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Sidell N, Rajakumar A. Retinoic Acid Action in Cumulus Cells: Implications for Oocyte Development and In Vitro Fertilization. Int J Mol Sci 2024; 25:1709. [PMID: 38338985 PMCID: PMC10855907 DOI: 10.3390/ijms25031709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
In the field of human in vitro fertilization (IVF), selecting the best oocyte for freezing or embryo for transfer remains an important focus of clinical practice. Although several techniques are and have been used for this goal, results have generally not been favorable and/or are invasive such that damage to some embryos occurs, resulting in a reduced number of healthy births. Therefore, the search continues for non-invasive oocyte and embryo quality markers that signal the development of high-quality embryos. Multiple studies indicate the important positive effects of retinoic acid (RA) on oocyte maturation and function. We previously showed that a high follicular fluid (FF) RA concentration at the time of oocyte retrieval in IVF protocols was associated with oocytes, giving rise to the highest quality embryos, and that cumulus granulosa cells (CGCs) are the primary source of follicle RA synthesis. Data also demonstrated that connexin-43 (Cx43), the main connexin that forms gap junctions in CGCs, is regulated by RA and that RA induces a rapid increase in gap junction communication. Here, we hypothesize that CGC RA plays a causal role in oocyte competency through its action on Cx43 and, as such, may serve as a biomarker of oocyte competence. Multiple studies have demonstrated the requirement for Cx43 in CGCs for the normal progression of folliculogenesis, and that the increased expression of this connexin is linked to the improved developmental competence of the oocyte. The data have shown that RA can up-regulate gap junction intercellular communication (GJIC) in the cumulus-oocyte complex via a non-genomic mechanism that results in the dephosphorylation of Cx43 and enhanced GJIC. Recognizing the positive role played by gap junctions in CGCs in oocyte development and the regulation of Cx43 by RA, the findings have highlighted the possibility that CGC RA levels may serve as a non-invasive indicator for selecting high-quality oocytes for IVF procedures. In addition, the data suggest that the manipulation of Cx43 with retinoid compounds could provide new pharmacological approaches to improve IVF outcomes in cases of failed implantation, recurrent miscarriage, or in certain diseases that are characterized by reduced fecundity, such as endometriosis.
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Affiliation(s)
- Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA 30322, USA;
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Banerjee S, Xu W, Doctor A, Driss A, Nezhat C, Sidell N, Taylor RN, Thompson WE, Chowdhury I. TNFα-Induced Altered miRNA Expression Links to NF-κB Signaling Pathway in Endometriosis. Inflammation 2023; 46:2055-2070. [PMID: 37389684 PMCID: PMC10673760 DOI: 10.1007/s10753-023-01862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
Endometriosis is a common gynecological inflammatory disorder characterized by immune system dysregulation, which is involved in lesion initiation and progression. Studies have demonstrated that several cytokines are associated with the evolution of endometriosis, including tumor necrosis factor-α (TNFα). TNFα is a non-glycosylated cytokine protein with potent inflammatory, cytotoxic, and angiogenic potential. In the current study, we examined the ability of TNFα to induce dysregulation of microRNAs (miRNAs) linked to NFkB signaling pathways, thus contributing to the pathogenesis of endometriosis. Using RT-qPCR, the expression of several miRNAs was quantified in primary cells derived from eutopic endometrium of endometriosis subjects (EESC) and normal endometrial stromal cells (NESC), and also TNFα-treated NESCs. The phosphorylation of the pro-inflammatory molecule NF-κB and the candidates of the survival pathways PI3K, AKT, and ERK was measured by western blot analysis. The elevated secretion of TNFα in EESCs downregulates the expression level of several miRNAs significantly in EESCs compared to NESCs. Also, treatment of NESCs with exogenous TNFα significantly reduced the expression of miRNAs in a dose-dependent manner to levels similar to EESCs. In addition, TNFα significantly increased the phosphorylation of the PI3K, AKT, ERK, and NF-κB signaling pathways. Notably, treatment with curcumin (CUR, diferuloylmethane), an anti-inflammatory polyphenol, significantly increased the expression of dysregulated miRNAs in EESC in a dose-dependent manner. Our findings demonstrate that TNFα is upregulated in EESCs, which subsequently dysregulates the expression of miRNAs, contributing to the pathophysiology of endometriotic cells. CUR effectively inhibits the expression of TNFα, subsequently altering miRNA levels and suppressing the phosphorylation of AKT, ERK, and NF-κB.
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Affiliation(s)
- Saswati Banerjee
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Wei Xu
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Aaron Doctor
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive Southwest, Atlanta, GA, 30310, USA
| | - Adel Driss
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Ceana Nezhat
- Nezhat Medical Center, 5555 Peachtree Dunwoody Road, Atlanta, GA, 30342, USA
| | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA
| | - Winston E Thompson
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive Southwest, Atlanta, GA, 30310, USA
| | - Indrajit Chowdhury
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive Southwest, Atlanta, GA, 30310, USA.
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Banerjee S, Xu W, Doctor A, Driss A, Nezhat C, Sidell N, Taylor RN, Thompson WE, Chowdhury I. TNFα-induced altered miRNA expression links to NF-κB signaling pathway in endometriosis. Res Sq 2023:rs.3.rs-2870585. [PMID: 37205467 PMCID: PMC10187425 DOI: 10.21203/rs.3.rs-2870585/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Endometriosis is a common gynecological inflammatory disorder characterized by immune system dysregulation, which is involved in lesion initiation and progression. Studies have demonstrated that several cytokines are associated with the evolution of endometriosis, including tumor necrosis factor-α (TNFα). TNFα is a non-glycosylated cytokine protein with potent inflammatory, cytotoxic, and angiogenic potential. In the current study, we examined the ability of TNFα to induce dysregulation of microRNAs (miRNAs) linked to NFkB-signaling pathways, thus contributing to the pathogenesis of endometriosis. Using RT-QPCR, the expression of several miRNAs were quantified in primary cells derived from eutopic endometrium of endometriosis subjects (EESC) and normal endometrial stromal cells (NESC) and also TNFα treated NESCs. The phosphorylation of the pro-inflammatory molecule NF-κB and the candidates of the survival pathways PI3K, AKT and ERK was measured by westernblot analysis. The elevated secretion of TNFα in EESCs downregulates the expression level of several miRNAs significantly (p < 0.05) in EESCs compared to NESC. Also treatment of NESCs with exogenous TNFα significantly reduced the expression of miRNAs in a dose-dependent manner to levels similar to EESCs. In addition, TNFα significantly increased the phosphorylation of the PI3K, AKT, ERK, and NF-κB signaling pathways. Notably, treatment with curcumin (CUR, diferuloylmethane), an anti-inflammatory polyphenol, significantly increased the expression of dysregulated miRNAs in EESC in a dose-dependent manner. Our findings demonstrate that TNFα is upregulated in EESCs, which subsequently dysregulates the expression of miRNAs, contributing to the pathophysiology of endometriotic cells. CUR effectively inhibits the expression of TNFα, subsequently altering miRNA levels and suppresses the phosphorylation of AKT, ERK, and NF-κB.
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Affiliation(s)
| | - Wei Xu
- Morehouse School of Medicine
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Chowdhury I, Driss A, Taylor RN, Nezhat C, Sidell N, Thompson WE, Xu W, Banerjee S, Chowdhury I. RF34 | PMON229 TNFa-Induced Altered miRNA Expression Links to Inflammation in Endometriosis. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Endometriosis is a common gynecological inflammatory disorder, which is characterized by immune system dysregulation with initiation and progression. It affects 5% to 15% of reproductive-age women and is present in as many as 30% to 50% of patients with infertility and/or pain. In previous studies, including ours, have demonstrated that several cytokines have been associated with the evolution of endometriosis, including tumor necrosis factor-a (TNFa). TNFa is a non-glycosylated protein which has potent inflammatory, cytotoxic, and angiogenic potential. Therefore, in the current studies, we examined the effects of TNFa over a time course in the regulation of proinflammatory and proangiogenic microRNAs (miRNAs) in primary cultures of normal endometrial stromal cells (NESC) and compared with the untreated cells derived from eutopic endometrium of endometriosis subjects (EESC). miRNAs are short, 18- to 22-nucleotide– size, non-coding RNAs that act as post-transcriptional modulators of gene expression and are involved in the pathogenesis of endometriosis. Using NanoString nCounter-based assays and quantitative RT-PCR, we have identified levels of several proinflammatory and proangiogenic miRNAs higher in EESC than NESC. NESC treatment with TNFa significantly altered the expression of proinflammatory and proangiogenic miRNAs in a time-dependent manner. Notably, TNFa significantly decreased phosphorylation of the PI3K, AKT, and ERK signaling pathways. Moreover, treatment of EESC and NESC with curcumin (diferuloylmethane, CUR), an anti-inflammatory folk medicine in Asian countries, significantly increased the expression of anti-inflammatory and anti-angiogenic miRNAs in a dose- and time-dependent manner. These findings demonstrate higher inflammatory, and proangiogenic miRNA production in EESC may be due to a higher concentration of TNFa than NESC under basal conditions. Therefore, suppressing TNFa may reduce the inflammatory and angiogenic miRNA associated with endometriosis.
Sources of Research Support: This study was supported in part by National Institutes of Health Grants 1SC3 GM113751, U01, 1SC1 GM130544, HD66439, 1R01HD057235, U54 CA118948, HD41749, S21MD000101 and G12-MD007602. This investigation was conducted in a facility constructed with support from Research Facilities Improvement Grant #C06 RR018386 from NIH/NCRR.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 1:06 p.m. - 1:11 p.m.
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Abstract
The vitamin A metabolite all-trans retinoic acid (RA) plays a key role in tissue homeostasis and mucosal immunity. RA is produced by gut-associated dendritic cells, which are among the first cells encountered by HIV. Acute HIV infection results in rapid reduction of RA levels and dysregulation of immune cell populations whose identities and function are largely controlled by RA. Here, we discuss the potential link between the roles played by RA in shaping intestinal immune responses and the manifestations and pathogenesis of HIV-associated enteropathy and similar conditions observed in SIV-infected non-human primate models. We also present data demonstrating the ability of RA to enhance the activation of replication-competent viral reservoirs from subjects on suppressive anti-retroviral therapy. The data suggest that retinoid supplementation may be a useful adjuvant for countering the pathologic condition of the gastro-intestinal tract associated with HIV infection and as part of a strategy for reactivating viral reservoirs as a means of depleting latent viral infection.
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Affiliation(s)
- Neil Sidell
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Correspondence: (N.S.); (M.A.K.)
| | - Maureen A. Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
- Correspondence: (N.S.); (M.A.K.)
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Olwenyi OA, Acharya A, Routhu NK, Pierzchalski K, Jones JW, Kane MA, Sidell N, Mohan M, Byrareddy SN. Retinoic Acid Improves the Recovery of Replication-Competent Virus from Latent SIV Infected Cells. Cells 2020; 9:E2076. [PMID: 32932813 PMCID: PMC7565696 DOI: 10.3390/cells9092076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/05/2020] [Accepted: 09/09/2020] [Indexed: 12/31/2022] Open
Abstract
The accurate estimation and eradication of Human Immunodeficiency Virus (HIV) viral reservoirs is limited by the incomplete reactivation of cells harboring the latent replication-competent virus. We investigated whether the in vitro and in vivo addition of retinoic acid (RA) enhances virus replication and improves the detection of latent virus. Peripheral blood mononuclear cells (PBMCs) from naive and anti-retroviral therapy (ART)-treated SIV-infected rhesus macaques (RMs) were cultured in vitro with anti-CD3/CD28 + IL-2 in the presence/absence of RA. Viral RNA and p27 levels were quantified using RT-qPCR and ELISA, respectively. Viral reservoirs were estimated using the Tat/Rev-Induced Limited Dilution Assay (TILDA) and Quantitative Viral Outgrowth Assay (QVOA). In vitro and in vivo measures revealed that there was also an increase in viral replication in RA-treated versus without RA conditions. In parallel, the addition of RA to either CD3/CD28 or phorbol myristate acetate (PMA)/ionomycin during QVOA and TILDA, respectively, was shown to augment reactivation of the replication-competent viral reservoir in anti-retroviral therapy (ART)-suppressed RMs as shown by a greater than 2.3-fold increase for QVOA and 1 to 2-fold increments for multi-spliced RNA per million CD4+ T cells. The use of RA can be a useful approach to enhance the efficiency of current protocols used for in vitro and potentially in vivo estimates of CD4+ T cell latent reservoirs. In addition, flow cytometry analysis revealed that RA improved estimates of various viral reservoir assays by eliciting broad CD4 T-cell activation as demonstrated by elevated CD25 and CD38 but reduced CD69 and PD-1 expressing cells.
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Affiliation(s)
- Omalla A. Olwenyi
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA; (O.A.O.); (A.A.); (N.K.R.)
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA
| | - Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA; (O.A.O.); (A.A.); (N.K.R.)
| | - Nanda Kishore Routhu
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA; (O.A.O.); (A.A.); (N.K.R.)
| | - Keely Pierzchalski
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA; (K.P.); (J.W.J.); (M.A.K.)
| | - Jace W. Jones
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA; (K.P.); (J.W.J.); (M.A.K.)
| | - Maureen A. Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA; (K.P.); (J.W.J.); (M.A.K.)
| | - Neil Sidell
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Mahesh Mohan
- Texas Biomedical Research Institute, Southwest National Primate Research Institute, San Antonio, TX 78227, USA;
| | - Siddappa N. Byrareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA; (O.A.O.); (A.A.); (N.K.R.)
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198-5800, USA
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Yu J, Berga SL, Zou W, Rajakumar A, Man M, Sidell N, Taylor RN. Human Endometrial Stromal Cell Differentiation is Stimulated by PPARβ/δ Activation: New Targets for Infertility? J Clin Endocrinol Metab 2020; 105:dgaa413. [PMID: 32594141 PMCID: PMC7373326 DOI: 10.1210/clinem/dgaa413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Implantation is a reproductive bottleneck in women, regulated by fluctuations in ovarian steroid hormone concentrations. However, other nuclear receptor ligands are modifiers of endometrial differentiation leading to successful pregnancy. In the present study we analyzed the effects of peroxisome-proliferator-activated receptor β/δ (PPARβ/δ) activation on established cellular biomarkers of human endometrial differentiation (decidualization). OBJECTIVE The objective of this work is to test the effects of PPARβ/δ ligation on human endometrial cell differentiation. DESIGN Isolated primary human endometrial stromal cells (ESCs) were treated with synthetic (GW0742) or natural (all trans-retinoic acid, RA) ligands of PPARβ/δ, and also with receptor antagonists (GSK0660, PT-S58, and ST247) in the absence or presence of decidualizing hormones (10 nM estradiol, 100 nM progesterone, and 0.5 mM dibutyryl cAMP [3',5'-cyclic adenosine 5'-monophosphate]). In some cases interleukin (IL)-1β was used as an inflammatory stimulus. Time course and dose-response relationships were evaluated to determine effects on panels of well characterized in vitro biomarkers of decidualization. RESULTS PPARβ/δ, along with estrogen receptor α (ERα) and PR-A and PR-B, were expressed in human endometrial tissue and isolated ESCs. GW0742 treatment enhanced hormone-mediated ESC decidualization in vitro as manifested by upregulation of prolactin, insulin-like growth factor-binding protein 1, IL-11, and vascular endothelial growth factor (VEGF) secretion and also increased expression of ERα, PR-A and PR-B, and connexin 43 (Cx43). RA treatment also increased VEGF, ERα, PR-A, and PR-B and an active, nonphosphorylated isoform of Cx43. IL-1β and PPARβ/δ antagonists inhibited biomarkers of endometrial differentiation. CONCLUSION Ligands that activate PPARβ/δ augment the in vitro expression of biomarkers of ESC decidualization. By contrast, PPARβ/δ antagonists impaired decidualization markers. Drugs activating these receptors may have therapeutic benefits for embryonic implantation.
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Affiliation(s)
- Jie Yu
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sarah L Berga
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Wei Zou
- Department of Bioengineering, Hebei University of Science and Technology, Hebei, China
| | - Augustine Rajakumar
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mingfei Man
- Department of Biology, University of North Carolina, Charlotte, North Carolina, USA
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Manley CN, Deepak V, Ravikumar N, Smith AK, Knight AK, Badell ML, Sidell N, Rajakumar A. Transcription factor AP2A affects sFLT1 expression and decidualization in decidual stromal cells: Implications to preeclampsia pathology. Pregnancy Hypertens 2020; 21:152-158. [PMID: 32535226 DOI: 10.1016/j.preghy.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/21/2022]
Abstract
Preeclampsia (PE) yields a spectrum of phenotypic expression, leading to varying degrees of hypertension, maternal renal dysfunction and placental insufficiency with resultant maternal and neonatal morbidity. Increased sFLT1 expression contributing to angiogenic factor imbalance, placental hypoxia, failed immune adaptation to the fetus and defective decidualization are among the commonly proposed theories of PE pathogenesis. Recently researchers have focused their attention on the events that occur at the maternal fetal interface as potential contributors to PE pathogenesis. Decidual stromal cells (DSC) isolated from preeclamptic women show diminished ability to decidualize upon stimulation and reduced capacity to downregulate sFlt-1 levels. In this study, we sought to gain insight into the molecular mechanism(s) involved in the aberrant decidualization capacity of PE DSC. Our findings using qRT-PCR show that PE DSCs have 6-fold higher basal levels of transcription factor AP2A (TFAP2A) RNA compared to women without PE and that expression of TFAP2A increases during decidualization but only in DSCs of normotensive (NT) women. Silencing of TFAP2A using Trilencer siRNA upregulated sFLT1 expression only in NT-DSCs but suppressed the expression of decidualization markers PRL, IGFBP1 and their regulator FOXO1 in cells from both groups. Collectively, our observations suggest that TFAP2A acts as a repressor of sFLT1 and plays a necessary role in decidualization possibly through interacting with another factor that is aberrantly expressed in PE DSCs.
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Affiliation(s)
- Charisma N Manley
- Division of Maternal Fetal Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Venkataraman Deepak
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Nithin Ravikumar
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Alicia K Smith
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Anna K Knight
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Martina L Badell
- Division of Maternal Fetal Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Neil Sidell
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Augustine Rajakumar
- Division of Research, Emory University School of Medicine, Atlanta, GA, United States; Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States.
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Chowdhury I, Banerjee S, Xu W, Driss A, Amin R, Delsarte LR, Keck K, Sidell N, Taylor RN, Nezhat C, Ali M, Yang Q, Al-Hendy A, Thompson WE. OR20-04 Modeling Uterine Disorders Utilizing Adult Uterine Stem Cells. J Endocr Soc 2020. [PMCID: PMC7208210 DOI: 10.1210/jendso/bvaa046.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Endometriosis and uterine fibroids (leiomyomas) are benign gynecological disorders affecting 5-15% of women of reproductive age. They cause a wide range of symptoms including mild to severe pelvic pain and infertility. Due to a paucity of proper study models, hormonal and cellular mechanisms driving the pathology of endometriosis and fibroid development and growth remain unclear. Therefore, in the current study, we established 3D spheroid/organoid cultures from human uterine epithelial and Stro-1+/CD44+ myometrial stem cells and also from cells isolated from normal proliferative phase endometrium. Uterine organoid cultures were derived from endometrial epithelial and myometrial cells isolated from women who were not receiving exogenous hormones at the time of laparoscopy or hysterectomy. They were embedded in Matrigel, and grown in culture media. To determine whether spheroids/organoids were responsive to steroid hormones, the cultures were treated in presence or absence of estradiol (E2), progesterone (P4) or the combination (E2+P4) in serum free culture media. Time-dependent spheroid/organoid-growth curves and morphological analyses were used to define growth characteristics of endometrial and myometrial organoids. Subsequently, immunohistochemical colocalization of steroid hormone receptors (estrogen receptor alpha (ER-α) and progesterone receptor (PR-A\B), alpha smooth muscle actin (α-SMA; myometrial cell marker), vimentin (stromal cell marker) and E-cadherin (endometrial epithelial cell marker) was assessed. Epithelial organoids expressed only E-cadherin in the absence of hormonal treatment. Myometrial organoids expressed α-SMA and vimentin. No expression of E-cadherin was observed in myometrial organoids. However, we observed the expression of ER-α and PR-A\B when organoids were treated with E2+P4 in a time-dependent manner. Stro-1+/CD44+ myometrial stem cells differentiated into α-SMA and fibroblast/stromal cells and response to sex hormones. These findings suggest human uterine organoid cultures retained their characteristic cellular responses to E2+P4 and could be maintained long-term in ex vivo culture. Thus, the current 3D uterine organoid systems show high expansion capacity with retention of phenotypical and functional properties, which can be used for uterine pathophysiological studies, drug discoveries and drug repositioning.
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Affiliation(s)
| | | | - Wei Xu
- Morehouse School of Medicine, Atlanta, GA, USA
| | - Adel Driss
- Morehouse School of Medicine, Atlanta, GA, USA
| | | | | | | | | | | | | | - Mohamed Ali
- Department of Obstetrics and Gynecology University of Illinois @ Chicago (UIC), Chicago, IL, USA
| | - Qiwei Yang
- University of Illinois at Chicago, Chicago, IL, USA
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Rajakumar A, Kane MA, Yu J, Taylor RN, Sidell N. Aberrant retinoic acid production in the decidua: Implications for pre-eclampsia. J Obstet Gynaecol Res 2020; 46:1007-1016. [PMID: 32343034 DOI: 10.1111/jog.14262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/03/2020] [Indexed: 01/05/2023]
Abstract
Fine-tuning of the endometrium during the evanescent 'window of implantation' relies upon an array of diverse and redundant signaling molecules, particularly the ovarian steroids E2 and P4, but also growth factors, eicosanoids, and vitamins including the vitamin A compounds (retinoids). Pregnancy complications such as preeclampsia (PE) can result from aberrations in the production or function of these molecules that arise during this critical period of decidual development. Such aberrations may be reflected by incomplete decidualization, reduced spiral artery modification, and/or loss of immune tolerance to the developing fetus. Our understanding of the role of the active retinoid metabolite all-trans retinoic acid (RA) in maintaining immune balance in certain tissues, along with data describing its role in decidualization, present a compelling argument that aberrant RA signaling in the decidua can play a significant role in the etiology of PE. Recent findings that decidualization and expression of the anti-angiogenic gene product, 'soluble fms-like tyrosine kinase-1' (sFLT1) are negatively correlated and that sFLT1 expression is directly inhibited by RA, provide additional evidence of the critical role of this retinoid in regulating early vascular development in the decidua. This review provides insight into the production and function of RA in the decidua and how modifications in its metabolism and signaling might lead to certain pregnancy disorders such as PE.
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Affiliation(s)
- Augustine Rajakumar
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Jie Yu
- Department of Obstetrics & Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert N Taylor
- Department of Obstetrics & Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
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Deepak V, Ravikumar N, Badell ML, Sidell N, Rajakumar A. Transcription factor ID1 is involved in decidualization of stromal cells: Implications in preeclampsia. Pregnancy Hypertens 2020; 21:7-13. [PMID: 32361395 DOI: 10.1016/j.preghy.2020.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 02/05/2023]
Abstract
Decidual stromal cells (DSC) from women with preeclampsia (PE) show defective decidualization upon in vitro treatment with cAMP. Decidualization is associated with a multitude of gene expression changes and is a prerequisite for embryo implantation. We reason that the process of decidualization involves a cascade of changes in transcriptional regulators. Our prior studies have found defective decidualization of PE-DSCs as reflected by low prolactin (PRL) levels and other decidualization markers. Transcription factor array analysis identified inhibitor of DNA binding (ID1) and FOXO1 as top differentially expressed genes during decidualization. Unlike ID1, FOXO1 involvement in decidualization has been established. We hypothesized that ID1 plays a major role in regulating stromal cell decidualization. Our data shows basal ID1 mRNA expression is significantly higher in PE DSCs. Cyclic AMP-mediated decidualization significantly upregulates ID1 mRNA expression in DSCs and siRNA-mediated knockdown of ID1 significantly interferes with decidualization as shown by a reduction in PRL and FOXO1 expression, and morphologic criteria. Thus ID1 may serve as a master regulator of stromal cell differentiation and defects in ID1 expression may affect decidualization as seen in PE-DSCs.
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Affiliation(s)
- Venkataraman Deepak
- Divisions of Research, Atlanta, GA, United States; Department of Gynecology and Obstetrics, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - Nithin Ravikumar
- Divisions of Research, Atlanta, GA, United States; Department of Gynecology and Obstetrics, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - Martina L Badell
- Maternal Fetal Medicine, Atlanta, GA, United States; Department of Gynecology and Obstetrics, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - Neil Sidell
- Divisions of Research, Atlanta, GA, United States; Department of Gynecology and Obstetrics, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States
| | - Augustine Rajakumar
- Divisions of Research, Atlanta, GA, United States; Department of Gynecology and Obstetrics, Atlanta, GA, United States; Emory University School of Medicine, Atlanta, GA, United States.
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Manley C, Deepak V, Ravikumar N, Badell M, Sidell N, Rajakumar A. 1169: Defects in placental stromal cell decidualization in preeclampsia are mediated by transcription Factor AP2A. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Deepak V, Sahu MB, Yu J, Jones JW, Kane MA, Taylor RN, Badell ML, Sidell N, Rajakumar A. Retinoic Acid Is a Negative Regulator of sFLT1 Expression in Decidual Stromal Cells, and Its Levels Are Reduced in Preeclamptic Decidua. Hypertension 2019; 73:1104-1111. [PMID: 30879360 DOI: 10.1161/hypertensionaha.118.12564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
sFLT1 (soluble VEGF [vascular endothelial growth factor] receptor-1) levels are increased in preeclampsia-a pathological condition of pregnancy. The mechanism of sFLT1 overexpression by gestational tissues, particularly the decidua, remains unknown. Mass spectrometry measurement of the active retinoid metabolite, all-trans retinoic acid (RA), showed significantly lower levels of RA in preeclamptic versus normotensive decidua. In this study, we investigated the involvement of RA in regulating decidual sFLT1 expression. When decidual stromal cells (DSCs) isolated from the decidua basalis of normotensive and preeclampsia placentas were treated with BMS493-a pan-RAR (RA nuclear receptor) antagonist-upregulation of sFLT1 expression was observed. Conversely, treatment with RA resulted in downregulation of sFLT1 in normotensive DSCs and preeclampsia DSCs. Unlike treatment with cAMP, which induces decidualization while downregulating sFLT1, RA treatment did not alter DSC expression of prolactin-a marker of decidualization-or FOXO1 (forkhead box protein 01)-a transcription factor required for prolactin upregulation. TFAP2A (transcription factor AP-2-alpha [activating enhancer-binding protein 2 alpha]), a different transcription factor was upregulated in normotensive DSCs but not in preeclampsia DSCs after RA treatment. Collectively, our data show that RA suppresses sFLT1 expression in DSCs independently of cellular decidualization. These findings suggest that reduced decidual RA levels may contribute to preeclampsia pathogenesis by allowing sFLT1 accumulation at the maternal-fetal interface.
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Affiliation(s)
- Venkataraman Deepak
- From the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (V.D., M.B.S., M.L.B., N.S., A.R.)
| | - Margaret B Sahu
- From the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (V.D., M.B.S., M.L.B., N.S., A.R.)
| | - Jianshi Yu
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore (J.Y., J.W.J., M.A.K.)
| | - Jace W Jones
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore (J.Y., J.W.J., M.A.K.)
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore (J.Y., J.W.J., M.A.K.)
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City (R.N.T.)
| | - Martina L Badell
- From the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (V.D., M.B.S., M.L.B., N.S., A.R.)
| | - Neil Sidell
- From the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (V.D., M.B.S., M.L.B., N.S., A.R.)
| | - Augustine Rajakumar
- From the Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (V.D., M.B.S., M.L.B., N.S., A.R.)
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Weisheng B, Nezhat CH, Huang GF, Mao YQ, Sidell N, Huang RP. Discovering endometriosis biomarkers with multiplex cytokine arrays. Clin Proteomics 2019; 16:28. [PMID: 31333337 PMCID: PMC6621950 DOI: 10.1186/s12014-019-9248-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022] Open
Abstract
Background Chronic pelvic pain is often overlooked during primary examinations because of the numerous causes of such “vague” symptoms. However, this pain can often mask endometriosis, a smoldering disease that is not easily identified as a cause of the problem. As such, endometriosis has been shown to be a potentially long-term and often undiagnosed disease due to its vague symptoms and lack of any non-invasive testing technique. Only after more severe symptoms arise (severe pelvic pain, excessive vaginal bleeding, or infertility) is the disease finally uncovered by the attending physician. Due to the nature and complexity of endometriosis, high throughput approaches for investigating changes in protein levels may be useful for elucidating novel biomarkers of the disease and to provide clues to help understand its development and progression. Methods A large multiplex cytokine array which detects the expression levels of 260 proteins including cytokines, chemokines, growth factors, adhesion molecules, angiogenesis factors and other was used to probe biomarkers in plasma samples from endometriosis patients with the intent of detecting and/or understanding the cause of this disease. The protein levels were then analyzed using K-nearest neighbor and split-point score analysis. Results This technique identified a 14-marker cytokine profile with the area under the curve of 0.874 under a confidence interval of 0.81–0.94. Our training set further validated the panel for significance, specificity, and sensitivity to the disease samples. Conclusions These findings show the utility and reliability of multiplex arrays in deciphering new biomarker panels for disease detection and may offer clues for understanding this mysterious disease. Electronic supplementary material The online version of this article (10.1186/s12014-019-9248-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bao Weisheng
- 1RayBiotech, Inc, 3607 Parkway Lane, Peachtree Corners, GA 30092 USA
| | - Ceana H Nezhat
- 2Nezhat Medical Center, 5555 Peachtree Dunwoody Rd #276, Atlanta, GA 30342 USA
| | - Gordon F Huang
- 1RayBiotech, Inc, 3607 Parkway Lane, Peachtree Corners, GA 30092 USA
| | - Ying-Qing Mao
- 1RayBiotech, Inc, 3607 Parkway Lane, Peachtree Corners, GA 30092 USA
| | - Neil Sidell
- 3Emory University, 201 Dowman Dr, Atlanta, GA 30322 USA
| | - Ruo-Pan Huang
- 1RayBiotech, Inc, 3607 Parkway Lane, Peachtree Corners, GA 30092 USA.,Guangzhou RayBiotech, 79 Ruihe Road, Huangpu District, Guangzhou, 510630 China.,5Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou Medical University, No. 232 Waihuan Dong Rd, Guangzhou University Town, Panyu District, Guangzhou, 510006 China.,South China Biochip Research Center, 79 Ruihe Road, Huangpu District, Guangzhou, 510630 China
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Chowdhury I, Banerjee S, Driss A, Xu W, Nezhat C, Sidell N, Taylor R, Thompson W. SAT-200 Therapeutic Targeting of Functional MicroRNA Expression by Curcumin in Human Endometrial Stromal Cells. J Endocr Soc 2019. [PMCID: PMC6551847 DOI: 10.1210/js.2019-sat-200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Endometriosis is a chronic gynecological inflammatory disorder in which immune system dysregulation is thought to play a role in its initiation and progression. Current agency-approved hormonal therapies, including synthetic progestins, GnRH-agonists, and danazol are often of limited efficacy and counterproductive to fertility, and cause systemic side effects due to suppression of endogenous steroid hormone production. Our recent publication (PMID: 30259980) suggests that curcumin (diferuloylmethane, CUR), an anti-inflammatory folk medicine in Asian countries, has therapeutic potential to reduce inflammation associated with endometriosis. Therefore, in the current studies we examined the effects of CUR at different doses over a time course in the regulation of proinflammatory and proangiogenic microRNAs (miRNAs) in primary cultures of normal endometrial stromal cells (NESC) and cells derived from eutopic endometrium of endometriosis subjects (EESC). miRNAs are non-coding RNAs that regulate protein translation and have been shown to be involved in the pathogenesis of endometriosis. Using NanoString nCounter-based assays and semi-quantitative RT-PCR we have identified levels of several proinflammatory and proangiogenic miRNAs (including has-miR-196b-5p, has-miR-199a-5p, has-miR-21-5p) that are higher in EESC compared to NESC. EESC and NESC treatment with CUR significantly reduced expression of proinflammatory and proangiogenic miRNAs in a dose- and time-dependent manner. Notably, CUR significantly decreased phosphorylation of the AKT, ERK and prohibitin signaling pathways. These findings demonstrate higher proinflammatory and proangiogenic miRNA production in EESC compared to NESC under basal conditions, and suggest that by suppressing these factors, CUR has the therapeutic potential to reduce inflammation associated with endometriosis. Nothing to Disclose: IC; SB; AD; WX; CN; NS, RNT, WET. Sources of Research Support: This study was supported in part by National Institutes of Health Grants 1SC3 GM113751, U01 HD66439, 1R01HD057235, U54 CA118948, HD41749, S21MD000101 and G12-MD007602. This investigation was conducted in a facility constructed with support from Research Facilities Improvement Grant #C06 RR018386 from NIH/NCRR.
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Affiliation(s)
| | | | - Adel Driss
- Physiology, Morehouse School of Medicine, Atlanta, GA, United States
| | - Wei Xu
- Morehouse School of Medicine, Atlanta, GA, United States
| | - Ceana Nezhat
- Nezhat Medical Center, Atlanta, GA, United States
| | - Neil Sidell
- Emory University, Atlanta, GA, United States
| | - Robert Taylor
- Univ of Utah School of Medicine, Salt Lake City, UT, United States
| | - Winston Thompson
- Ob/Gyn, Coop Reprod Sci Rsch Ctr, Morehouse School of Medicine, Atlanta, GA, United States
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Cottrell HN, Deepak V, Spencer JB, Sidell N, Rajakumar A. Effects of Supraphysiologic Levels of Estradiol on Endometrial Decidualization, sFlt1, and HOXA10 Expression. Reprod Sci 2019; 26:1626-1632. [PMID: 30832560 DOI: 10.1177/1933719119833485] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Supraphysiologic estradiol (E2) levels associated with controlled ovarian hyperstimulation in high in vitro fertilization (IVF) responders may alter implantation and placentation and increase the risk of preeclampsia. Our hypothesis is that elevated E2 levels in vitro significantly alter endometrial decidualization, sFlt1, and HOXA10 expression. METHODS Human endometrial stromal cells were treated with a decidualization cocktail of medroxyprogesterone, cyclic adenosine monophosphate, and 3 concentrations of E2 10 nM (standard), 100 nM (intermediate), or 1000 nM E2 (high). Effects on sFlt1, prolactin (PRL), insulin-like growth factor binding protein 1 (IGFBP-1), vascular endothelial growth factor (VEGF), and HOXA10 were studied. RESULTS Prolactin, IGFBP-1, and VEGF significantly increased at all 3 E2 concentrations. While IGFBP-1 and VEGF did not change with increasing E2, PRL was less with high E2 (6.0 ng/mL ± 1.4 standard error of the mean) compared to standard (21.4 ± 3.2) and intermediate (19.8 ± 3.8). sFlt1 decrease was similar at all E2 concentrations. HOXA10 was lower at standard (10%) and intermediate (30%) as expected, but did not change with high E2. CONCLUSIONS Supraphysiologic E2 levels associated with high IVF responders that exceed in vivo levels may impair in vitro endometrial decidualization. Although PRL did increase with high E2, the levels were, however, attenuated and 3.4-fold lower than standard and intermediate E2. sFlt1 was decreased under all 3 conditions with no differences between concentrations. Reduced HOXA10 was not observed with high E2. These findings suggest that elevated E2 levels in vitro may alter endometrial decidualization and subsequently affect implantation and placentation.
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Affiliation(s)
- Hanh N Cottrell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Venkataraman Deepak
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Augustine Rajakumar
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
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Bedient C, Rodriguez D, Sidell N, Roberts C, Schutte S. Alterations in the invasive properties of peripheral blood monocytes from patients with endometriosis. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4333.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Abstract
BACKGROUND Endometrial carcinoma is the most common gynaecologic malignancy in the world and develops through preliminary stages of endometrial hyperplasia. Atypical endometrial hyperplasia suggests a significant pre-malignant state with frank progression to endometrial carcinoma, and tends to occur at a young age. Oral progestins have been used as conservative treatment in young women with atypical endometrial hyperplasia, but they are associated with poor tolerability and side effects that may limit their overall efficacy. So it has become increasingly important and necessary to find a safe and effective fertility-sparing treatment with better tolerability and fewer side effects than the options currently available. The levonorgestrel-releasing intrauterine system (LNG-IUS) has been used to provide endometrial protection in women with breast cancer who are on adjuvant tamoxifen. The antiproliferative function of levonorgestrel is thought to reduce the risk of endometrial hyperplasia. OBJECTIVES To determine the efficacy and safety of oral and intrauterine progestogens in treating atypical endometrial hyperplasia. SEARCH METHODS In July 2018 we searched CENTRAL; MEDLINE; Embase; CINAHL, PsycINFO and the China National Knowledge Infrastructure for relevant trials. Cochrane Gynaecology and Fertility (CGF) Specialised Register and Embase were searched in November 2018. We attempted to identify trials from references in published studies. We also searched for ongoing trials in five major clinical trials registries. SELECTION CRITERIA Randomised controlled trials (RCTs) of oral and intrauterine progestogens (LNG-IUS) versus each other or placebo in women with a confirmed histological diagnosis of simple or complex endometrial hyperplasia with atypia. DATA COLLECTION AND ANALYSIS Two review authors assessed trial eligibility and risk of bias and extracted the data. The primary outcomes of the review were rate of regression and adverse effects. Secondary outcomes included rate of recurrence and proportion of women undergoing hysterectomy. We have used GRADE methodology to judge the quality of the evidence. MAIN RESULTS We included one RCT (153 women) comparing the LNG-IUS administering 20 micrograms (μu) levonorgestrel per day versus 10 milligrams of continuous or cyclical oral medroxyprogesterone (MPA) for treating any type of endometrial hyperplasia. Only 19 women in this study were histologically confirmed with atypical complex hyperplasia before treatment. The evidence was of low or very low quality. The included study was at low risk of bias, but the quality of the evidence was very seriously limited by imprecision and indirectness. We did not find any RCTS comparing the LNG-IUS or oral progestogens versus placebo in women with atypical endometrial hyperplasia.Among the 19 women with atypical complex hyperplasia, after six months of treatment there was insufficient evidence to determine whether there was a difference in regression rates between the LNG-IUS group and the progesterone group (odds ratio (OR) 2.76, 95% confidence interval (CI) 0.26 to 29.73; 1 RCT subgroup, 19 women, very low-quality evidence). The rate of regression was 100% in the LNG-IUS group (n = 6/6) and 77% in the progesterone group (n = 10/13).Among the total study population (N = 153), over the six months' treatment the main adverse effects were nausea and vaginal bleeding. There was no evidence of a difference between the groups in rates of nausea (OR 0.58, 95% CI 0.28 to 1.18; 1 RCT, 153 women, very low-quality evidence). Vaginal bleeding was more common in the LNG-IUS group (OR 2.89, 95% CI 1.11 to 7.52; 1 RCT, 153 women, low-quality evidence). Except for nausea and vaginal bleeding, no other adverse effects were reported. AUTHORS' CONCLUSIONS We did not find any RCTS of women with atypical endometrial hyperplasia, and our findings derive from a subgroup of 19 women in a larger RCT. All six women who used the LNG-IUS system achieved regression of atypical hyperplasia, but there was insufficient evidence to draw any conclusions regarding the relative efficacy of LNG-IUS versus oral progesterone (MPA) in this group of women. When assessed in a population of women with any type of endometrial hyperplasia, there was no clear evidence of a difference between LNG-IUS and oral progesterone (MPA) in risk of nausea, but vaginal bleeding was more likely to occur in women using the LNG-IUS. Larger studies are necessary to assess the efficacy and safety of oral and intrauterine progestogens in treating atypical endometrial hyperplasia.
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Affiliation(s)
- Li Luo
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyNo. 20, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduChina
| | - Bing Luo
- Chengdu Women and Children Central HospitalDepartment of Obstetrics and GynecologyNo.1617, Ri Yue StreetChengduSichuanChina610091
| | - Ying Zheng
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyNo. 20, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduChina
| | - Heng Zhang
- West China Second University Hospital, Sichuan UniversityDepartment of Obstetrics and GynecologyNo. 20, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University)ChengduChina
| | - Jing Li
- West China Hospital, Sichuan UniversityChinese Cochrane CentreNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Neil Sidell
- Emory University School of MedicineDepartment of Gynecology and Obstetrics1639 Pierce DriveAtlantaUSAWMB 4303 Atlanta
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Sahu MB, Deepak V, Gonzales SK, Rimawi B, Watkins KK, Smith AK, Badell ML, Sidell N, Rajakumar A. Decidual cells from women with preeclampsia exhibit inadequate decidualization and reduced sFlt1 suppression. Pregnancy Hypertens 2018; 15:64-71. [PMID: 30825929 DOI: 10.1016/j.preghy.2018.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 11/16/2022]
Abstract
Uterine stromal cell decidualization of maternal tissue is essential for implantation of and local adaptation to the fetal allograft, as well as growth and maintenance of the placenta in healthy pregnancies. Maternal defects in decidualization have been suggested as a possible driver of preeclampsia. Preeclampsia (PE) pregnancies demonstrate shallow implantation, inadequate spiral artery remodeling, and elevated levels of the anti-angiogenic protein, sFlt1. To test whether stromal cells (DSCs) isolated from PE placentas exhibit inadequate re-decidualization and increased expression of sFlt1, DSCs from normotensive (NT-DSCs) and PE (PE-DSCs) placentas were treated for 8 days (D8) with cAMP to induce decidualization and levels of decidualization markers (PRL, IGFBP1, VEGF) and sFlt1 were measured at day 0 (D0), D8, and after reversal of treatment. NT-DSCs achieved statistically significant elevations in PRL and IFGBP1 expression (25.72 [5.78-50.04], p = 0.0008 and 92.09 [1.79-543.10], p = 0.005). PE-DSCs increased PRL and IFGBP1 expression to 6.15 [2.30-10.73] (p = 0.18) and 8.67 [1.64-376.10] (p = 0.04). NT-DSCs reduced sFlt1 expression at D8 to 0.25 [0.17-0.49] (p = 0.0021) compared to 0.31 [0.25-0.82] (p = 0.087) in PE-DSCs. These results show that, when induced to decidualize, PE-DSCs fail to increase expression of decidualization markers to levels achieved by NT-DSCs. sFlt1 expression is higher in PE-DSCs during decidualization, suggesting inadequate suppression during the crucial implantation period. These defects at the maternal fetal interface may lead to the failed spiral artery modification, decreased placental invasion of the uterus, and elevated circulating sFlt1 levels seen in PE pathology.
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Affiliation(s)
| | - Venkataraman Deepak
- Division of Research, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Stephen K Gonzales
- Division of Maternal Fetal Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Bassam Rimawi
- Division of Maternal Fetal Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Keiana K Watkins
- Division of Research, Atlanta, GA, USA; Division of Maternal Fetal Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Alicia K Smith
- Division of Research, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Martina L Badell
- Division of Maternal Fetal Medicine, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Neil Sidell
- Division of Research, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA
| | - Augustine Rajakumar
- Division of Research, Atlanta, GA, USA; Department of Gynecology and Obstetrics, Atlanta, GA, USA; Emory University School of Medicine, Atlanta, GA, USA.
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Deepak V, Badell M, Sidell N, Rajakumar A. 170. Preeclamptic decidual stromal cells fail to decidualize during co-culture with placental villous explants. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Deepak V, Sahu M, Badell M, Sidell N, Rajakumar A. 169. Retinoic acid down regulates sFlt1 in decidual stromal cells independent of decidualization. Implications to preeclampsia. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Chowdhury I, Banerjee S, Driss A, Xu W, Mehrabi S, Nezhat C, Sidell N, Taylor RN, Thompson WE. Curcumin attenuates proangiogenic and proinflammatory factors in human eutopic endometrial stromal cells through the NF-κB signaling pathway. J Cell Physiol 2018; 234:6298-6312. [PMID: 30259980 PMCID: PMC6344303 DOI: 10.1002/jcp.27360] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/17/2018] [Indexed: 12/16/2022]
Abstract
Endometriosis is a chronic gynecological inflammatory disorder in which immune system dysregulation is thought to play a role in its initiation and progression. Due to altered sex steroid receptor concentrations and other signaling defects, eutopic endometriotic tissues have an attenuated response to progesterone. This progesterone-resistance contributes to lesion survival, proliferation, pain, and infertility. The current agency-approved hormonal therapies, including synthetic progestins, GnRH agonists, and danazol are often of limited efficacy and counterproductive to fertility and cause systemic side effects due to suppression of endogenous steroid hormone levels. In the current study, we examined the effects of curcumin (CUR, diferuloylmethane), which has long been used as an anti-inflammatory folk medicine in Asian countries for this condition. The basal levels of proinflammatory and proangiogenic chemokines and cytokines expression were higher in primary cultures of stromal cells derived from eutopic endometrium of endometriosis (EESC) subjects compared with normal endometrial stromal cells (NESC). The treatment of EESC and NESC with CUR significantly and dose-dependently reduced chemokine and cytokine secretion over the time course. Notably, CUR treatment significantly decreased phosphorylation of the IKKα/β, NF-κB, STAT3, and JNK signaling pathways under these experimental conditions. Taken together, our findings suggest that CUR has therapeutic potential to abrogate aberrant activation of chemokines and cytokines, and IKKα/β, NF-κB, STAT3, and JNK signaling pathways to reduce inflammation associated with endometriosis.
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Affiliation(s)
- Indrajit Chowdhury
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia
| | - Saswati Banerjee
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia
| | - Adel Driss
- Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia
| | - Wei Xu
- Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia
| | - Sherifeh Mehrabi
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia
| | - Ceana Nezhat
- Nezhat Medical Center, Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Atlanta, Georgia
| | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Winston E Thompson
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia.,Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia
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Gonzales SK, Badell M, Cottrell H, Rimawi B, Deepak V, Sidell N, Rajakumar A. Villous explants from preeclamptic placentas induce sFlt1 in PBMCs: An ex vivo co-culture study. Pregnancy Hypertens 2018; 12:40-46. [PMID: 29674197 DOI: 10.1016/j.preghy.2018.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Soluble Flt1 (sFlt1) is an anti-angiogenic protein linked to the pathology of preeclampsia (PE). While the placenta serves as the major organ producing sFlt1 during normal pregnancy, peripheral blood mononuclear cells (PBMCs), endothelial cells, and stromal cells also produce sFlt1. The key question is 'what drives the overexpression of sFlt1 observed during PE?' In the present work we show evidence for sFlt1 over-expression in PBMCs due to interaction with placental villi from PE patients. STUDY DESIGN sFlt1 production by PBMCs is estimated by using two blood collection methods with different coagulation chemistry. PBMCs were then cultured with homologous villous explants and heterologous villous explants to determine the effects of the interaction between the two tissues. MAIN OUTCOME MEASURES sFlt1 levels were estimated using real time PCR, ELISA, and gel electrophoresis. RESULTS Plasma samples obtained using CTAD as anti-coagulant showed 16-23% less sFlt1 compared to plasma collected in EDTA. Preeclamptic PBMCs showed higher basal level of sFlt1 mRNA. In addition, we show evidence of placental interaction as a cause of sFlt1 overexpression in PBMCs using homologous and heterologous co-culture system. However, during co-culture, we observed that while the sFlt1 expression in PE PBMCs is increased, PE villous explants show reduced sFlt1 RNA expression. CONCLUSION sFlt1 was produced in significant amounts by preeclamptic PBMCs, and ex vivo studies show that the placenta induces this over-expression. In contrast, exposure to PBMCs appears to decrease sFlt1 production by preeclamptic placenta.
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Affiliation(s)
| | | | | | | | - Venkataraman Deepak
- Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Neil Sidell
- Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Augustine Rajakumar
- Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
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24
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Rimawi BH, Badell ML, Wang E, Gonzales K, Sahu MB, Deepak V, Sidell N, Rajakumar A. 327: Differential expression of sFlt1 induced by cAMP in preeclamptic versus normal placentas. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.10.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Yu J, Berga SL, Zou W, Yook DG, Pan JC, Andrade AA, Zhao L, Sidell N, Bagchi IC, Bagchi MK, Taylor RN. IL-1β Inhibits Connexin 43 and Disrupts Decidualization of Human Endometrial Stromal Cells Through ERK1/2 and p38 MAP Kinase. Endocrinology 2017; 158:4270-4285. [PMID: 28938400 PMCID: PMC5711380 DOI: 10.1210/en.2017-00495] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/06/2017] [Indexed: 01/03/2023]
Abstract
Inflammation can interfere with endometrial receptivity. We examined how interleukin 1β (IL-1β) affects expression of the uterine gap junction protein connexin 43 (Cx43), which is known to be critical for embryonic implantation. We used an in vitro model of human endometrial stromal cells (ESCs), Western blotting, and a combination of validated, selective kinase inhibitors to evaluate five canonical IL-1β signaling pathways. Cx43 and two other markers of ESC differentiation (prolactin and VEGF) were inhibited predominantly via IL-1β-activated ERK1/2 and p38 MAP kinase cascades. The findings were corroborated using small interfering RNA to silence critical genes in either pathway. By contrast, upregulation of endogenous pro-IL-1α and pro-IL-1β following recombinant IL-1β treatment was mediated via the Jun N-terminal kinase pathway. The clinicopharmacological significance of our findings is that multiple signaling cascades may need to be neutralized to reverse deleterious effects of IL-1β on human endometrial function.
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Affiliation(s)
- Jie Yu
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
- Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Sarah L. Berga
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Wei Zou
- Department of Bioengineering, College of Bioscience and Bioengineering, Hebei University of Science and Technology, Hebei 050018, China
| | - D. Grace Yook
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Joshua C. Pan
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Aurora Arroyo Andrade
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México City, México 07360
| | - Lijuan Zhao
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
- Department of Prenatal Diagnosis, Shijiazhuang Obstetrics and Gynecology Hospital, Hebei 050017, China
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Indrani C. Bagchi
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801
| | - Milan K. Bagchi
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801
| | - Robert N. Taylor
- 1Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
- Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
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26
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Cottrell HN, Wu J, Rimawi BH, Duran JM, Spencer JB, Sidell N, Rajakumar A. Human endometrial stromal cell plasticity: Reversible sFlt1 expression negatively coincides with decidualization. Hypertens Pregnancy 2017; 36:204-211. [PMID: 28494174 DOI: 10.1080/10641955.2017.1299172] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Preeclampsia (PE) is a major complication of pregnancy in which the placenta is known to have shallow implantation into the uterine decidua. Studies have implicated soluble fms-like tyrosine kinase-1 (sFlt1), a soluble vascular endothelial growth factor (VEGF) receptor protein, in the pathogenesis of PE. sFlt1 has the ability to bind to and neutralize the angiogenic functions of VEGF and placental growth factor (PlGF). The presence of sFlt1 and its action in the endometrium is yet to be determined. We hypothesize that endometrial stromal cells (ESC) at the maternal-fetal interface may play a role in sFlt-1 regulation during pregnancy. In this study, we seek to understand the dynamic regulation of sFlt1 production in primary human ESC as a result of hormone stimulation and withdrawal. To mimic a biphasic menstrual cycle, ESC were treated with cAMP to induce endometrial decidualization that occurs during the luteal secretory phase, followed by cAMP withdrawal reflecting the follicular proliferative phase. Here, we present data to show that (1) ESC produce detectable amounts of sFlt1, (2) sFlt1 expression is turned off during decidualization at both the protein and RNA level (3) ESC decidualization and resulting sFlt1 expression are reversible phenomenon, and (4) Decidualization markers prolactin (PRL) and VEGF expressions in ESC are negatively correlated with sFlt1. These findings may have important implications in diseases such as PE that involve abnormal decidualization, implantation and angiogenesis at the maternal-fetal interface.
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Affiliation(s)
- Hanh N Cottrell
- a Division of Reproductive Endocrinology , Emory University School of Medicine , Atlanta , Georgia , USA.,b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA
| | - JuanJuan Wu
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA.,c Division of Research , Emory University School of Medicine , Atlanta , Georgia , USA
| | - Bassam H Rimawi
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA.,d Division of Maternal Fetal Medicine , Emory University School of Medicine , Atlanta , Georgia , USA
| | - Juan Manuel Duran
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA.,c Division of Research , Emory University School of Medicine , Atlanta , Georgia , USA
| | - Jessica B Spencer
- a Division of Reproductive Endocrinology , Emory University School of Medicine , Atlanta , Georgia , USA.,b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA
| | - Neil Sidell
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA.,c Division of Research , Emory University School of Medicine , Atlanta , Georgia , USA
| | - Augustine Rajakumar
- b Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta , Georgia , USA.,c Division of Research , Emory University School of Medicine , Atlanta , Georgia , USA
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27
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Byrareddy SN, Arthos J, Cicala C, Villinger F, Ortiz KT, Little D, Sidell N, Kane MA, Yu J, Jones JW, Santangelo PJ, Zurla C, McKinnon LR, Arnold KB, Woody CE, Walter L, Roos C, Noll A, Van Ryk D, Jelicic K, Cimbro R, Gumber S, Reid MD, Adsay V, Amancha PK, Mayne AE, Parslow TG, Fauci AS, Ansari AA. Sustained virologic control in SIV+ macaques after antiretroviral and α4β7 antibody therapy. Science 2017; 354:197-202. [PMID: 27738167 DOI: 10.1126/science.aag1276] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/09/2016] [Indexed: 01/20/2023]
Abstract
Antiretroviral drug therapy (ART) effectively suppresses replication of both the immunodeficiency viruses, human (HIV) and simian (SIV); however, virus rebounds soon after ART is withdrawn. SIV-infected monkeys were treated with a 90-day course of ART initiated at 5 weeks post infection followed at 9 weeks post infection by infusions of a primatized monoclonal antibody against the α4β7 integrin administered every 3 weeks until week 32. These animals subsequently maintained low to undetectable viral loads and normal CD4+ T cell counts in plasma and gastrointestinal tissues for more than 9 months, even after all treatment was withdrawn. This combination therapy allows macaques to effectively control viremia and reconstitute their immune systems without a need for further therapy.
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Affiliation(s)
- Siddappa N Byrareddy
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - James Arthos
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA
| | - Claudia Cicala
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA
| | - Francois Villinger
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. Division of Pathology, The Yerkes National Primate Center of Emory University, Atlanta, GA 30329, USA
| | - Kristina T Ortiz
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Dawn Little
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Neil Sidell
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, USA
| | - Jianshi Yu
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, USA
| | - Jace W Jones
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, USA
| | - Philip J Santangelo
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30680, USA
| | - Chiara Zurla
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30680, USA
| | - Lyle R McKinnon
- Centre for the AIDS Program of Research in South Africa (CAPRISA), Durban, South Africa
| | - Kelly B Arnold
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Caroline E Woody
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lutz Walter
- Primate Genetics Laboratory, German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Christian Roos
- Primate Genetics Laboratory, German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Angela Noll
- Primate Genetics Laboratory, German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Donald Van Ryk
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA
| | - Katija Jelicic
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA
| | - Raffaello Cimbro
- Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, MD 21201, USA
| | - Sanjeev Gumber
- Division of Pathology, The Yerkes National Primate Center of Emory University, Atlanta, GA 30329, USA
| | - Michelle D Reid
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Volkan Adsay
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Praveen K Amancha
- Division of Pathology, The Yerkes National Primate Center of Emory University, Atlanta, GA 30329, USA
| | - Ann E Mayne
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Tristram G Parslow
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Anthony S Fauci
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA
| | - Aftab A Ansari
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
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28
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Gonzales SK, Badell M, Cottrell H, Qu H, Sidell N, Rajakumar A. 933: Maternal peripheral blood mononuclear cells - a novel source of sFlt-1 in preeclampsia pathology. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.11.842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Cottrell H, Spencer J, Sidell N, Rajakumar A. Effects of supraphysiologic levels of estradiol on endometrial decidualization and HOXA10 expression. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Yu J, Berga SL, Johnston-MacAnanny EB, Sidell N, Bagchi IC, Bagchi MK, Taylor RN. Endometrial Stromal Decidualization Responds Reversibly to Hormone Stimulation and Withdrawal. Endocrinology 2016; 157:2432-46. [PMID: 27035651 PMCID: PMC4891781 DOI: 10.1210/en.2015-1942] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/23/2016] [Indexed: 01/08/2023]
Abstract
Human endometrial stromal decidualization is required for embryo receptivity, angiogenesis, and placentation. Previous studies from our laboratories established that connexin (Cx)-43 critically regulates endometrial stromal cell (ESC) differentiation, whereas gap junction blockade prevents it. The current study evaluated the plasticity of ESC morphology and Cx43 expression, as well as other biochemical markers of cell differentiation, in response to decidualizing hormones. Primary human ESC cultures were exposed to 10 nM estradiol, 100 nM progesterone, and 0.5 mM cAMP for up to 14 days, followed by hormone withdrawal for 14 days, mimicking a biphasic ovulatory cycle. Reversible differentiation was documented by characteristic changes in cell shape. Cx43 was reversibly up- and down-regulated after the estradiol, progesterone, and cAMP treatment and withdrawal, respectively, paralleled by fluctuations in prolactin, vascular endothelial growth factor, IL-11, and glycodelin secretion. Markers of mesenchymal-epithelial transition (MET), and its counterpart epithelial-mesenchymal transition, followed reciprocal patterns corresponding to the morphological changes. Incubation in the presence of 18α-glycyrrhetinic acid, an inhibitor of gap junctions, partially reversed the expression of decidualization and MET markers. In the absence of hormones, Cx43 overexpression promoted increases in vascular endothelial growth factor and IL-11 secretion, up-regulated MET markers, and reduced N-cadherin, an epithelial-mesenchymal transition marker. The combined results support the hypothesis that Cx43-containing gap junctions and endocrine factors cooperate to regulate selected biomarkers of stromal decidualization and MET and suggest roles for both phenomena in endometrial preparation for embryonic receptivity.
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Affiliation(s)
- Jie Yu
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Sarah L Berga
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Erika B Johnston-MacAnanny
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Neil Sidell
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Indrani C Bagchi
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Milan K Bagchi
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
| | - Robert N Taylor
- Department of Obstetrics and Gynecology (J.Y., S.L.B., E.B.J.-M., R.N.T.), Clinical and Translational Science Institute (J.Y., R.N.T.), and Molecular Medicine and Translational Sciences Program (R.N.T.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; Department of Gynecology and Obstetrics (N.S.), Emory University School of Medicine, Atlanta, Georgia 30322; and Departments of Comparative Biosciences (I.C.B.) and Molecular and Integrative Physiology (M.K.B.), University of Illinois Urbana/Champaign, Illinois 61801
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31
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Harp D, Driss A, Mehrabi S, Chowdhury I, Xu W, Liu D, Garcia-Barrio M, Taylor RN, Gold B, Jefferson S, Sidell N, Thompson W. Exosomes derived from endometriotic stromal cells have enhanced angiogenic effects in vitro. Cell Tissue Res 2016; 365:187-96. [PMID: 26841879 PMCID: PMC4917586 DOI: 10.1007/s00441-016-2358-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/30/2015] [Indexed: 02/07/2023]
Abstract
Our objective has been to establish a pro-angiogenic role for exosomes in endometriosis and to determine whether a differential expression profile of cellular and exosomal microRNAs (miRNAs) exists in endometriosis. We performed an in vitro study of human primary endometrial stromal cells (ESCs) and human umbilical vein endothelial cells (HUVECs). We isolated and characterized exosomes from ESCs from five endometriosis patients and five phase-matched controls. Exosomes were characterized by transmission electron microscopy and NanoSight technology. MiRNA was assessed by deep sequencing and reverse transcription with quantitative polymerase chain reaction. Exosome uptake studies were achieved by means of confocal microscopy. The pro-angiogenic experiments were executed by treating HUVECs with ESC-derived exosomes. We observed differential profiles of exosomal miRNA expression between exosomes derived from endometriosis lesion cells and diseased eutopic stromal cells compared with exosomes derived from control ESCs. We also demonstrated autocrine cellular uptake of exosomes and paracrine functional angiogenic effects of exosomes on HUVECs. The results of this study support the hypothesis that exosomes derived from ESCs play autocrine/paracrine roles in the development of endometriosis, potentially modulating angiogenesis. The broader clinical implications are that Sampson’s theory of retrograde menstruation possibly encompasses the finding that exosomes work as intercellular communication modulators in endometriosis.
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Affiliation(s)
- Djana Harp
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Adel Driss
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Sharifeh Mehrabi
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Indrajit Chowdhury
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Wei Xu
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Dong Liu
- Cardiovascular Research Institute, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.,Department of Physiology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Minerva Garcia-Barrio
- Cardiovascular Research Institute, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.,Department of Physiology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Bert Gold
- Center for Cancer Research, National Cancer Institute, Frederick, MD 21702, USA
| | | | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, 1639 Pierce Dr., WMB 4303, Atlanta, GA 30322, USA
| | - Winston Thompson
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.,Department of Physiology, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA
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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.
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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
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Abstract
Endometriosis is a nonmalignant, but potentially metastatic, gynecological condition manifested by the extrauterine growth of inflammatory endometrial implants. Ten percent of reproductive-age women are affected and commonly suffer pelvic pain and/or infertility. The theories of endometriosis histogenesis remain controversial, but retrograde menstruation and metaplasia each infer mechanisms that explain the immune cell responses observed around the ectopic lesions. Recent findings from our laboratories and others suggest that retinoic acid metabolism and action are fundamentally flawed in endometriotic tissues and even generically in women with endometriosis. The focus of our ongoing research is to develop medical therapies as adjuvants or alternatives to the surgical excision of these lesions. On the basis of concepts put forward in this review, we predict that the pharmacological actions and anticipated low side-effect profiles of retinoid supplementation might provide a new treatment option for the long-term management of this chronic and debilitating gynecological disease.
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Affiliation(s)
- Robert N Taylor
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
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Byrareddy SN, Sidell N, Arthos J, Cicala C, Zhao C, Little DM, Dunbar P, Yang GX, Pierzchalski K, Kane MA, Mayne AE, Song B, Soares MA, Villinger F, Fauci AS, Ansari AA. Species-specific differences in the expression and regulation of α4β7 integrin in various nonhuman primates. J Immunol 2015; 194:5968-79. [PMID: 25948815 DOI: 10.4049/jimmunol.1402866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/02/2015] [Indexed: 01/25/2023]
Abstract
Among nonhuman primates, SIV-infected Asian pigtailed macaques (PM) are relatively more susceptible to infection and disease progression than SIV-infected rhesus macaques (RM). In addition, SIV-infected African natural hosts such as the sooty mangabeys (SM) are resistant to disease. The mechanisms associated with such species-related variable clinical outcomes remain ill-defined but hold the potential to provide insights into the underlying mechanisms surrounding HIV pathogenesis. Recent findings indicate that the expression of the heterodimeric gut homing integrin α4β7 can influence both susceptibility and disease progression in RM. It was reasoned that differences in the frequencies/surface densities of α4β7-expressing lymphocytes might contribute to the differences in the clinical outcome of SIV infection among NHPs. In this article, we report that CD4(+) T cells from PM constitutively express significantly higher levels of α4β7 than RM or SM. Retinoic acid, a key regulator of α4β7 expression, was paradoxically found at higher levels in the plasma of SM versus RM or PM. We also observed pairing of β7 with αE (αEβ7) on CD4(+) T cells in the peripheral blood of SM, but not PM or RM. Finally, the differential mean density of expression of α4β7 in RM versus SM versus PM was predominantly dictated by species-specific sequence differences at the level of the β7 promoters, as determined by in vitro reporter/promoter construct transfection studies. We propose that differences in the regulation and expression of α4β7 may explain, in part, the differences in susceptibility and SIV disease progression in these NHP models.
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Affiliation(s)
- Siddappa N Byrareddy
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322
| | - James Arthos
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Claudia Cicala
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Chunxia Zhao
- Division of Microbiology and Immunology, Yerkes National Primate Center, Atlanta, GA 30329
| | - Dawn M Little
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322
| | - Paul Dunbar
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322
| | - Gui X Yang
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322
| | - Keely Pierzchalski
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, University of Maryland, Baltimore, MD 21201
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, University of Maryland, Baltimore, MD 21201
| | - Ann E Mayne
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322
| | - Byeongwoon Song
- Department of Molecular and Cellular Biology, University of California, Davis, Davis, CA 95616; and
| | - Marcelo A Soares
- Laboratory of Human Virology, Federal University of Rio de Janeiro, 20231-050 Rio de Janeiro, Brazil
| | - Francois Villinger
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322; Division of Microbiology and Immunology, Yerkes National Primate Center, Atlanta, GA 30329
| | - Anthony S Fauci
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Aftab A Ansari
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322;
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35
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Best MW, Wu J, Pauli SA, Kane MA, Pierzchalski K, Session DR, Woods DC, Shang W, Taylor RN, Sidell N. A role for retinoids in human oocyte fertilization: regulation of connexin 43 by retinoic acid in cumulus granulosa cells. Mol Hum Reprod 2015; 21:527-34. [PMID: 25877907 DOI: 10.1093/molehr/gav017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/08/2015] [Indexed: 11/12/2022] Open
Abstract
Retinoids are essential for ovarian steroid production and oocyte maturation in mammals. Oocyte competency is known to positively correlate with efficient gap junction intercellular communication (GJIC) among granulosa cells in the cumulus-oocyte complex. Connexin 43 (C x 43) is the main subunit of gap junction channels in human cumulus granulosa cells (CGC) and is regulated by all-trans retinoic acid (ATRA) in other hormone responsive cell types. The objectives of this study were to quantify retinoid levels in human CGC obtained during IVF oocyte retrievals, to investigate the potential relationship between CGC ATRA levels and successful oocyte fertilization, and to determine the effects of ATRA on C x 43 protein expression in CGC. Results showed that CGC cultures actively metabolize retinol to produce ATRA. Grouped according to fertilization rate tertiles, mean ATRA levels were 2-fold higher in pooled CGC from women in the highest versus the lowest tertile (P < 0.05). ATRA induced a rapid dephosphorylation of C x 43 in CGC and granulosa cell line (KGN) cultures resulting in a >2-fold increase in the expression of the functional non-phosphorylated (P0) species (P < 0.02). Similar enhancement of P0 by ATRA was shown in CGC and KGN cultures co-treated with LH or hCG which, by themselves, enhanced the protein levels of C x 43 without altering its phosphorylation profile. Correspondingly, the combination of ATRA+hCG treatment of KGN caused a significant increase in GJIC compared with single agent treatments (P < 0.025) and a doubling of GJIC from that seen in untreated cells (P < 0.01). These findings indicate that CGC are a primary site of retinoid uptake and ATRA biosynthesis. Regulation of C x 43 by ATRA may serve an important role in folliculogenesis, development of oocyte competency, and successful fertilization by increasing GJIC in CGC.
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Affiliation(s)
- Monica W Best
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Juanjuan Wu
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Samuel A Pauli
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Keely Pierzchalski
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Donna R Session
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Dori C Woods
- Vincent Center for Reproductive Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Weirong Shang
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Robert N Taylor
- Department of Obstetrics & Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
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36
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Hipp H, Loucks TL, Nezhat C, Sidell N, Session DR. Anti-Müllerian Hormone in Peritoneal Fluid and Plasma From Women With and Without Endometriosis. Reprod Sci 2015; 22:1129-33. [PMID: 25824010 DOI: 10.1177/1933719115578927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anti-Müllerian hormone (AMH) has potential local effects on ovarian function and endometrial tissue, including endometriosis, but its presence in peritoneal fluid is not fully understood. This is a cross-sectional study evaluating AMH in peritoneal fluid and plasma from women with endometriosis (N = 61) and from control women without endometriosis (N = 36). There was a significant correlation between AMH in plasma and peritoneal fluid from both patients with endometriosis (r(2) = .767 [P < .001]) and control participants (r(2) = .647 [P < .001]) less than 45 years of age. Anti-Müllerian hormone declined with women's increasing age in both plasma and peritoneal fluid in women with and without endometriosis. There were no differences in the plasma or peritoneal fluid AMH in women with endometriosis versus control women. The strong relationship between plasma and peritoneal fluid may allow plasma AMH to be a marker for peritoneal AMH in studies evaluating the local effects of AMH.
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Affiliation(s)
- Heather Hipp
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Tammy L Loucks
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Donna R Session
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
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37
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Bedient C, Rodriguez D, Roberts C, Sidell N, Schutte S. The role of monocytes in endometriosis. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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Pierzchalski K, Taylor RN, Nezhat C, Jones JW, Napoli JL, Yang G, Kane MA, Sidell N. Retinoic acid biosynthesis is impaired in human and murine endometriosis. Biol Reprod 2014; 91:84. [PMID: 25143356 DOI: 10.1095/biolreprod.114.119677] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Endometriosis is characterized by the presence of endometrial glands and stroma in extrauterine sites. Our objective was to determine whether endometriotic lesions (ELs) from women with endometriosis have altered retinoid levels compared with their eutopic endometrium, and to test the hypothesis that defects in all-trans retinoic acid (ATRA) biosynthesis in EL is related to reduced expression of cellular retinol-binding protein type 1 (RBP1). Retinoids were evaluated by liquid chromatography-tandem mass spectrometry and high-performance liquid chromatography in eutopic endometrial biopsies (EBs) and ELs from 42 patients with pathologically confirmed endometriosis. The ATRA levels were reduced, whereas the retinol and retinyl ester concentrations were elevated in EL compared with EB tissue. Similar results were found in a mouse model of endometriosis that used green fluorescent protein-positive endometrial tissue injected into the peritoneum of syngeneic hosts to mimic retrograde menses. The ATRA biosynthesis in vitro in retinol-treated primary human endometrial stromal cell (ESC) cultures derived from ELs was reduced compared with that of ESCs derived from patient-matched EBs. Correspondingly, RBP1 expression was reduced in tissue and ESCs derived from EL versus EB. Rbp1(-/-) mice showed reduced endometrial ATRA concentrations compared with wild type, associated with loss of tissue organization and hypercellularity. These findings provide the first quantitative measurements of ATRA in human endometrium and endometriosis, demonstrating reduced ATRA in ectopic tissue and corresponding ESC cultures. Quantitation of retinoids in murine endometriosis and in Rbp1(-/-) mice supports the contention that impaired ATRA synthesis caused by reduced RBP1 promotes an "endometriosis phenotype" that enables cells to implant and grow at ectopic sites.
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Affiliation(s)
- Keely Pierzchalski
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Robert N Taylor
- Department of Obstetrics & Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Jace W Jones
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Joseph L Napoli
- Department of Nutritional Science and Toxicology, University of California, Berkeley, California
| | - Guixiang Yang
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Neil Sidell
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia
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39
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Abstract
Endometrial stromal and epithelial cell cross talk is known to influence many of the dynamic changes that occur during the menstrual cycle. We modified our previous model and embedded telomerase-immortalized human endometrial stromal cells and Ishikawa adenocarcinoma epithelial cells in a collagen-Matrigel hydrogel to create a tissue-engineered model of the endometrium. Comparisons of single and cocultured cells examined communication between endometrial stromal and epithelial cells, which were cultured with 0 or 10 nmol/L 17β estradiol; conditioned medium was used to look at the production of paracrine factors. Using this model, we were able to identify the changes in interleukin 6 (IL-6) and active matrix metalloproteinase 2, which appear to be due to paracrine signaling and differences in transforming growth factor β1 (TGF-β1) that do not appear to be due to paracrine signaling. Moreover, IL-6, TGF-β1, and DNA content were also affected by the presence of estradiol in many of the tissues. These results indicate that paracrine and endocrine signaling are involved in human endometrial responses and support the use of coculture models to further investigate cell-cell and cell-matrix interactions.
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Affiliation(s)
- Stacey C Schutte
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher O James
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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40
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Yu J, Berga SL, Zou W, Sun HY, Johnston-MacAnanny E, Yalcinkaya T, Sidell N, Bagchi IC, Bagchi MK, Taylor RN. Gap junction blockade induces apoptosis in human endometrial stromal cells. Mol Reprod Dev 2014; 81:666-75. [PMID: 24753074 DOI: 10.1002/mrd.22334] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/16/2014] [Indexed: 11/10/2022]
Abstract
One of the most dynamic adult human tissues is the endometrium. Through coordinated, cyclical proliferation, differentiation, leukocyte recruitment, apoptosis, and desquamation, the uterine lining is expanded and shed monthly, unless pregnancy is established. Errors in these steps potentially cause endometrial dysfunction, abnormal uterine bleeding, failed embryonic implantation, infertility, or endometrial carcinoma. Our prior studies showed that gap junctions comprised of Gap junction alpha-1 (GJA1) protein, also known as connexin 43 (CX43), subunits are critical to endometrial stromal cell differentiation. The current studies were undertaken to explore the mechanism of endometrial dysfunction when gap junction intercellular communication (GJIC) is disrupted. Gap junction blockade by two distinct GJIC inhibitors, 18α-glycyrrhetinic acid (AGA) and octanol (OcOH), suppressed proliferation and induced apoptosis in endometrial stromal cells, as manifested by reduced biomarkers of cell viability, increased TUNEL staining, caspase-3 activation, sub-G1 chromosomal DNA complement, as well as shortened telomere length. Unexpectedly, we also observed that the chemical inhibitors blocked CX43 gene expression. Moreover, when endometrial stromal cells were induced to undergo hormonal decidualization, following a 7-day exposure to 10 nM 17β-estradiol + 100 nM progesterone + 0.5 mM dibutyryl cAMP, characteristic epithelioid changes in cell shape and secretion of prolactin were blunted in the presence of AGA or OcOH, recapitulating effects of RNA interference of CX43. Our findings indicate that endometrial stromal cell proliferation and maintenance of decidualized endometrial function are GJIC-dependent, and that disruption of gap junctions induces endometrial stromal cell apoptosis. These observations may have important implications for several common clinical endometrial pathologies.
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Affiliation(s)
- Jie Yu
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North California
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Lin C, Mathad RI, Zhang Z, Sidell N, Yang D. Solution structure of a 2:1 complex of anticancer drug XR5944 with TFF1 estrogen response element: insights into DNA recognition by a bis-intercalator. Nucleic Acids Res 2014; 42:6012-24. [PMID: 24711371 PMCID: PMC4027214 DOI: 10.1093/nar/gku219] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
XR5944, a deoxyribonucleic acid (DNA) bis-intercalator with potent anticancer activity, can bind the estrogen response element (ERE) sequence to inhibit estrogen receptor-α activities. This novel mechanism of action may be useful for overcoming drug resistance to currently available antiestrogen treatments, all of which target the hormone-receptor complex. Here we report the nuclear magnetic resonance solution structure of the 2:1 complex of XR5944 with the naturally occurring TFF1-ERE, which exhibits important and unexpected features. In both drug–DNA complexes, XR5944 binds strongly at one intercalation site but weakly at the second site. The sites of intercalation within a native promoter sequence appear to be context and sequence dependent. The binding of one drug molecule influences the binding site of the second. Our structures underscore the fact that the DNA binding of a bis-intercalator is directional and different from the simple addition of two single intercalation sites. Our study suggests that improved XR5944 bis-intercalators targeting ERE may be designed through optimization of aminoalkyl linker and intercalation moieties at the weak binding sites.
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Affiliation(s)
- Clement Lin
- College of Pharmacy, University of Arizona, 1703 E. Mabel Street, Tucson, AZ 85721, USA
| | - Raveendra I Mathad
- College of Pharmacy, University of Arizona, 1703 E. Mabel Street, Tucson, AZ 85721, USA
| | - Zhenjiang Zhang
- College of Pharmacy, University of Arizona, 1703 E. Mabel Street, Tucson, AZ 85721, USA
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Danzhou Yang
- College of Pharmacy, University of Arizona, 1703 E. Mabel Street, Tucson, AZ 85721, USA Department of Chemistry, University of Arizona, Tucson, AZ 85721, USA BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA The Arizona Cancer Center, Tucson, AZ 85724, USA
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42
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Yu J, Boicea A, Barrett KL, James CO, Bagchi IC, Bagchi MK, Nezhat C, Sidell N, Taylor RN. Reduced connexin 43 in eutopic endometrium and cultured endometrial stromal cells from subjects with endometriosis. Mol Hum Reprod 2013; 20:260-70. [PMID: 24270393 DOI: 10.1093/molehr/gat087] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Accumulating evidence indicates that reduced fecundity associated with endometriosis reflects a failure of embryonic receptivity. Microdomains composed of endometrial gap junctions, which facilitate cell-cell communication, may be implicated. Pharmacological or genetic inhibition of connexin (Cx) 43 block human endometrial cell differentiation in vitro and conditional uterine deletion of Cx43 alleles cause implantation failure in mice. The aim of this study was to determine whether women with endometriosis have reduced eutopic endometrial Cx43. Cx26 acted as a control. Endometrial biopsies were collected from age, race and cycle phase-matched women without (15 controls) or with histologically confirmed endometriosis (15 cases). Immunohistochemistry confirmed a predominant localization of Cx43 in the endometrial stroma, whereas Cx26 was confined to the epithelium. Cx43 immunostaining was reduced in eutopic biopsies of endometriosis subjects and western blotting of tissue lysates confirmed lower Cx43 levels in endometriosis cases, with Cx43/β-actin ratios=.4±1.5 in control and =1.2±0.3 in endometriosis biopsies (P<0.01). When endometrial stromal cells (ESC) were isolated from endometriosis cases, Cx43 levels and scrape loading-dye transfer were reduced by ∼45% compared with ESC from controls. In vitro decidualization of ESC derived from endometriosis versus control subjects resulted in lesser epithelioid transformation and a significantly reduced up-regulation of Cx43 protein (1.2±0.2- versus 1.7±0.4-fold, P<0.01). No changes in Cx26 were observed. While basal steady-state levels of Cx43 mRNA did not differ with respect to controls, ESC from endometriosis cases failed to manifest a response to hormone treatment in vitro. In summary, eutopic endometrial Cx43 concentrations in endometriosis cases were <50% those of controls in vivo and in vitro, functional gap junctions were reduced and hormone-induced Cx43 mRNA levels were blunted.
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Affiliation(s)
- Jie Yu
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1066, USA
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Hipp H, Loucks T, Barrett K, Yang G, Sidell N, Session D. Anti-MÜLLERIAN hormone (AMH) in peritoneal fluid and plasma in patients with endometriosis. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
BACKGROUND Endometrial carcinoma is the most common gynaecologic malignancy in the world and develops through preliminary stages of endometrial hyperplasia. Typical endometrial hyperplasia suggests a significant pre-malignant state with frank progression to endometrial carcinoma. Because atypical endometrial hyperplasia tends to occur at a young age, it has become increasingly important and necessary to find a safe and effective fertility-sparing treatment with better tolerability and fewer side effects than the options for treatment that are currently available. The levonorgestrel-releasing intrauterine system has already been used to provide endometrial protection in women with breast cancer who are on adjuvant tamoxifen. The antiproliferative function of levonorgestrel is thought to reduce the risk of endometrial hyperplasia. OBJECTIVES To determine the efficacy and safety of the levonorgestrel-releasing intrauterine system in reversing atypical endometrial hyperplasia. SEARCH METHODS In November 2012 we searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library; MEDLINE; EMBASE; and the China National Knowledge Infrastructure for relevant trials. Attempts were made to identify trials from references in published studies. We also searched for ongoing trials in five major clinical trials registries. SELECTION CRITERIA Randomised controlled trials (RCTs) of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus progestin therapy in women with a confirmed histological diagnosis of simple or complex endometrial hyperplasia with atypia. DATA COLLECTION AND ANALYSIS No eligible study was found. MAIN RESULTS We did not identify any studies which met our full inclusion criteria. AUTHORS' CONCLUSIONS There is no evidence available from randomised controlled trials regarding the efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) for atypical endometrial hyperplasia. RCTS are required to determine whether the LNG-IUS is safe and effective for treating atypical endometrial hyperplasia.
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Affiliation(s)
- Li Luo
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
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45
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Wu J, Taylor RN, Sidell N. Retinoic acid regulates gap junction intercellular communication in human endometrial stromal cells through modulation of the phosphorylation status of connexin 43. J Cell Physiol 2013; 228:903-10. [PMID: 23042455 DOI: 10.1002/jcp.24241] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 09/25/2012] [Indexed: 11/07/2022]
Abstract
Previous studies revealed that gap junction intercellular communication (GJIC) among uterine stromal cells plays critical roles in modulating decidualization, neovasularization, and embryo implantation. Connexin (Cx) proteins are the major component of gap junctions and Cx43 is the most widely expressed connexin in endometrium. Phosphorylation of Cx43 was found to impair gap junction communication in this tissue. Using primary human endometrial stromal cells (ESCs) and a stable high telomerase-expressing ESC transfectant (T-HESC), we found that retinoic acid (RA) altered the phosphorylation status of Cx43 protein such that there was a decrease in the phosphorylated (P1 and P2) species accompanied by an increase in the non-phosphorylated (P0) form. This process is dependent on protein phosphatase 2A (PP2A) activity since selective PP2A inhibitors prevented the ability of RA to dephosphorylate Cx43. Although RA had no effect on total PP2A expression or activity, it significantly increased the intracellular association of Cx43 and PP2A. Inhibition of transcription and protein synthesis by actinomycin D and cycloheximide, respectively, had no effect on the RA-induced changes in the Cx43 phosphorylation pattern. Furthermore, BMS493, a potent antagonist of the classical RA-mediated transcriptional pathway, did not inhibit RA-induced Cx43 dephosphorylation. Our data indicate that RA stimulates physical association of PP2A with Cx43, resulting in the dephosphorylation of Cx43 and, as a consequence, up-regulation of GJIC in ESCs. This process is independent of new mRNA and protein synthesis and suggests a novel mechanism by which aberrant retinoid metabolism can explain certain reproductive disorders manifested by dysfunctional endometrial cell GJIC.
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Affiliation(s)
- Juanjuan Wu
- Division of Research, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Zhang H, Taylor WR, Joseph G, Caracciolo V, Gonzales DM, Sidell N, Seli E, Blackshear PJ, Kallen CB. mRNA-binding protein ZFP36 is expressed in atherosclerotic lesions and reduces inflammation in aortic endothelial cells. Arterioscler Thromb Vasc Biol 2013; 33:1212-20. [PMID: 23559629 DOI: 10.1161/atvbaha.113.301496] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE We studied the expression and function of an mRNA-binding protein, zinc finger protein-36 (ZFP36), in vascular endothelial cells in vivo and in vitro. We tested the hypotheses that ZFP36 regulates inflammation in vascular endothelial cells and that it functions through direct binding to target cytokine mRNAs. We also tested whether ZFP36 inhibits nuclear factor-κB-mediated transcriptional responses in vascular endothelial cells. APPROACH AND RESULTS ZFP36 was minimally expressed in healthy aorta but was expressed in endothelial cells overlying atherosclerotic lesions in mice and humans. The protein was also expressed in macrophage foam cells of atherosclerosis. ZFP36 was expressed in human aortic endothelial cells in response to bacterial lipopolysaccharide, glucocorticoid, and forskolin, but not oxidized low-density lipoproteins or angiotensin II. Functional studies demonstrated that ZFP36 reduces the expression of inflammatory cytokines in target cells by 2 distinct mechanisms: ZFP36 inhibits nuclear factor-κB transcriptional activation and also binds to cytokine mRNAs, leading to reduced transcript stability. CONCLUSIONS ZFP36 is expressed in vascular endothelial cells and macrophage foam cells where it inhibits the expression of proinflammatory mRNA transcripts. The anti-inflammatory effects of ZFP36 in endothelial cells occur via both transcriptional and posttranscriptional mechanisms. Our data suggest that enhancing vascular ZFP36 expression might reduce vascular inflammation.
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Affiliation(s)
- Huanchun Zhang
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
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Pauli SA, Session DR, Shang W, Easley K, Wieser F, Taylor RN, Pierzchalski K, Napoli JL, Kane MA, Sidell N. Analysis of follicular fluid retinoids in women undergoing in vitro fertilization: retinoic acid influences embryo quality and is reduced in women with endometriosis. Reprod Sci 2013; 20:1116-24. [PMID: 23427183 DOI: 10.1177/1933719113477487] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Retinol (ROL) and its biologically active metabolite, all-trans retinoic acid (ATRA), are essential for a number of reproductive processes. However, there is a paucity of information regarding their roles in ovarian folliculogenesis, oocyte maturation, and early embryogenesis. The objectives of this study were to quantify and compare peripheral plasma (PP) and follicular fluid (FF) retinoid levels, including ATRA in women undergoing in vitro fertilization (IVF) and to investigate the relationship between retinoid levels and embryo quality. Retinoid levels were evaluated in PP and FF from 79 women undergoing IVF at the time of oocyte retrieval and corresponding embryo quality assessed on a daily basis after retrieval for 3 days until uterine transfer. Analysis compared the retinoid levels with day 3 embryo grades and between endometriosis versus control patients. Results demonstrated distinctive levels of retinoid metabolites and isomers in FF versus PP. There was a significantly larger percentage of high-quality grade I embryos derived from the largest versus smallest follicles. An increase in follicle size also correlated with a >50% increase in FF ROL and ATRA concentrations. Independent of follicle size, FF yielding grade I versus nongrade I embryos showed higher mean levels of ATRA but not ROL. In a nested case-control analysis, control participants had 50% higher mean levels of ATRA in their FF and PP than women with endometriosis. These findings strongly support the proposition that ATRA plays a fundamental role in oocyte development and quality, and that reduced ATRA synthesis may contribute to decreased fecundity of participants with endometriosis.
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Affiliation(s)
- Samuel A Pauli
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322, USA
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Chowdhury I, Harp D, Sutovsky P, Taylor RN, Sidell N, Thompson WE. Anti-Inflammatory Protein Neuregulin-1B (NRG1β) Is Identified in Ovarian Follicular Fluid and Microvesicles of Human and Porcine: A Possible Autocrine-Paracrine Function During Ovulation. Biol Reprod 2012. [DOI: 10.1093/biolreprod/87.s1.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wieser F, Wu J, Shen Z, Taylor RN, Sidell N. Retinoic acid suppresses growth of lesions, inhibits peritoneal cytokine secretion, and promotes macrophage differentiation in an immunocompetent mouse model of endometriosis. Fertil Steril 2012; 97:1430-7. [PMID: 22464761 DOI: 10.1016/j.fertnstert.2012.03.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 02/22/2012] [Accepted: 03/05/2012] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the effects of all-trans-retinoic acid (RA) on establishment and growth of endometrial lesions, peritoneal interleukin-6 (IL-6) and macrophage chemotactic factor-1 (MCP-1) concentrations, and CD38, CD11b, and F4/80 expression on peritoneal macrophages in an immunocompetent mouse model of endometriosis. DESIGN Experimental transplantation study using mice. SETTING Academic medical center. ANIMAL(S) C57BL/6 recipient mice and syngeneic green fluorescent protein transgenic (GFP+) mice. INTERVENTION(S) Recipient mice were inoculated with GFP+ minced uterine tissue to induce endometriosis and treated with RA (400 nmol/day) or vehicle for 17 days (3 days before to 14 days after tissue injection). MAIN OUTCOME MEASURE(S) Total number of GFP+ implants in recipient mice, number of implants showing visible blood vessels, total volume of established lesions per mouse, concentrations of IL-6 and MCP-1 in peritoneal fluid, and expression of CD11b, F4/80, and CD38 on peritoneal macrophages. RESULT(S) Retinoic acid treatment for 17 days reduced the number of implants versus controls and decreased the frequency of lesions with vessels. Peritoneal washings in RA-treated animals had lower concentrations of IL-6 and MCP-1 than controls 3 days after endometrial inoculation and lower levels of IL-6 on day 14 after inoculation. Concomitant with these effects on day 14, CD38, CD11b, and F4/80 were higher on macrophages from RA-treated mice versus controls. CONCLUSION(S) The development of endometriotic implants is inhibited by RA. This effect may be caused, at least in part, by reduced IL-6 and MCP-1 production and enhanced differentiation of peritoneal macrophages.
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Affiliation(s)
- Friedrich Wieser
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Brahma PK, Zhang H, Murray BS, Shu FJ, Sidell N, Seli E, Kallen CB. The mRNA-binding protein Zfp36 is upregulated by β-adrenergic stimulation and represses IL-6 production in 3T3-L1 adipocytes. Obesity (Silver Spring) 2012; 20:40-7. [PMID: 21818148 PMCID: PMC4127993 DOI: 10.1038/oby.2011.259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obesity produces a chronic inflammatory state that contributes to the development of diabetes and atherosclerosis. In obese humans, fat depot adipocytes and macrophages produce inflammatory cytokines and other factors which exert unfavorable local and systemic immune responses. The expression of many cytokines is modulated at the post-transcriptional level by mRNA-binding proteins which recognize AU-rich elements (AREs) in the 3'-untranslated regions (3'-UTR) of these transcripts. One such protein, zinc finger protein 36 (Zfp36), is known to destabilize target mRNAs leading to decreased cytokine expression. Few regulators of Zfp36 expression in adipocytes have been described and mRNA targets of Zfp36 in adipocytes are largely unknown. We found that macrophage-derived inflammatory stimuli enhanced endogenous Zfp36 expression in 3T3-L1 adipocytes. Furthermore, the β-adrenergic receptor agonist isoproterenol (Iso) and the glucocorticoid dexamethasone (Dex) each enhanced Zfp36 expression in adipocytes, the former most likely via a cyclic adenosine monophosphate (cAMP)-dependent pathway. By contrast, Zfp36 expression in murine macrophages (RAW 264.7) was not enhanced by exposure to Dex but was stimulated by retinoic acid (RA). Zfp36 inhibited basal and lipopolysaccharide (LPS)-stimulated interleukin-6 (IL-6) expression in adipocytes. These data reveal important and cell type-specific modulators of Zfp36 expression in adipocytes and macrophages and identify Zfp36 as a potent repressor of adipocyte-derived IL-6. Furthermore, this work identifies new factors that stimulate adipocyte Zfp36 expression that are neither classically inflammatory nor mitogenic. Upregulating an mRNA-binding protein for therapeutic purposes may provide a novel mechanistic approach with which to treat diverse inflammatory disorders including common conditions associated with obesity.
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Affiliation(s)
- Pavna K. Brahma
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Huanchun Zhang
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Betsy S. Murray
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Feng-jue Shu
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Neil Sidell
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emre Seli
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Caleb B. Kallen
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
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