Progesterone-associated proteins PP12 and PP14 in the human endometrium

Tissue-engineered multi-cellular models of the uterine wall

The human uterus is composed of three layers: endometrium, myometrium and perimetrium. It remodels during the monthly menstrual cycle and more significantly during the complex stages of reproduction. In vivo studies of the human uterine wall are yet incomplete due to ethical and technical limitations. The objective of this study was to develop in vitro uterine wall models that mimic the in vivo structure in humans. We co-cultured multiple cellular models of endometrial epithelial cells, endometrial stromal cells and smooth muscle cells on a synthetic membrane mounted in multi-purpose custom-designed wells. Immunofluorescence staining and confocal imaging confirmed that the new model represents the in vivo anatomical architecture of the inner uterine wall. Hormonal treatment with progesterone and β-estradiol demonstrated increased expression of progestogen-associated endometrial protein, which is associated with the in vivo receptive uterus. The new tissue-engineered in vitro models of the uterine wall will enable deeper investigation of molecular and biomechanical aspects of the blastocyst-uterus interaction during the window of implantation.

Endometrial receptivity in the eutopic endometrium of women with endometriosis: it is affected, and let me show you why

The endometrium maintains complex controls on proliferation and apoptosis as part of repetitive menstrual cycles that prepare the endometrium for the window of implantation and pregnancy. The reliance on inflammatory mechanisms for both implantation and menstruation creates the opportunity in the setting of endometriosis for establishment of chronic inflammation that is disruptive to endometrial receptivity, causing both infertility and abnormal bleeding. Clinically, there can be little doubt that the endometrium of women with endometriosis is less receptive to embryo implantation, and strong evidence exists to suggest that endometrial changes are associated with decreased cycle fecundity as a result of this disease. Here we provide unifying concepts regarding those changes and how they are coordinated to promote progesterone resistance and estrogen dominance through aberrant cell signaling pathways and reduced expression of key homeostatic proteins in eutopic endometrium of women with endometriosis.

Glycodelin: A New Biomarker with Immunomodulatory Functions in Non-Small Cell Lung Cancer

PURPOSE

In recent years, immune therapeutic strategies against non-small cell lung cancer (NSCLC) based on tissue-derived biomarkers, for example PD1/PD-L1 (CD274), have evolved as novel and promising treatment options. However, the crosstalk between tumor and immune cells is poorly understood. Glycodelin (gene name PAEP), initially described in the context of pregnancy and trophoblastic implantation, is a secreted immunosuppressive glycoprotein with an as-of-yet largely unknown function in lung cancer.

EXPERIMENTAL DESIGN

In this study, we characterized the expression and role of glycodelin in NSCLC through mRNA and protein expression analyses, functional knockdown experiments, and correlations with clinicopathologic parameters.

RESULTS

Glycodelin mRNA expression was significantly elevated in tumors (n = 336) compared with matched normal tissue (P < 0.0001). Overall survival (OS) was significantly reduced in NSCLC with high glycodelin mRNA levels in women but not in men. Glycodelin was detected in the sera of patients, and the levels correlated with recurrence and metastatic disease. Knockdown of glycodelin with siRNAs in NSCLC cell lines resulted in significant upregulation of immune system modulatory factors such as PDL1, CXCL5, CXCL16, MICA/B, and CD83 as well as proliferation stimulators EDN1 and HBEGF. Furthermore, decreased migration of tumor cells was observed.

CONCLUSIONS

Altogether, the comprehensive characterization of glycodelin in NSCLC provides strong support for its use as a biomarker with immune modulatory function.

Potential influence of the microbiome on infertility and assisted reproductive technology

Although an altered vaginal microbiota has been demonstrated to affect parturition, its role in assisted reproductive technologies is uncertain. Nevertheless, the effect of known pathogens such as Mycoplasma tuberculosis, Chlamydia trachomatis, and Neisseria gonorrhoeae is clear, causing subclinical changes thought to be risk factors in subfertility. The Human Microbiome Project (HMP) has allowed for metagenomic studies to aid in characterizing normal vaginal flora. Recent findings from the HMP demonstrate that many different species of Lactobacillus are present in the vaginal tract, with a few that predominate. Studies that characterize the vaginal microbiome in assisted reproductive technology support the hypothesis that colonizing the transfer-catheter tip with Lactobacillus crispatus at the time of embryo transfer may increase the rates of implantation and live birth rate while decreasing the rate of infection. In addition, there is some evidence that a progesterone-resistant endometrium might increase the risk of an abnormal vaginal microbiome.

High throughput, cell type-specific analysis of key proteins in human endometrial biopsies of women from fertile and infertile couples

BACKGROUND

Although histological dating of endometrial biopsies provides little help for prediction or diagnosis of infertility, analysis of individual endometrial proteins, proteomic profiling and transcriptome analysis have suggested several biomarkers with altered expression arising from intrinsic abnormalities, inadequate stimulation by or in response to gonadal steroids or altered function due to systemic disorders. The objective of this study was to delineate the developmental dynamics of potentially important proteins in the secretory phase of the menstrual cycle, utilizing a collection of endometrial biopsies from women of fertile (n = 89) and infertile (n = 89) couples.

METHODS AND RESULTS

Progesterone receptor-B (PGR-B), leukemia inhibitory factor, glycodelin/progestagen-associated endometrial protein (PAEP), homeobox A10, heparin-binding EGF-like growth factor, calcitonin and chemokine ligand 14 (CXCL14) were measured using a high-throughput, quantitative immunohistochemical method. Significant cyclic and tissue-specific regulation was documented for each protein, as well as their dysregulation in women of infertile couples. Infertile patients demonstrated a delay early in the secretory phase in the decline of PGR-B (P < 0.05) and premature mid-secretory increases in PAEP (P < 0.05) and CXCL14 (P < 0.05), suggesting that the implantation interval could be closing early. Correlation analysis identified potential interactions among certain proteins that were disrupted by infertility.

CONCLUSIONS

This approach overcomes the limitations of a small sample number. Protein expression and localization provided important insights into the potential roles of these proteins in normal and pathological development of the endometrium that is not attainable from transcriptome analysis, establishing a basis for biomarker, diagnostic and targeted drug development for women with infertility.

Changes in T-plastin expression with human trophoblast differentiation

During the first trimester of pregnancy, the human placenta is an actively dividing and highly invasive tumour-like tissue, while near term, it represents a fully developed, non-invasive unit. In order to understand the molecular basis of this marked difference in the placental phenotypes, an approach based on a differential display-reverse transcription-polymerase chain reaction (DD-RT-PCR) was adopted to analyse changes in gene expression, using total RNA isolated from first-trimester and term placental villi. Using this approach, T-plastin was initially identified as being differentially expressed in the human first-trimester placenta. T-plastin is an actin-bundling protein and is known to be highly expressed in actively dividing cells and up-regulated in several carcinomas. Using a homogenous population of cytotrophoblasts and syncytiotrophoblasts isolated from human placentae, the present authors demonstrate the differential expression of T-plastin in cytotrophoblasts compared with the terminally differentiated syncytiotrophoblasts. The down-regulation of T-plastin expression is further demonstrated in human trophoblastic BeWo cells induced to differentiate using transforming growth factor (TGF)beta1, a growth factor known for its anti-proliferative and anti-invasive response in placental cells. These studies suggest that expression of T-plastin in the placental context may indeed be associated with the enhanced replicative potential of placental trophoblasts.

Placental protein 14 concentrations in circulation related to hormonal parameters and reproductive outcome in women undergoing IVF/ICSI

Serum concentrations of placental protein 14 (PP14), steroids and gonadotrophins were related to the outcome of IVF/intracytoplasmic sperm injection in 195 normogonadotrophic women subjected to the long protocol gonadotrophin-releasing hormone agonist (GnRHa; buserelin) pituitary down-regulation protocol and gonadotrophin stimulation (HMG or rFSH). Pituitary down-regulation was initiated on cycle day 21 and the patients were randomized to either intranasal or s.c. administration of buserelin. After 14 days of down-regulation, the patients were randomized on stimulation day 1 (S1) to ovarian stimulation with 225 IU per day of either human menopausal gonadotrophin (HMG) or recombinant FSH (rFSH) for a fixed period of 7 days. The daily gonadotrophin dose was adjusted on the following day according to ovarian response. Patient's blood was sampled for PP14 and hormone analysis on cycle days 21, S1, S8 and on the day of oocyte retrieval. Mean concentrations of PP14 on day 21 of the cycle were significantly lower in conception than in non-conception cycles, whereas progesterone and oestradiol were similar in conception and non-conception cycles. PP14 concentrations on the first day of stimulation and at oocyte retrieval were significantly higher in conception than in non-conception cycles, whereas concentrations after 8 days of stimulation were similar. Neither mode of GnRHa administration nor type of gonadotrophin significantly influenced PP14 concentrations throughout ovarian stimulation. Circulating PP14 is thus an important physiological signal of the fertility status of the individual in the cycle antecedent to and during ovarian stimulation. Measuring mid-luteal serum PP14 may offer a clinical test helping to decide if infertility treatment should be initiated in the subsequent cycle.

Glycodelin serum levels in women with ectopic pregnancy

OBJECTIVE

Aim of our study was to determine circulating levels of glycodelin for biochemical monitoring of women with vaginal bleeding and/or abdominal pain in early pregnancy. The objective was, using glycodelin as a biochemical parameter, to distinguish between incomplete abortion and ectopic pregnancy in early weeks of gestation.

STUDY DESIGN

In 169 women with a first trimester pregnancy, a single serum measurement of maternal glycodelin was taken. Patients were divided into groups according to the clinical and/or ultrasonografic findings at the time of hospitalisation:ectopic pregnancy, incomplete abortion and control.

RESULTS

Glycodelin serum levels were significantly lower in patients with ectopic pregnancy comparable with intact pregnancy and incomplete abortion. There was no difference in serum levels between intact pregnancy and incomplete abortion.

CONCLUSION

Glycodelin might represent a biochemical parameter in the differential diagnosis between ectopic pregnancies and incomplete abortion. The number of patients was too small to give reference ranges for pregnancy weeks.

IGFBP-1 and glycodelin serum levels before and after hysterectomy with and without bilateral oophorectomy in premenopausal women

OBJECTIVES

The aim of our study was to investigate the role of the intact endometrium and ovaries for serum levels of insulin-like growth factor binding protein-1 (IGFBP-1) and glycodelin.

STUDY DESIGN

In 35 premenopausal patients with a planned hysterectomy, serum measurements of IGFBP-1 and glycodelin were done before surgery and 1, 3, 5, and 10 days after surgery. Patients were divided into three groups according to the kind and time of operation: (1) hysterectomy with bilateral adnexectomy in the luteal phase and (2) hysterectomy without adnexectomy in the follicular phase or (3) the luteal phase.

RESULTS

IGFBP-1-we could not show any differences in IGFBP-1 serum levels before and after hysterectomy with or without bilateral oophorectomy. Glycodelin-hysterectomized and oophorectomized patients showed decreasing serum levels up to day 3. After day 5, circulating concentrations of glycodelin increased continuously but remained below pre-operative levels. In both non-adnexectomized groups we saw a reduction up to day 5 but a rise at day 10. None of the results reached statistical significance.

CONCLUSION

The results indicate that endometrium and ovary are not the only sources of IGFBP-1 and glycodelin.

Endometrial receptivity and the window of implantation

Implantation is a highly co-ordinated event that involves both embryonic and endometrial participation. The endometrium expresses a sophisticated repertoire of proteins during the menstrual cycle many of which help to define a period of receptivity collectively known as the 'window of implantation'. Many of these factors, which are temporally aligned with this window, are now seen as chemical messengers that are recognized by the embryo and facilitate embryonic growth and differentiation. The use of such proteins as biomarkers has also advanced our understanding of the implantation process and may identify women with implantation failure and infertility. While the study of endometrial receptivity is still evolving, the field is growing rapidly and will probably enhance our ability to diagnose and treat couples with infertility, especially in the arena of assisted reproductive technologies (ART).

Effects of progestins and relaxin on glycodelin gene expression in human endometrial cells

OBJECTIVE

Glycodelin is an endometrial protein proposed to play an important role in embryonic implantation. We examined the effects of progestins and relaxin on glycodelin transcription, synthesis, and secretion.

STUDY DESIGN

Northern blotting, metabolic labeling, and fluorography were used to assess glycodelin messenger ribonucleic acid and protein synthesis in endometrial tissue and cells. Luciferase reporter constructs transfected into endometrial adenocarcinoma cells (Ishikawa cells) were used to determine whether progestins or relaxin could activate the glycodelin gene promoter.

RESULTS

Progestins but not relaxin stimulated glycodelin secretion in primary epithelial cell cultures. A 452-base pair fragment of the glycodelin gene promoter was activated 4.3 +/- 0.7 times normal by 10-nmol/L promegestone; however, addition of relaxin to the same construct repressed progestin-stimulate promoter activation by >30%.

CONCLUSION

Glycodelin transcription, synthesis, and secretion by endometrial epithelial cells were stimulated by progestins. However, relaxin failed to stimulate production of this immunomodulatory protein and, in fact, repressed progestin-stimulated activation of the glycodelin gene promoter.

Insulin-related growth factor binding protein-1 levels in ovum donation pregnancies

The finding that endometrial maturation may be delayed following hormone replacement therapy has suggested that a generalised endometrial dysfunction may exist in ovum recipients. In order to investigate this suggestion further, circulating levels of IGFBP-1 were measured in samples taken throughout pregnancies conceived either spontaneously or following ovum donation. When analysed at two-weekly intervals, the serum levels of IGFBP-1 in ovum donation pregnancies failed to show the expected peak towards the end of the first trimester and were significantly reduced at week ten (U = 364.5, p = 0.0002) and twelve (U = 138.0, p = 0.0047). For the remainder of pregnancy, circulating IGFBP-1 levels were similar in both groups. The birth weight of children born to the ovum donation group was not significantly different from a normal control group, suggesting that circulating levels of IGFBP-1 in early pregnancy do not reflect local function and that IGFBP-1 does not have an essential function (in relation to birth weight) in early pregnancy.

Immunohistochemical and glycohistochemical localization of the beta-galactoside-binding S-type lectin in human placenta

The localization of the beta-galactoside binding lectin was studied immunohistochemically on acetone-fixed cryostat sections of full-term placental tissue using a biotinylated monoclonal antibody and glycohistochemically applying biotinylated asialofetuin and lactosylated bovine serum albumin. On blots of placental tissue lysates the lectin is recognized by the biotinylated lactosylated bovine serum albumin. The glycoconjugate recognition of the lectin on blots was inhibited in the presence of 0.1 M lactose showing the specificity of the interactions. The anti-lectin monoclonal antibody stained syncytiotrophoblast and trophoblastic cells. Both reagents applied for glycohistochemistry stained syncytiotrophoblast and trophoblastic cells of placental villi and the trophoblastic layer of extraplacental membranes. A strong uniform cytoplasmic staining was characteristic for syncytiotrophoblast and to a lower extent for cytotrophoblastic cells. The localization of the lectin is discussed with respect to a possible immunosuppressive function.

In vitro decidualization of human endometrial stromal cells

Stromal cells isolated from proliferative human endometrium undergo morphologic and biochemical changes when exposed to a mixture of ovarian hormones, acquiring characteristics of decidual cells. In addition to the previously reported progestin-induced secretion of prolactin (PRL) by explants of human proliferative endometrium, and of PRL and laminin by stromal cells in culture, "in vitro" induction of several other decidual cell products was demonstrated in the present study, using cultures of stromal cells isolated from proliferative endometrium. Incubation of stromal cells with a mixture of estradiol, medroxyprogesterone acetate and relaxin, at a concentration reported to yield maximal stimulation of PRL production, resulted in changes from elongated to rounder cells, approx. 90% of which showed immunostaining for PRL under these conditions. Immunocytochemical procedures were carried out on cytospins of decidual cells isolated from decidual tissue adherent to fetal membranes collected at delivery (positive controls), and on stromal cells cultured in Lab-Tek chamber-slides, in the absence (negative controls) or in the presence of added hormones. Antibodies to 24K (a heat-shock protein also named HRP27), desmin (present in intermediate filaments), p29 (a protein associated with the estrogen receptor), and PP12 (an insulin growth factor-1 binding protein), did not react with stromal cells isolated from proliferative endometrium but showed immunostaining of the rounder cells obtained after hormonal treatment when tested with the peroxidase-labeled second antibody complex. In another series of similar experiments, in which the same decidualization end-points were employed, changes in 24K, desmin and PP12 expression were obtained by adding to the insulin-containing medium PRL instead of the hormonal mixture, a finding suggesting sequential steps during the decidualization process.

Growth factors in the uterus: steroidal regulation and biological actions

Rapid progress has been made within the last 5-6 years in characterizing polypeptide growth factors in uterine tissues and fluids. There is convincing evidence that their synthesis and/or secretion is regulated by steroid hormones. The possibility that these growth factors play a central role in growth and development of the uterus or placenta is suggested by the presence of their receptors on uterine or placental cells and their stimulatory effects on these cells in vitro. Since growth factors interact synergistically and also have non-mitogenic functions, the presence of a variety of these factors in the uterus suggests that they probably regulate various aspects of uterine function through complex autocrine and paracine pathways. However, experimental models need to be designed that will permit a more detailed analysis of the actual role of these factors in utero. Fruitful approaches may be to administer neutralizing antibodies or blocking peptides so as to antagonize uterine growth factor action, or to develop appropriate transgenic animals. These and other lines of study should help us to understand the role of growth factors in development of the immature uterus, growth of the placenta or gravid uterus, repair and angiogenesis of the endometrium, and uterine pathology.

Suppression by human placental protein 14 of natural killer cell activity

Human decidua of early pregnancy contains considerable numbers of CD3-CD56+ natural killer (NK) cells. In this study, two major protein products of the decidua, placental protein 14 (PP14) and placental protein 12 (PP12), were tested for the ability to regulate human NK cell activity. In vitro overnight exposure to PP14 of blood lymphocytes or purified large granular lymphocytes (LGL) resulted in suppression of cytotoxicity against K562 target cells in a 4-h 51Cr release assay. The NK inhibition was dependent on concentrations of PP14, being detectable at 5 micrograms/ml and reaching maximum at 50 micrograms/ml. Manifestation of PP14-induced NK suppression required 18-h contact with NK cells. The suppression of NK activity by PP14 was not abolished by indomethacin. In a target binding assay the number of PP14-treated LGL binding to K562 was comparable to that of untreated ones. By contrast with PP14, PP12 produced no effects on NK cells. These results indicate that PP14 suppresses the function of NK cells, which might be involved in prevention of maternal immune rejection of fetus at the fetomaternal interface.

Molecular cloning of complementary DNAs for two human endometrial proteins and cellular localization of their messenger RNAs

Insulin-like growth factor binding protein-1 (IGFBP-1) and a human beta-lactoglobulin homologue (beta LG/PP14) are two major secretory proteins of the human endometrium. The genes coding for these two proteins are expressed in separate types of the endometrial cells, with the IGFBP-1 gene being expressed in the stromal and the beta LG/PP14 gene in the glandular epithelial cells. Although the biological reasons for the presence and expression of IGFBP-1 and beta LG/PP14 in human endometrial cells remain to be elucidated, the fact that these gene products are expressed in different endometrial cell types provides a unique opportunity to employ them as markers in studies on epithelial-to-stromal cell communication in the endometrium. The primary structures of these proteins have been deduced from their cloned cDNAs. beta LG/PP14 is highly homologous to all known beta-lactoglobulins from various species. For example, horse beta-lactoglobulin I monomer exhibits a 53% protein sequence identity with beta LG/PP14; they have the same number of amino acid residues, and their three-dimensional structures are predicted to be similar. This latter conclusion is inferred from the fact that the four cysteinyl residues that are responsible for the formation of intramolecular bridges in beta-lactoglobulins are spatially conserved in beta LG/PP14. The human protein is encoded by a 900-base pair-long mRNA that is expressed in the glandular epithelial cells of the endometrium in a cyclic manner; in addition, it is found in the mucosal epithelial cells of the fallopian tubes. Several lines of circumstantial evidence suggest that the expression of the beta LG/PP14 gene is regulated by progesterone; however, whether this regulation is elicited by the progesterone receptor at the transcriptional level has not so far been demonstrated. The IGFBP-1 protein sequence contains 259 amino acid residues, with the propeptide possessing a 25-amino acid-long signal peptide. The NH2-terminal sequence of this and other IGFBPs is very cysteine-rich, suggesting the possibility that this domain is involved in the binding of IGF-I and IGF-II ligands. A PEST region, a sequence that is found in proteins with short intracellular half-lives, is included in the middle half of the IGFBP-1 polypeptide. Among the IGFBPs, IGFBP-1 appears to be the only one with a PEST sequence. The carboxy-terminal end of IGFBP-1 contains an Arg-Gly-Asp tripeptide that is also found in IGFBP-2 and may function as a cell attachment recognition signal in these proteins.(ABSTRACT TRUNCATED AT 400 WORDS)

Culture of human endometrial cells under polarizing conditions

Glandular epithelial and stromal cells were isolated from human endometrial biopsies and cultured in a dual-chambered system (Millicell; Millipore, Bedford, Ma., USA) that provides access of the medium to both sides of a membrane coated with reconstituted basement membrane material (Matrigel; Collaborative Research Inc., Bedford, Ma., USA). Examination by electron microscopy revealed that the epithelial cells formed a polarized cuboidal-columnar monolayer on the Matrigel surface. The cells exhibited apical microvilli, basal nuclei, and numerous cytoplasmic structures consistent with a well-differentiated cytoplasm; they were joined basally by interdigitating processes and apically by tight junctions and desmosomes. In contrast, epithelial cells cultured in parallel on plastic dishes were flattened, had fewer microvilli and cytoplasmic structures, and no junctional complexes.

Circulating levels of placental protein 14 and progesterone following Mifepristone (RU38486) and Gemeprost for termination of first trimester pregnancy

Ten patients underwent successful termination of first trimester pregnancies with RU38486 (Mifepristone, Roussel Laboratories Ltd., Broadwater Park, Uxbridge, Middlesex, United Kingdom) followed 2 days later by a prostaglandin (Gemeprost, May and Baker Ltd., Dagenham, Essex, United Kingdom) pessary. Four hours after administration of RU38486, the levels of progesterone (P) started to fall and continued to show a gradual decline until the abortion was completed, when a steep fall to follicular phase values was observed. Levels of placental protein 14 remained unaltered until 2 days after RU38486 administration, when levels were increased. The rise in placental protein 14 in association with falling P concentrations suggests that the decidual secretion of placental protein 14 might be independent of P. Fertil Steril 52:66, 1989.