Monolayer culture of human endometrium: methods of culture and identification of cell types

Three-dimensional culture models of human endometrium for studying trophoblast-endometrium interaction during implantation

During implantation, a symphony of interaction between the trophoblast originated from the trophectoderm of the implanting blastocyst and the endometrium leads to a successful pregnancy. Defective interaction between the trophoblast and endometrium often results in implantation failure, pregnancy loss, and a number of pregnancy complications. Owing to ethical concerns of using in vivo approaches to study human embryo implantation, various in vitro culture models of endometrium were established in the past decade ranging from two-dimensional cell-based to three-dimensional extracellular matrix (ECM)/tissue-based culture systems. Advanced organoid systems have also been established for recapitulation of different cellular components of the maternal-fetal interface, including the endometrial glandular organoids, trophoblast organoids and blastoids. However, there is no single ideal model to study the whole implantation process leaving more research to be done pursuing the establishment of a comprehensive in vitro model that can recapitulate the biology of trophoblast-endometrium interaction during early pregnancy. This would allow us to have better understanding of the physiological and pathological process of trophoblast-endometrium interaction during implantation.

Organoids to model the endometrium: implantation and beyond

Despite advances in assisted reproductive techniques in the 4 decades since the first human birth after in vitro fertilisation, 1–2% of couples experience recurrent implantation failure, and some will never achieve a successful pregnancy even in the absence of a confirmed dysfunction. Furthermore, 1–2% of couples who do conceive, either naturally or with assistance, will experience recurrent early loss of karyotypically normal pregnancies. In both cases, embryo-endometrial interaction is a clear candidate for exploration. The impossibility of studying implantation processes within the human body has necessitated the use of animal models and cell culture approaches. Recent advances in 3-dimensional modelling techniques, namely the advent of organoids, present an exciting opportunity to elucidate the unanswerable within human reproduction. In this review, we will explore the ontogeny of implantation modelling and propose a roadmap to application and discovery.

Endometriotic cell culture contamination and authenticity: a source of bias in in vitro research?

STUDY QUESTION

Are the primary cell cultures and cell lines used in endometriosis research of sufficient quality?

SUMMARY ANSWER

Primary cells used in endometriosis research lack purity and phenotypic characterisation, and cell lines are not genotypically authenticated.

WHAT IS KNOWN ALREADY

The poor reproducibility of in vitro research and the lack of authenticity of the cell lines used represent reasons of concern in the field of reproductive biology and endometriosis research.

STUDY DESIGN, SIZE, DURATION

In the present study, past in vitro research in the field of endometriosis was systematically reviewed to determine whether the appropriate quality controls were considered. In addition, we explored the performance of Paired Box 2 (Pax2) as an endometrium specific marker in endometrial and endometriotic primary cell cultures; we also characterised the most diffused endometriosis cell lines with respect to important markers including the short tandem repeat (STR) profile.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Literature review part: almost 300 published protocols describing the isolation and creation of primary cell cultures from endometriosis were reviewed. Wet-lab part: primary cells isolated from 13 endometriosis patients were analysed by immunohistochemistry, immunofluorescence and FACS for the expression of Pax2. Cell lines Z11 and Z12, the most diffused endometriosis cell lines, were characterised with respect to the expression of Pax2, steroid hormone receptors and STR profile.

MAIN RESULTS AND THE ROLE OF CHANCE

From the literature review work, we underscored the lack of sufficient cell purity and phenotypic characterisation of primary cell cultures, which present high risk of contaminations from surrounding non-endometriotic tissues. Past work based on the use of cell lines was reviewed as well, and it emerged that cell line authentication was never performed.

In an effort to address these weaknesses for future research, we present data on the performance of Pax2, a suitable marker to exclude ovarian (and other non-endometrial) cell contaminations from primary cell cultures; STR profiles of cell lines Z11 and Z12 were analysed and indicated that the cells were authentic. These profiles are now available for authentication purposes to researchers wishing to perform experiments with these cells.

A quality control pipeline to assure sufficient quality of in vitro research in the field of reproductive biology and endometriosis is proposed. We encourage scientists, research institutes, journal reviewers, editors and funding bodies to raise awareness of the problem and adopt appropriate policies to solve it in the future.

LARGE-SCALE DATA

STR profiles of cell lines Z11 and Z12 are deposited at the Cellosaurus database—web.expasy.org.

LIMITATIONS, REASONS FOR CAUTION

There may be additional markers suitable to assess cell quality.

WIDER IMPLICATIONS OF THE FINDINGS

Future in vitro research in endometriosis and the reliability of outcomes can be improved by using the recommendations presented in this study.

STUDY FUNDING/COMPETING INTEREST(S)

The study was partly financed by the ‘Stichting Fertility Foundation’ (The Netherlands). The authors declare no existing conflict of interest.

TRIAL REGISTRATION NUMBER

Non-applicable.

In vitro models of the human endometrium: evolution and application for women's health

The endometrium is the inner lining of the uterus that undergoes complex regeneration and differentiation during the human menstrual cycle. The process of endometrial shedding, regeneration, and differentiation is driven by ovarian steroid hormones and prepares the endometrium and intrauterine environment for embryo implantation and pregnancy establishment. Endometrial glands and their secretions are essential for pregnancy establishment, and cross talk between the glandular epithelium and stromal cells appears vital for decidualization and placental development. Despite being crucial, the biology of the human endometrium during pregnancy establishment and most of pregnancy is incomplete, given the ethical and practical limitations of obtaining and studying endometrium from pregnant women. As such, in vitro models of the human endometrium are required to fill significant gaps in understanding endometrial biology. This review is focused on the evolution and development of in vitro three-dimensional models of the human endometrium and provides insight into the challenges and promises of those models to improve women's reproductive health.

Organ-on-a-Chip Systems for Women's Health Applications

Biomedical research, for a long time, has paid little attention to the influence of sex in many areas of study, ranging from molecular and cellular biology to animal models and clinical studies on human subjects. Many studies solely rely on male cells/tissues/animals/humans, although there are profound differences in male and female physiology, which can significantly impact disease mechanisms, toxicity of compounds, and efficacy of pharmaceuticals. In vitro systems have been traditionally very limited in their capacity to recapitulate female-specific physiology and anatomy such as dynamic sex-hormone levels and the complex interdependencies of female reproductive tract organs. However, the advent of microphysiological organ-on-a-chip systems, which attempt to recreate the 3D structure and function of human organs, now gives researchers the opportunity to integrate cells and tissues from a variety of individuals. Moreover, adding a dynamic flow environment allows mimicking endocrine signaling during the menstrual cycle and pregnancy, as well as providing a controlled microfluidic environment for pharmacokinetic modeling. This review gives an introduction into preclinical and clinical research on women's health and discusses where organ-on-a-chip systems are already utilized or have the potential to deliver new insights and enable entirely new types of studies.

Androgens Upregulate Endometrial Epithelial Progesterone Receptor Expression: Potential Implications for Endometriosis

BACKGROUND

Androgenic compounds have been implicated in induction of endometrial atrophy yet the mechanisms of androgen effects on human endometrium have not been well studied. We hypothesized that androgens may promote their endometrial effects via modulation of progesterone receptor (PR) expression.

METHODS

Proliferative phase endometrial samples were collected at the time of hysterectomy. We evaluated the effect of the potent androgen 5α-dihydrotestosterone (DHT) on endometrial PR expression by treating human endometrial explants, endometrial stromal cells, and Ishikawa cells with DHT. Ishikawa cells were also treated with DHT ± the androgen receptor (AR) blocker flutamide. The PR-B, total PR messenger RNA (mRNA), and PR protein expression were assessed. Expression of cyclin D1 and D2 was checked as markers of cell proliferation.

RESULTS

As expected, estradiol induced PR expression in isolated stromal cells, endometrial epithelial cells, and tissue explants. The DHT treatment also resulted in increased PR expression in endometrial explants and Ishikawa cells but not in stromal cells. Further, protein levels of both nuclear PR isoforms (PR-A and PR-B) were induced with the DHT treatment. Although flutamide treatment alone did not affect PR expression, flutamide diminished androgen-induced upregulation of PR in both endometrial explants and Ishikawa cells. Although estradiol induced both cyclin D1 and cyclin D2 mRNA, DHT did not induce these markers of cell proliferation.

CONCLUSION

Androgens may mediate endometrial effects through upregulation of PR gene and protein expression. Endometrial PR upregulation by androgens is mediated, at least in part, through AR.

Isolation, proliferation and characterization of endometrial canine stem cells

In the last decade, progenitor cells isolated from dissociated endometrial tissue have been the subject of many studies in several animal species. Recently, endometrial cells showing characteristics of mesenchymal stem cells (MSC) have been demonstrated in human, pig and cow uterine tissue samples. The aim of this study was the isolation and characterization of stromal cells from the endometrium of healthy bitches, a tissue that after elective surgery is routinely discarded. Multipotent stromal cells could be isolated from all bitches enrolled in the study (n = 7). The multipotency of cells was demonstrated by their capacity to differentiate into adipocytic, osteocytic and chondrocytic lineages. Clonogenicity and cell proliferation ability were also tested. Furthermore, gene expression analysis by RT-PCR was used to compare the expression of a set of genes (CD44, CD29, CD34, CD45, CD90, CD13, CD133, CD73, CD31 CD105, Oct4) with adipose tissue-derived MSC. Stromal cells isolated from uterine endometrium showed similar morphology, ability of subculture and plasticity, and also expressed a panel of genes comparable with adipose tissue-derived MSC. These data suggest that endometrial stromal cells fulfil the basic criteria proposed by the "Mesenchymal and Tissue Stem Cell Committee of the International Society for Cellular Therapy" for the identification of mesenchymal stem cells. Although endometrial mesenchymal stem cells (EnMSC) showed a lower replicative ability in comparison with adipose tissue-derived MSC, they could be considered a cell therapeutic agent alternative to adipose tissue or bone marrow-derived MSC in dog.

Endometrial stromal cells regulate epithelial cell growth in vitro: a new co-culture model

The regulation of epithelial cell function and morphogenesis by the paracrine effectors from the mesenchyme or stroma has been well established using in-vivo studies. A more complete understanding of these relationships has been delayed due, in part, to a lack of appropriate co-culture models. In this study, we describe a co-culture model which demonstrates that normal paracrine relationships can be reconstituted in vitro and that human endometrial stromal cells regulate both growth and differentiation of primary human endometrial epithelial cells. Interesting differences in the proliferation of stromal and epithelial cells were noted in response to the basement membrane extract, Matrigel((R)). Exposure of stromal cells to Matrigel((R)) enhanced the paracrine capacity of these cells in vitro. When epithelial cells were co-cultured in contact with stromal cells embedded in Matrigel((R)), epithelial cell growth was inhibited by 65-80% compared to controls. Stromal cells in contact with Matrigel((R)) also regulated epithelial cell differentiation, as shown by induction of glycodelin expression. These co-culture studies show great promise as a method to investigate the cellular interactions between endometrial stromal and epithelial cells and their environment and to understand the molecular basis for the regulation of normal growth and differentiation of cells within complex tissues such as the endometrium.

Basic research in endometriosis

A more thorough understanding of the mechanisms associated with the cause and pathophysiology of endometriosis may help in the development of new diagnostic and therapeutic methods for the management of endometriosis. Research has begun to enhance our understanding of endometriosis by demonstrating the differences and similarites between eutopic and ectopic endometrium, and by characterizing the peritoneal environment. Animal models have been developed and validated to conduct studies that are ethically impossible in women. Recently, cell culture models, using purified populations of cells from endometriotic lesions, have provided an appropriate in vitro endometriosis model to study the language by which cells communicate; to evaluate the biochemical effects of steroids, growth factors, pharmacological agents and immunomodulatory agents on the cells; and to study the effects of endometriosis on reproduction.

Effects of conditioned media on porcine embryos at different stages of development

The objective of our study was to determine the effect of conditioning media with homologous porcine uterine cells on the developmental rate of porcine embryos. Cell monolayers were prepared by selective dissection and digestion of sections from the uterus of prepuberal gilts that were primed with PMSG and hCG. Conditioned media were used with 2 type of embryos: 4-cell stage (Experiment 1) or blastocyst stage (Experiment 2). In Experiment 1, embryos were collected surgically by flushing the oviducts, 36 to 48 h following the first of 2 inseminations. Embryos were cultured in Whitten's medium containing 1.5% BSA as a protein source until they attained the 4-cell stage. Embryos at the 4-cell stage were cultured randomly in either Whitten's medium with 1.5% BSA or Whitten's medium with 1.5% BSA that was previously conditioned for 24 h with an endometrial epithelial cell monolayer. Embryos were cultured in 50-microl drops covered with oil in a 38.5 degrees C, 5% CO(2) in air incubator. There was no advantage to using the conditioned media with the 4-cell stage embryos. The embryos were less developed than those cultured in nonconditioned Whitten's medium (P <0.001). In Experiment 2, embryos were cultured at the blastocyst stage. They were recovered the same way as in Experiment 1 and then cultured in Whitten's medium containing 1.5% BSA until they reached the blastocyst stage. At the blastocyst stage (Day 6), embryos were randomly assigned to 1 of the 6 following treatments: Whitten's with 1.5% BSA or Whitten's plus 1.5% BSA that was previously conditioned with endometrial epithelial cell monolayer, TCM-199 containing 0.4% BSA or TCM-199 plus 0.4% BSA that was previously conditioned with endometrial epithelial cell monolayer, finally, TCM-199 containing 10% serum or TCM-199 plus 10% serum that was previously conditioned with endometrial epithelial cell monolayer. Results show that initiation of hatching was significantly enhanced by conditioning the Whitten's media.

Effect of antiprogestin RU 486 on the proliferation and metabolic activity of stromal cells separated from human endometrium

The effects of RU 486 on the proliferation and metabolic activity of human endometrial stromal cells in culture were studied. RU 486 at 10(-7) M/well significantly stimulated (P < 0.001) the growth as well as metabolic activity in the culture system. Interestingly, RU 486 at 10(-6) M/well did not stimulate metabolic activity in the culture. Progesterone, in combination with RU 486 at 10(-7) M/well, caused a significant increase in proliferation (assessed by thymidine incorporation) (P < 0.001) over control and P4 alone, but not significantly different from RU 486 at 10(-7) M/well alone. The same pattern was observed for metabolic functions (assessed by uridine incorporation) when RU 486 at 10(-7) M/well, along with P4, was added to the culture. Interestingly, RU 486 at 10(-6) M/well with P4 had no effect on RNA synthesis in the culture. The relevance of these findings is discussed.

Proliferative and morphogenic changes induced by the coculture of rat uterine and peritoneal cells: a cell culture model for endometriosis

OBJECTIVE

To evaluate the proliferative and morphogenic effects induced by the coculture of uterine and peritoneal cells to establish a cell culture model for endometriosis.

DESIGN

Uterine epithelial and stromal cells and peritoneal mesothelial and subserosal cells were cocultured with homologous cell types, heterologous cell types, or as isolated populations using a bicameral chamber design.

SETTING

Department of Obstetrics and Gynecology at the University of Missouri, Columbia, Missouri.

ANIMALS

Cells isolated and purified from five mature female Sprague Dawley rats of normal reproductive status were used to establish cell cultures.

MAIN OUTCOME MEASURES

Cell proliferation (deoxyribonucleic acid synthesis) was measured by the incorporation of 3H-thymidine, and cell morphology was assessed using inverted phase-contrast microscopy.

RESULTS

Peritoneal mesothelial cells augmented proliferation and induced cellular aggregation of uterine stromal cell monolayers. Peritoneal subserosal cells amplified proliferation and induced an irregular, compacted morphology in uterine epithelial cells. The proliferation and morphology of the two peritoneal cell types was not altered by uterine cell coculture.

CONCLUSIONS

The coculture of uterine and peritoneal cells in bicameral chambers provides a tool to study the paracrine interactions of cells that comprise the endometriotic lesion. The altered proliferation and morphology of the uterine cells may be related to the histologic and biochemical asynchrony observed between uterine endometrium and ectopic endometriotic tissue in vivo and offers insight into possible mechanisms of the histogenesis of endometriosis.

Differential effects of dioctanoylglycerol on fibronectin localization in normal, partially transformed, and malignant human endometrial stromal cells

In this study, we describe the effects of direct activation of PKC by dioctanoylglycerol (DiC8) on cellular morphology and the localization of fibronectin (Fn) in normal, oncogene-transfected, and malignant human endometrial stromal cells. We questioned whether DiC8, an endogenous specific activator of PKC, would function as a second oncogene in partially transformed human endometrial stromal cells (HESC). Cells utilized were (1) normal HESC, (2) HESC transfected with a plasmid containing an origin-defective temperature-sensitive SV40 large T antigen alone or (3) in combination with an EJ ras oncogene, and (4) an endometrial sarcoma cell line (S7). Cell cultures were treated for 1 h with sn-dioctanoylglycerol (DiC8) and stained with a monoclonal fluorescein-labeled anti-Fn antibody. In normal HESC, DiC8 induced cell rounding and caused Fn localization to revert from the perinuclear region to the cell periphery. All experiments in this investigation were performed when cells were maintained at the permissive temperature for SV40 large T antigen function. In HESC expressing the SV40 large T antigen alone, Fn was localized to the perinuclear region and also occurred as parallel strands between cells. When these cells were treated with DiC8, Fn localization changed to intense punctate regions at the cell periphery or to matrix-like patterns between cells. Also, in these cells, DiC8 induced greater detachment of cells from the substrate than from other cells, resulting in an apparent piling up of cells. Control and treated SV40/EJ ras cells and uterine sarcoma cells expressed Fn in a matrix-like pattern between cells. The rounded cellular morphology of treated HESC and treated cells expressing SV40 resembled the morphology of control or treated SV40/EJ ras cells and uterine sarcoma cells. Thus, treated cells expressing the SV40 large T antigen resembled the SV40/EJ ras cells and uterine sarcoma cells with respect to Fn localization and cellular morphology. DiC8 did not appear to further transform HESC expressing SV40 and EJ ras. However, with regard to cell shape and Fn localization, our results suggest that DiC8 may function as a second oncogene in the signal transduction pathway, in cells expressing SV40 alone. It appears that, with regard to Fn localization, DiC8 may alter signal transduction analogously to that caused by the activated Ha-ras oncogene in HESC expressing the SV40 large T antigen.

Isolation and monolayer culture of human fallopian tube epithelial cells

In the present study we have established a pure monolayer culture system of human fallopian tube epithelial cells. The cells were isolated using collagenase digestion, and were cultured in Medium 199 supplemented with 15% fetal bovine serum. The epithelial cells derived from primary and secondary culture were characterized using immunocytochemical staining and electron microscopy. The cells continued to grow for 2 to 3 wk once the monolayer culture of the cells was established. It is currently possible to maintain the cultures until the third generation. Proliferation of these cells was enhanced by epidermal growth factor but not by basic-fibroblast growth factor, insulin, transferrin, estradiol-17 beta, or progesterone. This culture system offers a good model for determining characteristics of the tubal epithelium and would permit effective study of co-culture with embryos.

Regulation of epidermal growth factor and insulin-like growth factor I receptors by estradiol and progesterone in normal and neoplastic endometrial cell cultures

Growth factors are polypeptides which regulate cell proliferation through binding to specific receptor proteins. Normal and neoplastic human endometrium have been shown to express epidermal growth factor (EGF) and insulin-like growth factor I (IGF-1) receptors. Endometrial cell cultures were used to test modulation of EGF and IGF-1 receptors in response to steroid hormones. Endometrial gland and stroma cells were separated by enzymatic dispersion and were incubated in medium containing estradiol (10, 100, or 1000 pg/ml) or progesterone (1, 10, or 100 ng/ml) followed by radioligand assays. Normal endometrial cultures (n = 6) treated with estradiol demonstrated 40% less EGF binding than control cultures (P less than 0.05), while IGF-1 binding was unaffected. Stromal cells treated identically decreased in only one treatment group. Progesterone treatment stimulated a significant increase in EGF and IGF-1 receptors in gland cultures. Cultures derived from adenocarcinoma (n = 2) demonstrated decreased EGF binding compared with normal endometrium (P less than 0.05). Carcinoma cells treated with progesterone resulted in a dose-dependent increase in EGF binding over control (P less than 0.05). These data illustrate effects of steroid hormones upon growth factor receptors in human endometrium, and suggest involvement of growth factors in the regulation of normal and neoplastic endometrial growth.

Human endometrial cells grown on an extracellular matrix form simple columnar epithelia and glands

Normal human endometrial cells were grown on an extracellular matrix containing type IV collagen, laminin, heparan sulfate proteoglycan, and entactin (Matrigel). On the extracellular matrix, dispersed endometrial cells remained rounded, and aggregated to form mounds of cells, which continued to grow in this arrangement. At 10 d, light microscopy demonstrated that these mounds were comprised of an eosinophilic substance, containing individual fusiform stromal cells. About 50% of the mounds were covered with a single layer of polarized cuboidal to columnar cells with basal nuclei, whereas 60% contained columnar cells forming glandular structures with open lumina. These polarized cuboidal and columnar cells were epithelial, based on their positive staining for cytokeratins and the possession of microvilli, tonofilaments, abundant glycogen, ribosomes, and primitive junctional complexes. Kreyberg's stain showed the presence of mucin within the lumina of the glands, indicating that they were functional. Thus, human endometrial cells grown on an extracellular matrix form a simple cuboidal to columnar epithelium, a stromal component, and glandular structures, thereby mimicking the in vivo morphology of the endometrium.

Development of a method to isolate and culture highly purified populations of stromal and epithelial cells from human endometrial biopsy specimens

Appropriate endometrial maturation is of paramount importance to achieve reproductive success. Practical and ethical considerations require that in vitro methods be available to evaluate regulation of human endometrial function. Additionally, tissue complexity requires separation of individual cell populations. This report describes an improved method for isolation of endometrial epithelial and stromal cells, using biopsy specimens as a tissue source. Separated cells were obtained using selective enzymatic digestion in conjunction with physical separation procedures. Isolated populations exhibited over 95% homogeneity, ascertained immunocytochemically. Using this system, isolated cells from normal endometrium can readily be obtained for in vitro studies. Within the defined conditions of a culture system, important areas of current concern in the endometrium such as ectopic endometrial growth and implantation can be addressed.

Indication of selective growth of human endometrial epithelial cells on extracellular matrix

The culturing of human endometrium in conventional plastic dishes and media is only partially successful, mainly because a growth of a heterogeneous population of cells is achieved. Naturally produced extracellular matrix closely resembles the subepithelial basement membrane and seems to affect both growth and differentiation of cells. These qualities of the extracellular matrix (ECM) were applied for obtaining endometrial epithelial cultures. Endometrial tissue specimens were plated after slicing on ECM-coated dishes and kept for up to 8 d. The growth of a confluent homogeneous tissue composed of polygonal epithelial-like cells was demonstrated. To further characterize these cells, cultures were examined by scanning electron microscopy and transmission electron microscopy. Scanning electron microscopy revealed flattened polygonal cells covered with microvilli, among which ciliated cells were observed. By transmission electron microscopy the cells were seen as a monolayer, with some cells overlapping, closely adherent to the matrix. Microvilli, as well as intracellular vacuoles and glycogen granules were observed. Cell type specific cytoskeletal markers were demonstrated by antibodies to intermediate filament proteins (keratin and epithelial membrane antigen). Taken together, the morphologic and immunohistochemical studies indicate that a selective growth of the epithelial component of endometrial tissue was obtained after plating unprocessed endometrial tissue fragments on ECM-coated culture dishes.

Gland formation from human endometrial epithelial cells in vitro

We have developed methods for the culture of human endometrial glandular epithelia in vitro. The culture medium is serum-free and is used in combination with Matrigel, an extracellular matrix material applied as a coating on cell culture plates. Cell growth begins as a monolayer, but the cells subsequently form glandular or organoid structures. The glands are composed of polar columnar cells facing a central lumen, which is enclosed by the apical surfaces of cells displaying numerous microvilli and sealed by tight junction complexes. The ability to study in vitro the complex process of glandular morphogenesis represents an important new tool in cell biology which may be used to investigate growth regulation, hormone production and dependency, and cellular recognition and interactions. Ultimately, these characteristics may be applied to study the alterations of glandular epithelia associated with neoplasia.

Characteristics of cell lines derived from normal and malignant endometrial tissue

Five established cell lines of human endometrium, two of normal endometrium and three of proven tumorigenicity, have been compared in terms of morphology and chromosomal numbers. Each of the five cell lines was then analyzed using immunocytochemical techniques to show that the epithelial and stromal elements could be separately identified. Antibodies directed against cytokeratin and desmoplakins were used to identify epithelial elements and antibodies directed against fibronectin were used as a marker for stroma. These results were then confirmed using Western blot analysis. We conclude that cell lines of human endometrium in culture can be differentiated as being of epithelial or stromal origin. Cell lines derived from reportedly normal human endometrium exhibit a stromal phenotype with a normal karyotype, whereas cells of tumorigenic human endometrial cell lines exhibit an epithelial phenotype and abnormal karyologic characteristics.

Proliferative potential and polymorphism of human endometrial stromal cells

The proliferative potential of stromal cells from human endometrium, separated from glands by dispersion in the presence of collagenase and subsequent passage through a sieve, was evaluated by determining the total number of cell doublings achieved when cells were repeatedly subcultured in a 1:2 split ratio in Ham's F-10 medium containing 10% fetal bovine serum (FBS). Fifty doublings or more (up to 100) were observed in 8 of the 26 specimens (30%) which we examined. This number of doublings is high for cells obtained from adult tissues and may in part reflect the unusually great proliferative capacity of human endometrium when compared to that of other tissues. The shape of the stromal cells depended on the medium in which they were originally cultured. Cells cultured in Ham's F-10 medium containing 10% FBS showed the typical fibroblastic morphology at confluence; they appeared elongated or spindle-shaped and formed monolayers. In contrast, cultures in CMRL-1066 medium in the presence of 10% FBS appeared polygonal or stellate-shaped and also formed monolayers. In about 50% of the cultures in CMRL-1066 medium we observed fibroblast-shaped cells that superficially resembled cells grown in Ham's F-10 medium, but were able to form dome structures. In some cultures the regions of prominent overgrowth were macroscopically visible. Switching media during later passages did not reverse the shape of the cells obtained in CMRL-1066 medium or that of the fibroblast-shaped cells in Ham's F-10 medium, suggesting either that the growth of a subpopulation was favoured early during cellular adaptation to primary culture or that there was a single cell population whose phenotype was determined early in culture and then no longer responded to medium factors. Examination of the cytoskeleton after visualization with rhodamine-labelled phalloidin revealed that the arrangement of the microfilaments corresponded to the cell shape observed in living cells under the phase contrast microscope. Distinct changes in morphology were observed when primary stromal cell cultures in CMRL-1066 medium were exposed to progesterone, indicating that progestins may affect cytoskeletal proteins.

Cell of the mucous membrane of the female genital tract in culture: a comparative study with regard to the histogenesis of endometriosis

Cellular elements from the mucous membrane of the uterus and oviducts and from peritoneal washings were cultured. The in vitro behavior of these cells was compared to elucidate the histogenesis of endometriosis and the role of various diagnostic procedures. In 65% of the cultured material obtained by uterine-tubal flushing, proliferating cells of the uterine-tubal mucous membrane were present. Their morphology and behavior corresponded to those of cultured cells obtained by separate washing of the uterine cavity and the tubes, respectively, curetted material, and biopsies of endometriosis lesions. Epithelial and stromal cells were identified using phase contrast microscopy, electron microscopy, and immunohistochemical methods. These cell types did not occur in peritoneal washings before the flushing of uterus and tubes. It was therefore assumed that they were detached and transported to the pelvic cavity during the above-mentioned procedures. In view of their intensive proliferation they may form the basis in the development of nodules of endometriosis. This would support the implantation theory concerning the pathogenesis of endometriosis. Interactions between epithelial and mesothelial cells point to the possible role of the latter in encapsulating the endometrial elements.

Preparation and characterization of rabbit myometrial cells in primary culture: influence of estradiol and progesterone treatment

Myometrial cells were obtained following a three-step enzymatic digestion of uterine horns from Day 1 pseudopregnant rabbits. Isolated cells were cultured in RPMI 1640 supplemented with 10% fetal bovine serum (FBS), whole or steroid depleted (FBS-DC) at a plating density of 0.5 X 10(6) cells/ml. The cells reached confluency on Day 6 to 7 with whole serum and on Day 7 to 8 with DC serum. The process yielded myometrial cells at a purity level of at least 80% as assessed by indirect immunofluorescence using desmin antibody on confluent cultures. The addition of increasing doses of 17 beta-estradiol (E2) (0.1 nM to 1 microM) to the culture medium resulted in an increase in total protein and DNA content (1.5-fold at 1 nM). Similar treatment with progesterone (P) resulted in a 25% inhibition of protein and DNA content at 10 nM. Pretreatment of cells with E2 (1 nM) for 3 d followed by P (10 nM) for 3 d resulted in a 1.8-fold stimulation of protein with a higher protein: DNA ratio indicating that the increase was due to cellular hypertrophy. Analysis of desmin by polyacrylamide gel electrophoresis showed that this cytoskeleton protein was not affected by steroid treatment. Our results indicate that PR can generate two different responses depending on cell pretreatment. In as much as myometrial cells grown in primary culture respond differentially to E2 and P they should provide a useful model to study the regulation of myometrial contractility.

Inhibition of fibroblast proliferation in a culture of human endometrial stromal cells using a medium containing D-valine

A nutrient medium in which D-valine was substituted for L-valine inhibited fibroblast proliferation in a culture of human endometrial stromal cells. Fibroblasts were not killed by D-valine and were able to grow again when D-valine was replaced by L-valine. The stromal cells proliferate in the D-valine medium only when seeded at high density. They were distinguished from fibroblasts by their morphology in light microscopy, their surface characteristics at scanning electron microscopy and their lower staining with fibronectin antibodies.

Morphologically stable epithelial vesicles cultured from normal human endometrium in defined media

Epithelium from normal human endometrium was cultured as morphologically stable vesicular structures in a defined, hormone-supplemented PFMR-4 medium. The structures consisted of a single layer of polarized epithelial cells with the apical surface facing the external culture medium, and the basal surface resting on a well-defined basal lamina adjacent to the internal lumen. Vesicles were shown to retain their viability for up to 3 mo. in culture, to actively synthesize DNA after being cultured for over a month in a defined medium, and to respond to steroid hormones. When embedded within a collagen gel, the vesicles reversed their epithelial polarity and formed branching, pseudoglandular structures. It was concluded that the three-dimensional shape of the epithelial vesicles had a critical role to play in their morphological stability, nutrient requirement, and hormone sensitivity.

Endometrial stromal cells in culture: an attempt to understand the genesis and biologic activity of uterine sarcomas

The genesis of uterine sarcomas in vivo has been difficult to elucidate. The reasons are multifactorial and are compounded by the rarity of these tumors. In an effort to understand the biologic activity of this disease, normal endometrial tissue was subjected to tissue culture, histochemical study, and hormonal manipulation. Protein markers were used to differentiate endometrial epithelium from endometrial stromal cells in culture. The endometrial stromal cells grew rapidly following subculturing and were responsive to hormonal manipulation. When the stromal cells in culture were treated with the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), the resultant morphologic changes mimicked uterine sarcomas grown in culture. These changes appeared to occur in a sequential manner, somewhat analogous to changes occurring in the endometrial epithelium as it undergoes transformation to endometrial adenocarcinoma. These studies, therefore, may serve as a model system in understanding the genesis and biologic activity of uterine sarcomas.

Behavior of cultured glandular cells obtained by flushing of the uterine cavity

In 77 of 115 cultures from uterine/tubal flushes performed in women undergoing diagnostic laparoscopy for reasons of infertility, epithelioid colonies of "tadpole-like" cells appeared. In cultured jet washings from the uterine cavities in women with ligated tubes, the same tadpole-like cells are present. These cells are also observed in vitro in laparoscopic biopsy specimens of active endometriosis nodules. Judged by the presence of cytokeratin in these cells, demonstrated by polyvalent or monoclonal antikeratin antibodies (the latter as a marker for glandular epithelia), there can be no doubt about their origin from the lining and glandular epithelium of part of the genital tract. Peritoneal washings not preceded by uterine/tubal flushing never contained the tadpole-like cells in culture. True epithelial cells were observed in the peritoneal cavity after flushing, and the proliferative capacity of these cells in vitro during the preovulatory phase was proven.

Pattern of steroid interaction with inducers of aryl hydrocarbon hydroxylase activity in several cloned estradiol-responsive stromal cell strains from mouse endometrium

Several steroid responsive stromal cell strains were isolated from normal mouse endometrium. Both estrogen responsive and progesterone responsive strains were obtained. The estrogen responsive cells were also responsive to diethylstilbestrol (DES). The progesterone responsive strains were inhibited by estrone and estriol. One of the estrogen responsive cell strains, E041, was cloned in the presence and absence of 17-beta-estradiol (E2). Of 14 clones developed in the absence of E2 and screened for responsivity of growth, six were significantly responsive to E2. Six of 26 clones developed in the presence of E2 were responsive to E2. Microsomes isolated from these clones were shown to have aryl hydrocarbon hydroxylase (AHH) activity which was inducible with either benzanthracene (BA) or 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD). The basal levels of AHH activity were significantly reduced by E2 in E2 responsive clones. The TCDD induced levels of AHH activity in the E2 responsive and E2 non-responsive clones were significantly reduced by E2. The BA induced levels of AHH were significantly increased by E2 in one of the clones. These results show that mouse endometrial stroma consists of a number of populations of cells with different specific proliferative and metabolic responses to steroids.

Establishment and morphologic characterization of normal human endometrium in vitro

Tissue culture offers a model system with which to study the endocrine-mediated growth, differentiation, and metabolic activities of the endometrium. We have established and continue to maintain monolayer cultures of normal human endometrial epithelial cells from each phase of the menstrual cycle. At present, eight proliferative, two secretory, and two menstrual phase cultures have been established. These have been passed at least three times. One proliferative phase culture has been growing for 18 mo, and passed 10 times. Colonies of epithelioid cells as well as single cells appear in the cultures within 2 to 8 h of initial culture and maintain this appearance throughout long-term growth. The cells are periodic acid Schiff positive for carbohydrates and positive for keratin, an immunochemical marker for epithelial tissues. Studies comparing the ultrastructure of the cultures with fresh endometrial tissue revealed morphologic features common to both, including prominent nucleoli, Golgi, mitochondria-rough endoplasmic reticulum complexes, and abundant glycogen. The cells are not tumorigenic in the nude mouse and do not form colonies on soft agarose, confirming the nonneoplastic identity of the cells.

Histochemical identification of cultured cells from human endometrium

Histochemical techniques have been applied to the identification of cell types cultured from human endometrium. Previous work from this laboratory characterized two principal cell types found in cultures of endometrium: a mature epithelial cell and another cell which was classified as the endometrial stromal cell based on light and electron microscopy. In this report we compare the histochemical staining of endometrial tissue in frozen sections to that of cultured cells. These results confirm the epithelial and stromal nature of the respective cell types. Several markers were found that could distinguish between cells of epithelial and stromal origin. The enzymes alkaline phosphatase, gamma-glutamyltranspeptidase, peroxidase, and beta-glucuronidase were localized in glandular and surface epithelia in frozen sections and in colonies of epithelial cells in culture. Stroma in frozen sections and cultured stromal cells contained leucine aminopeptidase and fibronectin. Epithelia in sections and in culture could also be distinguished from cells of stromal origin by preferential binding of lotus and peanut lectin. Several other markers were found in both endometrial epithelium and stroma.

Enhancement by TPA of phenotypes associated with transformation in carcinogen-treated human cells: evidence for a selective mechanism

The tumor promoter 12-O-tetradecanoylphorbol 13-acetate (TPA) was found to increase the incidence of phenotypic alterations induced by the direct-acting carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in human endometrial stromal cells. Following carcinogen treatment, changes in saturation density, gamma-glutamyltranspeptidase expression, morphology, and growth in selective media were enhanced in cell cultures subjected to continuous TPA exposure as compared to cultures receiving ethanol vehicle. This enhancement may have resulted, at least in part, from selection of cells altered by carcinogen, as evidenced by differences in the colony-forming abilities of MNNG-treated and control cultures after prolonged TPA exposure, and by differences in morphologic response to TPA challenge in these two populations.

Morphology and growth potential of stromal cell cultures derived from human endometrium

Propagable cell cultures derived from human endometrial tissue were determined to contain cells predominantly of stromal cell origin based on their morphologic resemblance to endometrial stromal cells. These features included nexi, solitary cilia, and predecidual cytology. In addition to morphology the cell cultures retained a normal karyotype and responded to steroid hormones as evidenced by cellular aggregation. The stromal cells were evaluated for a variety of characteristics associated with transformed cells and seemed to be biologically normal without neoplastic phenotypes. Growth potential of the stromal cell cultures was also characterized in normal maintenance medium, in nutritionally depleted medium with reduced levels of calcium or serum, and in medium with increased levels of serum. The prolonged survival of the stromal cells in vitro coupled with the retention of in vivo characteristics and an absence of neoplastic phenotype provides a human cell system that is amenable to a variety of long-term experimental analyses.