Matrix metalloproteinases 3 polymorphism increases the risk of developing advanced endometriosis and infertility: A case-control study

Investigation of biomarkers in Endometriosis-associated infertility: Systematic Review

The relationship between endometriosis and infertility is still unknown, but it is possible that genetic polymorphisms influence these two variables. This study aims to identify, in the literature, which polymorphisms are related to infertility in women with endometriosis. A search was performed in databases using the descriptors: polymorphisms genetics and infertility and endometriosis. 386 articles were identified, and after applying the inclusion and exclusion criteria, 33 case-control studies were included. Genes and their respective polymorphisms, which exhibited statistically significant values, were classified into three categories: related to metabolic/cellular processes, steroidogenesis and sex hormone receptors, inflammation and immune response. In summary, the results of these studies suggest that the polymorphisms rs882605 of MUC4 gene, rs16826658 of WNT4 gene, rs10953316 of MUC17 gene, rs10928050 of KAZN gene, rs1799889 of PAI-1 gene, (TA)n repeats of ESR1 gene, (CA)n repeats of ESR2 gene, rs605059 of HSD17B1 gene, rs743572 of CYP17A1 gene, insLQ of LHR gene, p.Ile49Ser of AMH gene, rs12700667 of NPVF/NFE2L3 gene, G1502A of LHβ gene, G + 1730A of ERβ gene, rs7528684 of FCRL3 gene, rs3761549 of FOXP3 gene and rs28362491 of NFKβ1 gene are implicated in the etiology of infertility in women with endometriosis.

Altered differentiation of endometrial mesenchymal stromal fibroblasts is associated with endometriosis susceptibility

Cellular development is tightly regulated as mature cells with aberrant functions may initiate pathogenic processes. The endometrium is a highly regenerative tissue, shedding and regenerating each month. Endometrial stromal fibroblasts are regenerated each cycle from mesenchymal stem cells and play a pivotal role in endometriosis, a disease characterised by endometrial cells that grow outside the uterus. Why the cells of some women are more capable of developing into endometriosis lesions is not clear. Using isolated, purified and cultured endometrial cells of mesenchymal origin from 19 women with (n = 10) and without (n = 9) endometriosis we analysed the transcriptome of 33,758 individual cells and compared these to clinical characteristics and in vitro growth profiles. We show purified mesenchymal cell cultures include a mix of mesenchymal stem cells and two endometrial stromal fibroblast subtypes with distinct transcriptomic signatures indicative of varied progression through the differentiation processes. The fibroblast subgroup characterised by incomplete differentiation was predominantly (81%) derived from women with endometriosis and exhibited an altered in vitro growth profile. These results uncover an inherent difference in endometrial cells of women with endometriosis and highlight the relevance of cellular differentiation and its potential to contribute to disease susceptibility.

Comparing single cell transcriptome data to clinical characteristics and in vitro growth profiles uncovers a potential role for divergent mesenchymal-derived stromal fibroblast maturation in endometriosis susceptibility.

Whole-exome sequencing and functional validation reveals a rare missense variant in MMP7 confers ovarian endometriosis risk

Prior studies have shown that genetic factors play important roles in ovarian endometriosis. Herein, we first analyzed the WES data from 158 patients with ovarian endometriosis and 385 local control women without endometriosis. Among which, a rare missense variant in the MMP7 (p.I79T, rs150338402) gene exhibited significant frequency difference. This rare variant was screened in an additional 1176 patients and 600 control women via direct DNA sequencing. Meanwhile, a total of 38 available clinical characteristics were collected. Our results showed 45 out of 1334 (3.37%) patients, while 15 out of 985 control women (1.52%) (P = 0.0076) harbored this rare variant, respectively. This rare variant was associated with clinical features such as follicle stimulating hormone (FSH, Padj = 0.0342), luteinizing hormone (LH, Padj = 0.0038), progesterone (PROG, Padj = 1.4e-7), testosterone (TESTO, Padj = 0.0923), total bilirubin (TBIL, Padj = 0.0699), carcinoembryonic antigen (CEA, Padj = 0.0665), and squamous cell carcinoma antigen (SCC, Padj = 0.0817), respectively. Functional assays showed this rare variant could promote cell migration, invasion, epithelial-mesenchymal transition (EMT), and increase the proteolytic protein activity of MMP7, implicating that the increased capacities of cell invasion, migration, and EMT might be mediated by enhanced proteolytic activity of MMP7 mutant. These results showed the MMP7 rare missense variant (p.I79T) played important roles in the pathogenesis of ovarian endometriosis. In conclusion, we identified for the first time, a significantly enriched MMP7 rare variant in ovarian endometriosis; this rare variant was closely associated with certain clinical features in ovarian endometriosis, thus, it could be a promising early diagnostic biomarker for this disease.

Investigating the association of matrix metalloproteinase-2 gene variants with endometriosis in an Iranian population

OBJECTIVES

matrix metalloproteinases including matrix metalloproteinase-2 play a key role in endometrial extra cellular matrix breakdown in endometriosis. Aberrant expression of matrix metalloproteinase-2 has been reported in eutopic and ectopic endometrial tissue of endometriosis patients so altered expression of matrix metalloproteinase-2 due to polymorphisms may lead to establishment and progression of endometriosis. In this study the association between -735 C/T (rs2285053) and -1575 G/A (rs243866) variants of matrix metalloproteinase-2 gene with presence of endometriosis in an Iranian population were investigated for the first time.

STUDY DESIGN

A case-control association study was conducted to investigate the role of MMP-2-735 C/T and _1575 G/A variants in development of endometriosis. Polymerase chain reaction-restriction fragment length polymorphism method was used to determine genotype frequencies of these variants in 100 endometriosis patients and 200 normal samples. Total genomic DNA was extracted from blood samples and single-nucleotide polymorphism flanking regions were amplified using designed specific primers. Enzymatic digestion was performed using Pag I and Hinf I restriction enzymes for rs2285053 and rs243866 variants, respectively. Statistical analysis was ascertained using statistical package for social science version 16 and "SHEsis" software.

RESULTS

There were no significant differences in genotype frequencies of rs2285035 (-735C/T) variant between case and control groups (CC + CT vs. TT p = 0.40; OR = 0.50, 95 % CI 0.100-2.551). There were also no significant differences for C allele frequencies in both case and control groups (p = 0.9). For variant rs243866 (-1575 G/A) the differences in genotype frequencies between case and controls group were determined to be significant (GG + GA vs. AA p = 0.041; OR = 6.46, 95 % CI 0.82-50.43). The frequency of G allele was significantly different in case and control groups (p = 0.037).

CONCLUSION

In conclusion, existence of rs243866 variant in promoter region of matrix metalloproteinase-2 gene can increase the risk of endometriosis in Iranian women.

ADAMS-1 and ADAMS-9, novel markers in endometriosis

Objectives:

ADAMTS (A Disintegrin And Metalloproteinase with ThromboSpondin repeats) proteinases, which are released outside the cell (soluble) have very critical roles in damage and repair of extracellular matrix (ECM) processes. Our aim was to analyse the ADAMTS-1 and ADAMTS-9 which were the member of the ADAMTS gene family of metalloproteinases that might had been involved in the cytokines-mediated etiopathogenesis of endometriosis.

Methods:

A case-control study was performed in an university hospital. Thirty-four patient with endometriosis which was defined via laparoscopy and thirty-three healthy female volunteers were recruited in the present study. Serum ADAMTS-1 and ADAMTS-9 and IL-beta (IL-1 β) and vascular endothelial growth factor (VEGF) levels were determined by a human enzyme-linked immunoassay (ELISA) in all subjects.

Results:

The demographic characteristics of the patients were significantly higher than healthy control group. The IL-1 β and VEGF levels were significantly higher; ADAMTS-1 and ADAMTS-9 levels were significantly lower in the endometriosis patients compared to the controls. We also found a negative correlation between ADAMTS-1, ADAMTS-9, and IL-1 β, VEGF.

Conclusion:

The results of the study might suggest that ADAMS-1 and ADAMTS-9 have a role in the pathogenesis of the endometriosis.

The -1195A>G polymorphism in Ciclooxygenase-2 gene is associated with lower risk of endometriosis

OBJECTIVES

This study aimed to evaluate the potential role of the PTGS2 single nucleotide polymorphisms (SNPs) -1195 A>G and +8473 T>C in endometriosis' development, and characterizing their association with the prognostic features of the disease.

STUDY DESIGN

DNA from 254 women with endometriosis and 267 controls, recruited from two reference hospitals from the Brazilian public health system, were genotyped using TaqMan allelic discrimination assays. The association between SNPs and endometriosis features was evaluated by multivariate logistic regression, using the adjusted odds ratios (OR) with their respective 95% confidence intervals (95% CI).

RESULTS AND CONCLUSION

There were significant differences between cases and controls regarding age (P < 0.001), body mass index (BMI) (P = 0.001), educational level (P < 0.001), physical activity (P = 0.003), smoking status (P < 0.001), contraception use (P = 0.02), family history of endometriosis (P = 0.002) and all symptoms (P < 0.001). The distribution of -1195 A > G was statistically different between the groups, suggesting a lower risk of developing the disease for the carriers of the -1195 GG genotype (OR = 0.19; 95% CI = 0.04 - 0.93). No differences were found for the +8473 T>C between the two groups and neither in prognostic features of the disease for both PTGS2 SNPs. In conclusion, PTGS2 -1195A>G SNP was negatively associated with development of endometriosis and the two groups were statistically different regarding age, BMI, educational level, physical activity, smoking status, contraception use, history of endometriosis and all endometriosis symptoms.