pelvis. J Chin Med Assoc 2020; 83:577-581. [PMID: 32502120 DOI: 10.1097/jcma.0000000000000307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Endometriosis is a pelvic inflammatory process, and hormonal, environmental, and genetic factors play a role in its etiopathogenesis; especially, deep pelvic endometriosis exhibits an extensive anatomical distribution. In the present study, we evaluated the contribution of routinely measured hematological parameters to the diagnosis as the number of endometriotic nodule localization increases, when evaluated with C-reactive protein (CRP) and carbohydrate antigen (CA) 125. METHODS The present study included patients with histopathologically confirmed diagnosis of endometriosis who underwent surgery at our hospital between January 2007 and December 2018. Their medical records were examined retrospectively. RESULTS In total, 205 patients were included in the study, of which 129 patients (62.9%) with ovarian endometrioma and 76 patients (37.1%) with deep infiltrative endometriosis were assigned to Group 1 and Group 2, respectively, and the two groups were compared. Endometriotic nodules were observed in several localizations in 71 patients (34.6%) of the 205 patients with endometriosis. Pelvic nodules were grouped as per their four different localizations: uterosacral, recto-vaginal, bladder, and ureteral. Because the anatomical localization of endometriotic nodules increased in the pelvis, the variability in the levels of CA 125 and CRP as well as hematological parameters was examined. There were significant differences in hemoglobin (p < 0.036), CA 125 (p < 0.000), and CRP (p < 0.007) levels between patients with nodules in ≤2 localizations and those with nodules in ≥3 localizations. CONCLUSION Our study included a total of 205 patients. There was a significant difference in the CRP, CA 125, and hemoglobin levels between Group 1 and Group 2, but it was concluded that coexistence of the endometriotic nodule had no effect on the other hematological parameters. For this purpose, prospective studies with a larger number of patients are needed.
Collapse
Affiliation(s)
| | - Yunus Emre Topdagi
- Department of Gynecology and Obstetrics, Sanko University School of Medicine, Gazinatep, Turkey
| | - Ragip Atakan Al
- Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey
| | - Yakup Kumtepe
- Department of Gynecology and Obstetrics, Atatürk University School of Medicine, Erzurum, Turkey
| |
Collapse
|
10
|
McLaughlin JE, Santos MT, Binkley PA, Sultana M, Tekmal RR, Schenken RS, Knudtson JF. Inhibition of Hyaluronic Acid Synthesis Decreases Endometrial Cell Attachment, Migration, and Invasion. Reprod Sci 2020; 27:1058-1063. [PMID: 32016803 DOI: 10.1007/s43032-019-00100-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/02/2019] [Indexed: 12/24/2022]
Abstract
To characterize the effects of 4-methylumbelliferone (4-MU) on expression of the hyaluronic acid (HA) system and on attachment, migration, and invasion of endometrial epithelial (EECs) and stroma cells (ESCs) to peritoneal mesothelial cells (PMCs), this in vitro study was performed in an Academic Center. De-identified endometrial tissue samples used were from reproductive-aged women. EECs and ESCs isolated from menstrual endometrial biopsies were treated with 4-MU or vehicle. Real-time polymerase chain reaction and western blot were used to assess expression of HA synthases (HAS), hyaluronidase, and standard CD44. Established in vitro assays were used to assess attachment, migration, and invasion with and without treatment with 4-MU. Chi square and Student's t-test were used to analyze the results as appropriate. The addition of 4-MU decreased mRNA and protein expression of HAS 2, HAS 3, and CD44 in EECs and ESCs compared to control. Treatment with 4-MU also decreased attachment, migration, and invasion of EECs and ESCs to PMCs compared to control. 4-MU decreases endometrial cell adhesion, migration, and invasion to PMCs. This effect appears to be mediated by a decrease in HAS 2, HAS 3, and CD44. 4-MU is a potential treatment for endometriosis. Future in vivo studies are needed to evaluate 4-MU as a therapeutic agent for endometriosis.
Collapse
Affiliation(s)
- Jessica E McLaughlin
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Marlen Tellez Santos
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Peter A Binkley
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Mubeen Sultana
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Rajeshwar R Tekmal
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Robert S Schenken
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA
| | - Jennifer F Knudtson
- Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7836, San Antonio, TX, 78229, USA.
| |
Collapse
|
11
|
Abstract
Endometriosis is one of the most common benign gynecological diseases in women of reproductive age worldwide. In past decades, a number of in-vitro models have been used to investigate the pathology and therapeutic methods for the treatment of endometriosis. The current review summarized the majority of currently available in-vitro models, which utilize a variety of cell or tissues types, including endometriotic cell lines, primary endometrial stromal cells, endometrial stem cells, endometrial explants, peritoneal explants and immune cells. These cells or tissues are cultured individually, co-cultured in 2D or 3D systems with various matrices or cultured in chicken chorioallantotic membranes and amniotic membranes culture systems. These models are able to represent one or more aspects of the process of endometriosis. These models are helpful and can be used to investigate the development of endometriosis and the underlying mechanisms of this disorder in detail, and help investigators select appropriate models for their experiments. Recently, the new concept of endometriosis as a fibrotic condition will lead research to investigate the differentiation of myofibroblasts and the development of fibrosis in endometriotic lesions, which will increase the development of novel models that can be used to investigate endometriotic fibrosis.
Collapse
Affiliation(s)
- Hongjie Fan
- The Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P.R. China
| |
Collapse
|
12
|
Noh EJ, Kim DJ, Lee JY, Park JH, Kim JS, Han JW, Kim BC, Kim CJ, Lee SK. Ureaplasma Urealyticum Infection Contributes to the Development of Pelvic Endometriosis Through Toll-Like Receptor 2. Front Immunol 2019; 10:2373. [PMID: 31636643 PMCID: PMC6788432 DOI: 10.3389/fimmu.2019.02373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/23/2019] [Indexed: 12/29/2022] Open
Abstract
Endometriosis is a chronic gynecological disorder, characterized by the presence of ectopic endometrial tissue outside the uterine cavity. Among several hypotheses, Sampson's theory of retrograde menstruation is still applicable. Recent studies have reported the importance of inflammation among endometrial tissue, the peritoneum, and immune cells. However, less is known regarding the role of bacterial infection in the pathophysiology of endometriosis. We hypothesized that Ureaplasma urealyticum infection might contribute to the development of endometriosis by inducing the production of inflammatory mediators by peritoneal mesothelial cells (PMCs), possibly through TLR2. Hence, our objective was to reveal whether PMC infection by U. urealyticum is associated with endometriosis. Moreover, we aimed to demonstrate the molecular mechanism involved in this relationship. We developed a new infection-induced mouse model of endometriosis with wild type and Tlr2-deficient mice. Based on the in vivo mouse model, U. urealyticum-infected mice showed significantly increased numbers and sizes of ectopic endometriotic lesions. U. urealyticum upregulated not only the production of IL-6, CXCL1, and CCL2, but also the expression of ICAM-1, VCAM-1, and MMP2 in murine PMCs. Similarly, endometrial stromal cells dose-dependently produced IL-6, CXCL1, and CCL2 in response to U. urealyticum infection. The series of inflammatory responses in PMCs was mediated mainly through TLR2. The phosphorylation of ERK and JNK was observed when U. urealyticum was added to PMCs and knock out of Tlr2 inhibited these MAPKs phosphorylation. Based on our co-culture study, U. urealyticum-infected PMCs exhibited significantly increased attachment to ESCs compared with uninfected PMCs. Collectively, U. urealyticum infection promotes the development of endometriosis by increasing inflammatory mediators, adhesion molecules, and MMP-2 expression in PMCs through TLR2 signaling. Through our results, we present a theory that infection-induced pelvic inflammation contributes to the initiation and progression of endometriosis. Appropriate treatment of reproductive tract infection may decrease the prevalence of endometriosis.
Collapse
Affiliation(s)
- Eui Jeong Noh
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, South Korea
| | - Dong Jae Kim
- Laboratory Animal Resource Centre, Daegu Gyeongbuk Institute of Science & Technology (DGIST), Daegu, South Korea
| | - Jun Young Lee
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, South Korea
| | - Jong Hwan Park
- Laboratory Animal Medicine, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Jong-Seok Kim
- Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, South Korea
| | - Jae Won Han
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, South Korea
| | - Byoung Chan Kim
- Korean Collection for Type Cultures, Biological Resource Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Chul Jung Kim
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, South Korea
| | - Sung Ki Lee
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, South Korea.,Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, South Korea
| |
Collapse
|
13
|
Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, Kohlmeier A, Yin P, Milad M, Wei J. Endometriosis. Endocr Rev 2019; 40:1048-1079. [PMID: 30994890 PMCID: PMC6693056 DOI: 10.1210/er.2018-00242] [Citation(s) in RCA: 355] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/08/2019] [Indexed: 02/08/2023]
Abstract
Pelvic endometriosis is a complex syndrome characterized by an estrogen-dependent chronic inflammatory process that affects primarily pelvic tissues, including the ovaries. It is caused when shed endometrial tissue travels retrograde into the lower abdominal cavity. Endometriosis is the most common cause of chronic pelvic pain in women and is associated with infertility. The underlying pathologic mechanisms in the intracavitary endometrium and extrauterine endometriotic tissue involve defectively programmed endometrial mesenchymal progenitor/stem cells. Although endometriotic stromal cells, which compose the bulk of endometriotic lesions, do not carry somatic mutations, they demonstrate specific epigenetic abnormalities that alter expression of key transcription factors. For example, GATA-binding factor-6 overexpression transforms an endometrial stromal cell to an endometriotic phenotype, and steroidogenic factor-1 overexpression causes excessive production of estrogen, which drives inflammation via pathologically high levels of estrogen receptor-β. Progesterone receptor deficiency causes progesterone resistance. Populations of endometrial and endometriotic epithelial cells also harbor multiple cancer driver mutations, such as KRAS, which may be associated with the establishment of pelvic endometriosis or ovarian cancer. It is not known how interactions between epigenomically defective stromal cells and the mutated genes in epithelial cells contribute to the pathogenesis of endometriosis. Endometriosis-associated pelvic pain is managed by suppression of ovulatory menses and estrogen production, cyclooxygenase inhibitors, and surgical removal of pelvic lesions, and in vitro fertilization is frequently used to overcome infertility. Although novel targeted treatments are becoming available, as endometriosis pathophysiology is better understood, preventive approaches such as long-term ovulation suppression may play a critical role in the future.
Collapse
Affiliation(s)
- Serdar E Bulun
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bahar D Yilmaz
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Christia Sison
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kaoru Miyazaki
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lia Bernardi
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shimeng Liu
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amanda Kohlmeier
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ping Yin
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Magdy Milad
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - JianJun Wei
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| |
Collapse
|
14
|
Li W, Fan X, Zhang M, Huang L, Lv S, Wang L, Wu Y, Dai C, Xu J, Xu P, Fu Z, Jia X, Shi X. Systematic analysis of hsa-miR-363 gene overexpression pattern in endometrial stromal cells. Int J Mol Med 2018; 42:2793-2800. [PMID: 30226573 DOI: 10.3892/ijmm.2018.3840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 01/18/2018] [Indexed: 11/06/2022] Open
Abstract
Endometriosis is a benign disease, but has invasion and metastasis characteristics similar to malignant tumors. Clinically, it is a difficult problem of gynecological clinical treatment for its high recurrence rate. It has been confirmed that miR-363 was downregulated in endometriosis tissues and miR-363 overexpression inhibited the invasion ability of endometrial stromal cells (ESCs). In order to explore the potential mechanism of miR-363-reduced ESC migration and invasion progression, we sought to demonstrate the targeted mRNA expression levels of miR-363 through microarray, and performed cluster analysis to identify potential functions of these targeted genes in ESCs. The wound migration assay showed that there was an observable trend of cell migration potential decrease after transfection with hsa-miR-363. The qRT-PCR result showed that compared to miR-363 negative control cell group, miR-363 was upregulated 3,264.58-fold after miR-363 lentiviral transfection in miR-363 mimics group. The microarray data showed that compared to ESCs miR-363 negative control cell group, 249 genes were upregulated in ESCs miR-363 mimics cells group, and 139 genes were downregulated. Gene Ontology analysis and the pathway analysis data demonstrated that these target genes are mainly involved in cell migration, cell adhesion and invasion, proliferation, apoptosis, alteration of endometrial cells and some related signaling pathways. Our study explored the gene expression pattern after miR-363 overexpression, which could expand the insights into the miR-363 function and molecular mechanisms in endometriosis.
Collapse
Affiliation(s)
- Wenqu Li
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Xuemei Fan
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Mi Zhang
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Lei Huang
- Department of General Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P.R. China
| | - Shanshan Lv
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Luyu Wang
- Soochow University, Soochow, Jiangsu 215004, P.R. China
| | - Ying Wu
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Chencheng Dai
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Juan Xu
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Pengfei Xu
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Ziyi Fu
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Xuemei Jia
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| | - Xiaoyan Shi
- Department of Gynecology, Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternal and Child Health Care Hospital, Nanjing, Jiangsu 210004, P.R. China
| |
Collapse
|
15
|
Capobianco A, Cottone L, Monno A, Ferrari S, Panina-Bordignon P, Manfredi AA, Rovere-Querini P. Innate Immune Cells: Gatekeepers of Endometriotic Lesions Growth and Vascularization. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/228402651000200202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infiltration by inflammatory leukocytes is a hallmark of all forms of endometriosis. Conversely, the innate immune system plays a key role in regulating events such as cell adhesion, migration, survival and neoangiogenesis of transformed or ectopic tissue. All these features are involved, and possibly required, in the development of endometriotic lesions. Recent data suggest that infiltrating leukocytes are not a mere epiphenomenon but represent an actual requirement for the development of the disease. In this scenario, the functional plasticity of infiltrating macrophages is a key event in the origin and maintenance of endometriotic lesions: the erroneous polarization of macrophages towards cells sustaining angiogenesis and tissue remodeling represents a potential target for novel molecular therapies.
Collapse
Affiliation(s)
- Annalisa Capobianco
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| | - Lucia Cottone
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| | - Antonella Monno
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| | - Stefano Ferrari
- Department of Gynecology and Obstetrics, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| | | | - Angelo A. Manfredi
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| | - Patrizia Rovere-Querini
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute and Vita Salute San Raffaele University, Milan - Italy
| |
Collapse
|
16
|
Capobianco A, Cottone L, Monno A, Manfredi AA, Rovere-Querini P. The peritoneum: healing, immunity, and diseases. J Pathol 2017; 243:137-147. [PMID: 28722107 DOI: 10.1002/path.4942] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/06/2017] [Accepted: 07/02/2017] [Indexed: 12/13/2022]
Abstract
The peritoneum defines a confined microenvironment, which is stable under normal conditions, but is exposed to the damaging effect of infections, surgical injuries, and other neoplastic and non-neoplastic events. Its response to damage includes the recruitment, proliferation, and activation of a variety of haematopoietic and stromal cells. In physiological conditions, effective responses to injuries are organized; inflammatory triggers are eliminated; inflammation quickly abates; and the normal tissue architecture is restored. However, if inflammatory triggers are not cleared, fibrosis or scarring occurs and impaired tissue function ultimately leads to organ failure. Autoimmune serositis is characterized by the persistence of self-antigens and a relapsing clinical pattern. Peritoneal carcinomatosis and endometriosis are characterized by the persistence of cancer cells or ectopic endometrial cells in the peritoneal cavity. Some of the molecular signals orchestrating the recruitment of inflammatory cells in the peritoneum have been identified in the last few years. Alternative activation of peritoneal macrophages was shown to guide angiogenesis and fibrosis, and could represent a novel target for molecular intervention. This review summarizes current knowledge of the alterations to the immune response in the peritoneal environment, highlighting the ambiguous role played by persistently activated reparative macrophages in the pathogenesis of common human diseases. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Annalisa Capobianco
- San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Milan, Italy
| | - Lucia Cottone
- San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Milan, Italy.,University College London, Genetics and Cell Biology of Sarcoma Group, London, UK
| | - Antonella Monno
- San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Milan, Italy
| | - Angelo A Manfredi
- San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Patrizia Rovere-Querini
- San Raffaele Scientific Institute, Division of Immunology, Transplantation, and Infectious Diseases, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
17
|
Tanaka Y, Mori T, Ito F, Koshiba A, Takaoka O, Kataoka H, Maeda E, Okimura H, Mori T, Kitawaki J. Exacerbation of Endometriosis Due To Regulatory T-Cell Dysfunction. J Clin Endocrinol Metab 2017; 102:3206-3217. [PMID: 28575420 DOI: 10.1210/jc.2017-00052] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/22/2017] [Indexed: 02/04/2023]
Abstract
CONTEXT Endometriosis is a chronic inflammatory disease associated with altered immune response to endometrial cells facilitating the implantation and proliferation of ectopic endometrial tissues. Although regulatory T (Treg) cells play a key role in T cell-mediated immune response and development of immune disorders, their significance in endometriosis remains to be elucidated. Recently, CD4+CD45RA- forkhead box protein 3 (Foxp3)hi T cells, activated Treg cells, have been identified as a functionally true suppressive population of Treg cells. OBJECTIVE To investigate the role of Treg cells in endometriosis. DESIGN Three Treg cell fractions (resting Treg cells, activated Treg cells, and non-Treg cells) were examined using flow cytometry in the endometrioma, endometrium, peritoneal fluid, and peripheral blood obtained from women with (n = 27) and without (n = 28) endometriosis. A mouse model of endometriosis was made in Foxp3tm3Ayr/J (Foxp3DTR) C57BL/6 Treg cell-depleted mice (n = 28). RESULTS In women with endometrioma, the proportion of activated Treg cells in the endometrioma and the endometrium, but not in the peritoneal fluid or peripheral blood, was significantly decreased compared with that in women without endometriosis. In Foxp3DTR/diphtheria toxin mice, the number and weight of endometriotic lesions, inflammatory cytokine levels and angiogenetic factors were significantly increased compared with those in control mice. CONCLUSIONS Treg cell deficiency exaggerates local inflammation and angiogenesis and simultaneously facilitates the attachment and growth of endometrial implants. The findings provide an insight into dysregulated immune response for the pathogenesis and development.
Collapse
Affiliation(s)
- Yukiko Tanaka
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Fumitake Ito
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Akemi Koshiba
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Osamu Takaoka
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Hisashi Kataoka
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Eiko Maeda
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Hiroyuki Okimura
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takahide Mori
- Academia for Repro-regenerative Medicine, Kyoto 602-0917, Japan
| | - Jo Kitawaki
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| |
Collapse
|
18
|
Freire MJ, Dinis PJ, Medeiros R, Sousa L, Águas F, Figueiredo A. Deep Infiltrating Endometriosis-Urinary Tract Involvement and Predictive Factors for Major Surgery. Urology 2017; 108:65-70. [PMID: 28694092 DOI: 10.1016/j.urology.2017.06.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/23/2017] [Accepted: 06/27/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate urinary tract involvement by deep infiltrating endometriosis as well as the surgical treatment and existence of predictive factors for major urologic surgery. METHODS We conducted a retrospective analysis of 656 women submitted to surgery for endometriosis, of which 28 patients underwent minor or major surgery for deep infiltrating endometriosis involving the urinary tract, with a mean age of 38 ± 6.9 years (27-50) at diagnosis. Clinical data, surgeries performed, and complications were analyzed. Minor surgery was defined by endoscopic surgery or insertion of a percutaneous nephrostomy catheter, and major surgery included open or laparoscopic procedures. RESULTS Endometriomas affected the ureter in 13 (46.4%), the bladder in 11 (39.3%), and both structures in 4 (14.3%) patients. Twelve (42.9%) patients had decreased renal function, and ureteral involvement was predictive of renal function loss (P = .034). Minor surgeries were performed in most women with isolated bladder involvement and in 12 (42.9%) patients with ureteral infiltration. Patients with ureteric involvement underwent major surgeries more often (n = 12 vs n = 3; P = .025) and had longer hospitalization (8.2 vs 3.1 days, P = .05). After a mean follow-up of 36.3 (1-102) months, there was no bladder involvement recurrence. The most common complication was ureteral stenosis (Clavien-Dindo grade IIIb) in 3 (10.7%) patients. CONCLUSION Surgery is highly successful in most cases. Patients with ureteric involvement are more likely to lose kidney function, undergo major surgery, and have longer hospitalization.
Collapse
Affiliation(s)
- Maria José Freire
- Department of Urology and Renal Transplantation, Coimbra Hospital and University Centre, Portugal.
| | - Paulo Jorge Dinis
- Department of Urology and Renal Transplantation, Coimbra Hospital and University Centre, Portugal
| | - Rita Medeiros
- Department of Gynaecology A, Coimbra Hospital and University Centre, Portugal
| | - Luís Sousa
- Department of Urology and Renal Transplantation, Coimbra Hospital and University Centre, Portugal
| | - Fernanda Águas
- Department of Gynaecology A, Coimbra Hospital and University Centre, Portugal
| | - Arnaldo Figueiredo
- Department of Urology and Renal Transplantation, Coimbra Hospital and University Centre, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| |
Collapse
|
19
|
Tani H, Sato Y, Ueda M, Miyazaki Y, Suginami K, Horie A, Konishi I, Shinomura T. Role of Versican in the Pathogenesis of Peritoneal Endometriosis. J Clin Endocrinol Metab 2016; 101:4349-4356. [PMID: 27533311 DOI: 10.1210/jc.2016-2391] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
CONTEXT Sampson's theory cannot explain why only some cycling women develop peritoneal endometriosis. Few studies have focused on the pelvic peritoneum, which receives regurgitated endometrial tissues. We hypothesized that molecular alterations in the peritoneum are involved in the development of peritoneal endometriosis and conducted a microarray analysis to compare macroscopically normal peritoneum sampled from women with peritoneal endometriosis (endometriotic peritoneum) and those without (non-endometriotic peritoneum). Versican, a major proteoglycan component of the extracellular matrix, is one of the molecules up-regulated in endometriotic peritoneum. OBJECTIVE To investigate the role of versican in peritoneal endometriosis. Design, Patients, and Main Outcome Measure: Endometriotic peritoneum and non-endometriotic peritoneum were subjected to RT-PCR, immunostaining, and Western blotting. The versican V1 isoform was stably transfected into Chinese hamster ovary cells (CHO-V1), and the effects of CHO-V1-derived conditioned medium (V1-CM) on primary human endometrial stromal cells were investigated with attachment, invasion, and proliferation assays. The effects of peritoneal fluid collected from endometriotic women (endometriotic PF) or cytokines/growth factors, which were shown to be elevated in endometriotic PF, on versican expression in a human peritoneal cell line (HMrSV5) were also examined. RESULTS Versican V1 expression levels were significantly higher in endometriotic peritoneum. In vitro, V1-CM promoted attachment to the HMrSV5 cell monolayer as well as the Matrigel invasion of endometrial stromal cells. Although versican V1 expression was up-regulated by TGF-β1 in HMrSV5 cells, it remained unchanged in endometriotic PF. CONCLUSIONS Our results suggest the involvement of peritoneal versican in the development of peritoneal endometriosis.
Collapse
Affiliation(s)
- Hirohiko Tani
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yukiyasu Sato
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Masashi Ueda
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yumiko Miyazaki
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Koh Suginami
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tamayuki Shinomura
- Department of Gynecology and Obstetrics (H.T., M.U., Y.M., K.S., A.H., I.K.), Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Obstetrics and Gynecology (Y.S.), Otsu Red Cross Hospital, Otsu 520-8511, Japan; and Tissue Regeneration (T.S.), Department of Bio-Matrix, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| |
Collapse
|
20
|
Nair HB, Baker R, Owston MA, Escalona R, Dick EJ, VandeBerg JL, Nickisch KJ. An efficient model of human endometriosis by induced unopposed estrogenicity in baboons. Oncotarget 2016; 7:10857-69. [PMID: 26908459 PMCID: PMC4905444 DOI: 10.18632/oncotarget.7516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/09/2016] [Indexed: 11/25/2022] Open
Abstract
Endometriosis is a chronic estrogen-dependent disease that occurs in approximately 10% of reproductive age women. Baboons offer a clear benefit for studying the initiation and progression of endometriosis since baboon is very close to humans phylogenetically. Progestins are used in the treatment of endometriosis. The therapeutic window of progestins depends on the ratio of its affinity towards progesterone receptor agonism verses antagonism. The present study is to determine the role of pure antiprogestin in baboon endometriosis. We hypothesize that pure antiprogestin will induce unopposed estrogenicity and spontaneous endometriosis in baboons. The rate of endometrial invasion and attachment through modeled peritoneum in the presence and absence of progesterone and antiprogestin was evaluated in this study. A baboon model of endometriosis induced by unopposed estrogenicity using progesterone receptor antagonist (EC304) was used in this study. We observed EC304 has induced unopposed estrogenicity that deregulated proteins involved in attachment, invasion, cell growth, and steroid hormone receptors in this model. Our data suggest that depleting progesterone levels in the endometrium will increase estrogen hyper-responsiveness that leads to increased endometriotic lesion progression in the baboon (Papio anubis) model. This study reports a refined model of human endometriosis in baboons that could potentially be used to develop new diagnostic and therapeutic strategies for the benefit of women suffering from endometriosis.
Collapse
Affiliation(s)
| | - Robert Baker
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Michael A Owston
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Renee Escalona
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - John L VandeBerg
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | | |
Collapse
|
21
|
Porter KM, Wieser FA, Wilder CL, Sidell N, Platt MO. Cathepsin Protease Inhibition Reduces Endometriosis Lesion Establishment. Reprod Sci 2015; 23:623-9. [PMID: 26482207 DOI: 10.1177/1933719115611752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endometriosis is a gynecologic disease characterized by the ectopic presence of endometrial tissue on organs within the peritoneal cavity, causing debilitating abdominal pain and infertility. Current treatments alleviate moderate pain symptoms associated with the disorder but exhibit limited ability to prevent new or recurring lesion establishment and growth. Retrograde menstruation has been implicated for introducing endometrial tissue into the peritoneal cavity, but molecular mechanisms underlying attachment and invasion are not fully understood. We hypothesize that cysteine cathepsins, a group of powerful extracellular matrix proteases, facilitate endometrial tissue invasion and endometriosis lesion establishment in the peritoneal wall and inhibiting this activity would decrease endometriosis lesion implantation. To test this, we used an immunocompetent endometriosis mouse model and found that endometriotic lesions exhibited a greater than 5-fold increase in active cathepsins compared to tissue from peritoneal wall or eutopic endometrium, with cathepsins L and K specifically implicated. Human endometriosis lesions also exhibited greater cathepsin activity than adjacent peritoneum tissue, supporting the mouse results. Finally, we tested the hypothesis that inhibiting cathepsin activity could block endometriosis lesion attachment and implantation in vivo. Intraperitoneal injection of the broad cysteine cathepsin inhibitor, E-64, significantly reduced the number of attached endometriosis lesions in our murine model compared to vehicle-treated controls demonstrating that cathepsin proteases contribute to endometriosis lesion establishment, and their inhibition may provide a novel, nonhormonal therapy for endometriosis.
Collapse
Affiliation(s)
- Kristi M Porter
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Friedrich A Wieser
- Department of Gynecology and Obstetrics, Emory University School of Medicine, GA, USA
| | - Catera L Wilder
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, GA, USA
| | - Manu O Platt
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| |
Collapse
|
22
|
Quattrone F, Sanchez AM, Pannese M, Hemmerle T, Viganò P, Candiani M, Petraglia F, Neri D, Panina-Bordignon P. The Targeted Delivery of Interleukin 4 Inhibits Development of Endometriotic Lesions in a Mouse Model. Reprod Sci 2015; 22:1143-52. [PMID: 25850899 DOI: 10.1177/1933719115578930] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Endometriosis is caused by the displacement of endometrium outside the uterus contributing heavily to infertility and debilitating pelvic pain. Ectopic adhesion and growth are believed to occur under the influence of a favorable hormonal environment and immunological factors. The objective of this study is to analyze the effect of a targeted therapy with an antibody-based pharmacodelivery of interleukin 4 (F8-IL4) in a mouse model of experimentally induced endometriosis. Endometriosis-like lesions were induced in Balb/c mice. The animals were treated intravenously with F8-IL4 or with untargeted IL4 (KSF-IL4). Twelve days after disease induction, the lesions were isolated. A significant reduction in the number of total lesions/mouse and in the total volume of lesions/mouse was observed in mice treated with F8-IL4 compared to controls (P = .029 and P = .006, respectively), while no difference was found between KSF-IL4-treated mice and their controls. Gene expression was evaluated by quantitative real-time polymerase chain reaction. Expression of genes involved in cell adhesion, extracellular matrix invasion, and neovascularization was significantly downregulated in F8-IL4-treated mice compared to their controls (integrin β1: P = .02; metalloproteinase [MMP] 3: P = .02; MMP9: P = .04; vascular endothelial growth factor: P = .04). Gene expression of inflammatory cytokines (tumor necrosis factor α, IL1β, IL1α, and IL6) did not vary in the ectopic lesions isolated from F8-IL4-treated mice compared to their controls. Immunohistochemistry demonstrated a significantly reduced expression of E-cadherin and β-catenin in the lesions of mice treated with F8-IL4. Our results show that the antibody-mediated targeted delivery of IL4 inhibits the development of endometriosis in a syngeneic mouse model by likely impairing adhesion, invasion, and vascularization of the ectopic endometrium.
Collapse
Affiliation(s)
- Federica Quattrone
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ana Maria Sanchez
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria Pannese
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Teresa Hemmerle
- Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zürich, Switzerland
| | - Paola Viganò
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Felice Petraglia
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Dario Neri
- Department of Chemistry and Applied Biosciences, ETH Zurich, CH-8093 Zürich, Switzerland
| | - Paola Panina-Bordignon
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| |
Collapse
|
23
|
Roy SS, Kirma NB, Santhamma B, Tekmal RR, Agyin JK. Effects of a novel proteasome inhibitor BU-32 on multiple myeloma cells. Cancer Chemother Pharmacol 2014; 73:1263-71. [PMID: 24728817 DOI: 10.1007/s00280-014-2463-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 03/31/2014] [Indexed: 11/28/2022]
Abstract
Proteasome inhibition is associated with substantial antitumor effects in preclinical models of multiple myeloma (MM) as well as in patients. However, results of recent clinical trials to evaluate the effect of the proteasome inhibitor Bortezomib (Velcade(®), also called PS-341) in MM patients have shown limited activity when used as a single agent. This underscores the need to find new efficacious and less toxic proteasome inhibitors. Recently, carfilzomib was approved for the treatment of refractory/relapsed MM and several new agents have been introduced into the clinic, including marizomib and MLN9708, and trials investigating these second-generation proteasome inhibitors have demonstrated promising results. We have recently synthesized a novel proteasome inhibitor, BU-32, and tested its growth inhibitory effects in different human MM cells including RPMI8226, MM.1S, MM.1R, and U266. In this study, we evaluate the efficacy of the novel proteasome inhibitor BU-32 (NSC D750499) using an in vitro MM model. BU-32 exhibits strong cytotoxicity in a panel of MM cell lines--RPMI8226, MM1S, MM1R, and U266. In addition, we demonstrate by proteasome inhibition assay that BU-32 potently inhibits the chymotryptic- and caspase-like activities of the 26S proteasome. We further show from Annexin V-FITC binding studies that BU-32, like Bortezomib, induces apoptosis in a panel of MM cell lines but the effect is more pronounced with BU-32-treated cells. Invasion assay with the MM.1S cell line indicates that BU-32 inhibits the invasiveness of myeloma cells. Results from our studies using real-time PCR array analyses show that BU-32 effectively downregulates an array of angiogenesis and inflammatory markers. Our results suggest that BU-32 might be a potential chemotherapeutic agent with promising antitumor activity for the treatment of MM.
Collapse
Affiliation(s)
- Sudipa S Roy
- Department of Biochemistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | | | | | | | | |
Collapse
|
24
|
Weimar CHE, Macklon NS, Post Uiterweer ED, Brosens JJ, Gellersen B. The motile and invasive capacity of human endometrial stromal cells: implications for normal and impaired reproductive function. Hum Reprod Update 2013; 19:542-57. [PMID: 23827985 DOI: 10.1093/humupd/dmt025] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mechanisms underlying early reproductive loss in the human are beginning to be elucidated. The migratory and invasive capacity of human endometrial stromal cells (ESCs) is increasingly recognized to contribute to the intense tissue remodelling associated with embryo implantation, trophoblast invasion and endometrial regeneration. In this review, we examine the signals and mechanisms that control ESC migration and invasion and assess how deregulation of these cell functions contributes to common reproductive disorders. METHODS The PubMed database was searched for publications on motility and invasiveness of human ESCs in normal endometrial function and in reproductive disorders including implantation failure, recurrent pregnancy loss (RPL), endometriosis and adenomyosis, covering the period 2000-2012. RESULTS Increasing evidence suggests that implantation failure and RPL involve abnormal migratory responses of decidualizing ESCs to embryo and trophoblast signals. Numerous reports indicate that endometriosis, as well as adenomyosis, is associated with increased basal and stimulated invasiveness of ESCs and their progenitor cells, suggesting a link between a heightened menstrual repair response and the formation of ectopic implants. Migration and invasiveness of ESCs are controlled by a complex array of hormones, growth factors, chemokines and inflammatory mediators, and involve signalling through Rho GTPases, phosphatidylinositol-3-kinase and mitogen-activated protein kinase pathways. CONCLUSIONS Novel concepts are extending our understanding of the key functions of ESCs in effecting tissue repair imposed by cyclic menstruation and parturition. Migration of decidualizing ESCs also serves to support blastocyst implantation and embryo selection through discriminate motile responses directed by embryo quality. Targeting regulatory molecules holds promise for developing new strategies for the treatment of reproductive disorders such as endometriosis and recurrent miscarriage; and harnessing the migratory capacity of progenitor mesenchymal stem cells in the endometrium may offer new opportunities in regenerative medicine.
Collapse
Affiliation(s)
- Charlotte H E Weimar
- Laboratory of Neuroimmunology and Developmental Origins of Disease (NIDOD), University Medical Center Utrecht, Utrecht 3584 EA, The Netherlands
| | | | | | | | | |
Collapse
|
25
|
Young VJ, Brown JK, Saunders PT, Horne AW. The role of the peritoneum in the pathogenesis of endometriosis. Hum Reprod Update 2013; 19:558-69. [DOI: 10.1093/humupd/dmt024] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
26
|
Bhaskaran S, Dileep KV, Deepa SS, Sadasivan C, Klausner M, Krishnegowda NK, Tekmal RR, VandeBerg JL, Nair HB. Gossypin as a Novel Selective Dual Inhibitor of v-raf Murine Sarcoma Viral Oncogene Homolog B1 and Cyclin-Dependent Kinase 4 for Melanoma. Mol Cancer Ther 2013; 12:361-72. [DOI: 10.1158/1535-7163.mct-12-0965] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
27
|
Capobianco A, Rovere-Querini P. Endometriosis, a disease of the macrophage. Front Immunol 2013; 4:9. [PMID: 23372570 PMCID: PMC3556586 DOI: 10.3389/fimmu.2013.00009] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/07/2013] [Indexed: 12/14/2022] Open
Abstract
Endometriosis, a common cause of pelvic pain and female infertility, depends on the growth of vascularized endometrial tissue at ectopic sites. Endometrial fragments reach the peritoneal cavity during the fertile years: local cues decide whether they yield endometriotic lesions. Macrophages are recruited at sites of hypoxia and tissue stress, where they clear cell debris and heme-iron and generate pro-life and pro-angiogenesis signals. Macrophages are abundant in endometriotic lesions, where are recruited and undergo alternative activation. In rodents macrophages are required for lesions to establish and to grow; bone marrow-derived Tie-2 expressing macrophages specifically contribute to lesions neovasculature, possibly because they concur to the recruitment of circulating endothelial progenitors, and sustain their survival and the integrity of the vessel wall. Macrophages sense cues (hypoxia, cell death, iron overload) in the lesions and react delivering signals to restore the local homeostasis: their action represents a necessary, non-redundant step in the natural history of the disease. Endometriosis may be due to a misperception of macrophages about ectopic endometrial tissue. They perceive it as a wound, they activate programs leading to ectopic cell survival and tissue vascularization. Clearing this misperception is a critical area for the development of novel medical treatments of endometriosis, an urgent and unmet medical need.
Collapse
Affiliation(s)
- Annalisa Capobianco
- Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute Milan, Italy
| | | |
Collapse
|
28
|
De La Garza EM, Binkley PA, Ganapathy M, Krishnegowda NK, Tekmal RR, Schenken RS, Kirma NB. Raf-1, a potential therapeutic target, mediates early steps in endometriosis lesion development by endometrial epithelial and stromal cells. Endocrinology 2012; 153:3911-21. [PMID: 22619359 DOI: 10.1210/en.2011-1879] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Endometriosis is a hormone-sensitive gynecological disorder characterized by the benign growth of endometrial-like tissue in the pelvic cavity. Endometriotic lesions composed of endometrial stromal cells (ESC) and glandular epithelial cells (EEC) are thought to arise from menstrual endometrial tissue reaching the pelvic cavity via retrograde menstruation. The cause of endometriotic lesion formation is still not clear. Recent evidence suggest that cytokines may play a role in the early development of endometriosis lesions. Because cytokines and growth factors signal via the v-raf-1 murine leukemia viral oncogene homolog 1 (Raf-1) kinase pathway, we have examined the role of Raf-1 in early steps of endometriosis lesion formation, specifically attachment of endometrial cells to peritoneal mesothelial cells (PMC) and invasion of endometrial cells through PMC (trans-mesothelial invasion). Raf-1 antagonist GW5074 decreased attachment to PMC and trans-mesothelial invasion by primary EEC and ESC. Raf-1 also mediated TGFβ-induced trans-mesothelial invasion by the established, low-invasive EEC line EM42. TGFβ treatment of EEC resulted in Raf-1 phosphorylation at S338 and phosphorylation of ERK, suggesting that TGFβ activates Raf-1 signaling in these cells. GW5074 had little effect on ESC proliferation but inhibited EEC growth significantly under reduced serum conditions. Antagonizing Raf-1 activity and expression via GW5074 and specific Raf-1 small interfering RNA, respectively, did not alter EEC resistance to growth inhibition by TGFβ. Raf-1 inhibition blocked induction of EEC growth by epidermal growth factor. Our data suggest that Raf-1 may mediate pathologic steps involved in early endometriosis lesion formation and may be a mediator of TGFβ and epidermal growth factor actions in endometriosis.
Collapse
Affiliation(s)
- Elizabeth M De La Garza
- Department of Obstetrics and Gynecology, University of Texas Health Science Centre at San Antonio, San Antonio, Texas 78229, USA
| | | | | | | | | | | | | |
Collapse
|
29
|
Budrys NM, Nair HB, Liu YG, Kirma NB, Binkley PA, Kumar S, Schenken RS, Tekmal RR. Increased expression of macrophage colony-stimulating factor and its receptor in patients with endometriosis. Fertil Steril 2012; 97:1129-35.e1. [PMID: 22365076 DOI: 10.1016/j.fertnstert.2012.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/02/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the expression and regulation of colony-stimulating factor 1 (CSF-1) and its receptor, C-FMS, in endometriosis. DESIGN In vivo and vitro study. SETTING University-based academic medical center. PATIENT(S) Reproductive-age women undergoing surgery for benign conditions. INTERVENTION(S) Peritoneal and endometrial tissue samples were obtained. MAIN OUTCOME MEASURE(S) CSF-1 and C-FMS expression. RESULT(S) Significantly higher CSF-1 levels were found in peritoneal fluid of patients with endometriosis compared with control subjects. Ectopic endometriotic tissue had 3.5-fold and 1.7-fold increases in CSF-1 and C-FMS expression, respectively, compared with eutopic tissue. Coculture of endometrial cells from either established cell lines or patient samples with peritoneal mesothelial cells (PMCs) led to increased expression of CSF-1 and C-FMS. A higher but nonsignificant increase in levels of C-FMS and CSF-1 was found in cocultures of endometrial epithelial cells from patients with endometriosis compared with those without endometriosis. CONCLUSION(S) Increased CSF-1 levels may contribute to endometriosis lesion formation and progression. Elevation in CSF-1 after coculture of endometrial cells with PMCs suggests that endometrial tissue may be a source of peritoneal CSF-1. Increased C-FMS expression in endometrial cells from women with endometriosis cocultured with PMCs suggests that endometrial tissue involved in lesion formation is highly responsive to CSF-1 signaling.
Collapse
Affiliation(s)
- Nicole M Budrys
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, Texas 78229, USA
| | | | | | | | | | | | | | | |
Collapse
|
30
|
The management of stage III and IV endometriosis. Arch Gynecol Obstet 2011; 285:387-96. [PMID: 22159746 DOI: 10.1007/s00404-011-2160-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 11/23/2011] [Indexed: 01/09/2023]
Abstract
The clinical manifestations of severe endometriosis are variable and unpredictable in both presentation and course. There are also a proportion of women with severe endometriosis who remain asymptomatic. The treatment of severe endometriosis must be individualised, taking into account the impact of the disease and treatment on pain, fertility and quality of life. Surgery is usually required and multiple organs are sometimes involved. Therefore, if endometriosis is severe, referral to a center with the expertise to offer all available treatments in a multidisciplinary team, including advanced laparoscopic surgery and laparotomy, is strongly recommended. It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and to seek advice where appropriate.
Collapse
|
31
|
Aligeti S, Kirma NB, Binkley PA, Schenken RS, Tekmal RR. Colony-stimulating factor-1 exerts direct effects on the proliferation and invasiveness of endometrial epithelial cells. Fertil Steril 2011; 95:2464-6. [PMID: 21481374 DOI: 10.1016/j.fertnstert.2011.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 02/14/2011] [Accepted: 03/09/2011] [Indexed: 11/18/2022]
Abstract
Although macrophage colony-stimulating factor (CSF-1) has been suggested to play a role in maintaining the chronic inflammatory response in endometriosis, our data suggest that CSF-1 may also play a role in early endometriosis lesion formation. We have shown that CSF-1, in an autocrine fashion, has a direct effect on endometrial epithelial cell proliferation and attachment to peritoneal mesothelial cells, early steps in endometriosis lesion formation on the peritoneum.
Collapse
Affiliation(s)
- Sabitha Aligeti
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA
| | | | | | | | | |
Collapse
|
32
|
Rodgers AK, Nair A, Binkley PA, Tekmal R, Schenken RS. Inhibition of CD44 N- and O-linked glycosylation decreases endometrial cell lines attachment to peritoneal mesothelial cells. Fertil Steril 2011; 95:823-5. [PMID: 20970123 DOI: 10.1016/j.fertnstert.2010.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 08/27/2010] [Accepted: 09/08/2010] [Indexed: 10/18/2022]
Abstract
The attachment of endometrial epithelial cells (EECs) and endometrial stromal cells (ESCs) to peritoneal mesothelial cells (PMCs) with and without inhibition of N- and O-linked glycosylation, the viability of EECs and ESCs, and the expression of CD44 surface density were evaluated. Inhibition of CD44 N- and O-linked glycosylation by using tunicamycin and/or B-GalNAc statistically significantly inhibited endometrial cell attachment to peritoneal mesothelial cells, suggesting a role in establishment of early endometriotic lesions.
Collapse
Affiliation(s)
- Allison K Rodgers
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, Texas 78229, USA
| | | | | | | | | |
Collapse
|
33
|
Griffith JS, Binkley PA, Kirma NB, Schenken RS, Witz CA, Tekmal RR. Imatinib decreases endometrial stromal cell transmesothial migration and proliferation in the extracellular matrix of modeled peritoneum. Fertil Steril 2010; 94:2531-5. [DOI: 10.1016/j.fertnstert.2010.04.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 03/10/2010] [Accepted: 04/10/2010] [Indexed: 10/19/2022]
|
34
|
Eyster KM, Hansen KA, Winterton E, Klinkova O, Drappeau D, Mark-Kappeler CJ. Reciprocal communication between endometrial stromal cells and macrophages. Reprod Sci 2010; 17:809-22. [PMID: 20601541 DOI: 10.1177/1933719110371854] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study tested the hypothesis that reciprocal communication occurs between macrophages and cultured human endometrial stromal cells and that this communication may contribute to the pathology of endometriosis. An endometrial stromal cell line (telomerase-immortalized human endometrial stromal cell [T-HESC]) was treated with macrophage-conditioned medium (CM) +/- estradiol + progesterone. Macrophages were treated without or with T-HESC CM. DNA microarray identified 716 differentially expressed genes in T-HESCs in response to factors secreted by macrophages. Upregulated genes in T-HESC included interleukin 8 (IL-8)/chemokine (C-X-C motif) ligand 8 (CXCL8), matrix metalloproteinase 3 (MMP3), phospholamban, cysteine-rich angiogenic inducer 61 (CYR61), connective tissue growth factor (CTGF), tenascin C, and nicotinamide N-methyltransferase (NNMT), whereas integrin alpha-6 was downregulated. In contrast, 15 named genes were differentially expressed in macrophages in response to factors secreted by endometrial stromal cells. The data document reciprocal communication between macrophages and endometrial stromal cells and suggest that interaction with macrophages stimulates the expression of genes in endometrial stromal cells that may support the establishment of endometriosis.
Collapse
Affiliation(s)
- Kathleen M Eyster
- Division of Basic Biomedical Sciences, Sanford School of Medicine of the University of South Dakota, Vermillion, SD 57069, USA.
| | | | | | | | | | | |
Collapse
|
35
|
|
36
|
Jensen JR, Witz CA, Schenken RS, Tekmal RR. A potential role for colony-stimulating factor 1 in the genesis of the early endometriotic lesion. Fertil Steril 2010; 93:251-6. [PMID: 18990370 PMCID: PMC2812666 DOI: 10.1016/j.fertnstert.2008.09.050] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Revised: 09/02/2008] [Accepted: 09/14/2008] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the role(s) of colony-stimulating factor 1 (CSF-1) on the development of early endometriosis in a murine model by comparing rate of lesion formation in mice [1] homozygous for a CSF-1 mutation versus syngeneic controls and [2] after treatment with imatinib, a commercially available tyrosine kinase inhibitor that alters interaction(s) between CSF-1 and its receptor, c-fms. DESIGN Prospective, placebo-controlled animal study. SETTING Academic medical center. ANIMALS Six- to 8-week old female FVB, wild-type C57BL/6, and CSF-1 op/op mice. INTERVENTION(S) Endometrial tissue from donor mice was used to induce endometriosis in murine recipients. In some experiments, mice homozygous for a CSF-1 mutation (CSF-1 op/op) were donors or recipients. In other experiments, donor and/or recipient mice received imatinib. MAIN OUTCOME MEASURE(S) Histologic confirmation of endometriosis, rate of lesion formation. RESULT(S) By 40 hours, recipient mice developed a mean of 7.2 +/- 0.9 endometriotic lesions that had invaded host surfaces, and mesothelial cells had proliferated over the entire surface of the implants. The CSF-1 op/op mice developed significantly fewer (mean 0.9 +/- 0.3) endometriotic lesions versus syngeneic controls. Imatinib treatment resulted in significantly fewer lesions when compared with sham-treated controls. CONCLUSION(S) Colony-stimulating factor 1 has a role in establishing early endometriotic lesions. Agents targeting CSF-1 or its actions have therapeutic potential for treating endometriosis.
Collapse
Affiliation(s)
- Jani R Jensen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, the University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
| | | | | | | |
Collapse
|
37
|
Griffith JS, Rodgers AK, Schenken RS. Reviews: in vitro models to study the pathogenesis of endometriosis. Reprod Sci 2009; 17:5-12. [PMID: 19546323 DOI: 10.1177/1933719109338221] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several in vitro models that attempt to replicate the intraperitoneal environment have been developed to study the pathogenesis of endometriosis. The chicken chorioallantotic membrane has been used, but it has not been well characterized and may introduce some species specific variables. In vitro models using human tissues include amniotic membrane, human peritoneal explants, and cell culture monolayers. These models have been used to qualitatively, quantitatively, and temporally assess attachment of endometrial cells to peritoneal mesothelial and subsequent transmesothelial invasion. These models have also been used to assess the role of cytokines in the development of the early endometriotic lesion. Two- and three dimensional invasion chamber models have been utilized to assess endometrial cell interactions with peritoneal mesothelial cells and the extracellular matrix. Invasion models are also useful to evaluate novel therapeutic approaches. This review will focus on the above models to assist reproductive scientists interested in the pathogenesis of endometriosis.
Collapse
Affiliation(s)
- Jason S Griffith
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Texas Health Science Center San Antonio, San Antonio, Texas 78229, USA
| | | | | |
Collapse
|
38
|
Liu YG, Tekmal RR, Binkley PA, Nair HB, Schenken RS, Kirma NB. Induction of endometrial epithelial cell invasion and c-fms expression by transforming growth factor beta. Mol Hum Reprod 2009; 15:665-73. [PMID: 19505996 DOI: 10.1093/molehr/gap043] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Transforming growth factor beta 1 (TGF-beta1) levels are increased in the peritoneal fluid of endometriosis patients, and endometrial cells express TGF-beta signaling components; however, little is known regarding the role of TGF-beta in endometriosis. Our objective was to examine the effects of TGF-beta1 on (i) the expression of macrophage colony-stimulating factor receptor encoded by the c-fms gene, (ii) transmesothelial invasiveness of endometrial cells, (iii) cellular proliferation and (iv) attachment to peritoneal mesothelial cells (PMCs). Effects of TGF-beta1 on c-fms mRNA expression were determined by real-time RT-PCR and c-fms cell-surface expression by flow cytometry. Effects of TGF-beta1 on the invasiveness of the immortalized endometrial epithelial cell (EEC) line EM42 and primary EECs were examined using a three-dimensional in vitro system modeling the peritoneum. Cellular proliferation and attachment to PMCs were also examined using established techniques. TGF-beta1 had little or no effect on cellular proliferation and endometrial cell attachment to PMCs. TGF-beta1 significantly induced the expression of c-fms mRNA and c-fms cell-surface expression. TGF-beta1 enhanced transmesothelial invasion by EM42 cells and EECs. Antagonists of TGF-beta1 signaling significantly inhibited both the induction of c-fms expression and cellular invasiveness, suggesting that additional studies are warranted to assess the therapeutic potential of TGF-beta antagonists in endometriosis.
Collapse
Affiliation(s)
- Ya-Guang Liu
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
BACKGROUND Although surgery is currently the treatment of choice for managing endometriosis, recurrence poses a formidable challenge. To delay or to eliminate the recurrence is presently an unmet medical need in the management of endometriosis. To this end, proposals to investigate patterns of recurrence, to develop biomarkers for recurrence and to carry out biomarker-based intervention have been made. METHODS Publications pertaining to the recurrence of endometriosis and its related yet unaddressed issues were identified through MEDLINE. The reported recurrence rates, risk factors for recurrence, the effects of post-operative medication and causes of recurrence were reviewed and synthesized. In addition, several poorly explored issues such as time hazard function and mechanisms of recurrence were reviewed. Approaches to the development of biomarkers for recurrence and future intervention are discussed. RESULTS The reported recurrence rate was high, estimated as 21.5% at 2 years and 40-50% at 5 years. Few risk factors for recurrence have been consistently identified, and the evidence on the efficacy of the post-operative use of medication was scanty. The investigation on the patterns of recurrence may provide us with new insight into the possible mechanisms of recurrence and its control. The attempt to identify biomarkers for recurrence has started only very recently. CONCLUSIONS Much research is needed to better understand the patterns of recurrence and risk factors, and to develop biomarkers. One top priority is to develop biomarkers for recurrence, which may provide much needed clues to the possible mechanisms underlying recurrence and would allow the identification of patients with high recurrence risk, and permit for targeted intervention.
Collapse
Affiliation(s)
- Sun-Wei Guo
- Institute of Obstetric and Gynecologic Research, Shanghai Jiao Tong University School of Medicine, Renji Hospital, 145 Shandong Zhong Road, Shanghai 200001, People's Republic of China.
| |
Collapse
|
40
|
Affiliation(s)
- Serdar E Bulun
- Division of Reproductive Biology Research, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
| |
Collapse
|