Differential expression of selected gene products in uterine leiomyomata and adenomyosis

The expression of BECN1, LC3B, and BCL2 genes in eutopic endometrium of patients with adenomyosis: A cross-sectional study

Introduction:

Both autophagy and apoptosis play a role in the cyclic remodeling of the endometrium. The abnormal regulation of genes and signaling pathways in the eutopic endometrium plays a role in the abnormal migration and implantation in adenomyosis.

Objective:

The present study investigates the mRNA expression of autophagy and apoptosis-related genes BECN1, LC3B, and BCL2 in the eutopic endometrium of patients with adenomyosis compared with healthy premenopausal women.

Materials and methods:

The present work was a cross-sectional study conducted between July 2018 and April 2019. The participants were 32 premenopausal women who attended the surgery for adenomyosis and other benign gynecological conditions. The participants were divided into two groups, with 16 women in the adenomyosis group and 16 healthy women in the control group. Endometrial tissues were collected during the proliferative menstrual phase for a quantitative real-time polymerase chain reaction.

Results:

The mRNA expression of BECN1, LC3B, and BCL2 were normalized by geometric mean mRNA expression of actin and GAPDH. There was no significant difference in mRNA expression for all three genes when comparing the control and adenomyosis groups.

Conclusions:

The mRNA expressions of autophagy-related genes BECN1 and LC3B and anti-apoptosis-related gene BCL2 were not significantly different in the eutopic endometrium of patients with adenomyosis compared with healthy premenopausal women during the proliferative menstrual phase.

Rapid Effects of Oestrogen on Intracellular Ca2+ in the Uterine Junctional Myometrium of Patients With and Without Adenomyosis in Different Phases of the Menstrual Cycle

We investigated the role of oestrogen receptor 1 (ESR1) in regulating the [Ca²⁺]i concentration in the junctional zone (JZ) and its effect on adenomyosis. JZ smooth muscle cells (JZSMCs) were isolated from 17 control and 24 adenomyotic uteri, and membrane proteins were extracted from the cells. In the control group, the levels of membrane ESR1 and [Ca²⁺]i in the proliferative phase were significantly greater than they were in the secretory phase. While no difference was detected between the two phases, ESR1 and [Ca²⁺]i levels in the adenomyosis group were significantly higher in the proliferative and secretory phases than they were in the control groups. Oestradiol induced a rapid increase in [Ca²⁺]i in the JZSMCs of both groups. When pretreated with the ESR1 antagonist ICI 182,780, the increase in [Ca²⁺]i was clearly reduced in both groups compared with the control, but the differences were not significant. Filtered E-6-BSA also induced [Ca²⁺]i, and its actions were similar to those of oestrogen. Removal of extracellular Ca²⁺ did not alter the effect of oestradiol, but the phospholipase C inhibitor U73122 (10 μM) and 2-aminoethoxydiphenyl borate (5 μM) significantly reduced the oestradiol-induced [Ca²⁺]i flux. Oestradiol was unable to induce a [Ca²⁺]i flux in thapsigargin-depleted cells; this result indicated that oestradiol mediates the [Ca²⁺]i flux in JZSMCs through ESR1, which activates the phospholipase C pathway. ESR1 levels were assessed by Western blotting. Changes in the [Ca²⁺]i concentration induced by oestrogen stimulation were analysed by immunofluorescence. The ΔFCa²⁺ was calculated as the difference between baseline and peak fluorescence response to stimulation. We found that the abnormal intracellular [Ca²⁺]i response to oestrogen could account for aberrant JZ peristalsis.

The Association of Sonographic Evidence of Adenomyosis with Severe Endometriosis and Gene Expression in Eutopic Endometrium

STUDY OBJECTIVE

To examine the presence of sonographic evidence of adenomyosis (SEOA) in patients undergoing laparoscopic surgery for the investigation of endometriosis and to assess if there is an association between SEOA and endometriosis severity. Using gene expression analysis, we also aimed to determine if gene expression in eutopic endometria differed in patients with and without adenomyosis.

DESIGN

A prospective study (Canadian Task Force classification II-2).

SETTING

A tertiary medical center.

PATIENTS

Reproductive-age women who underwent laparoscopic surgery after presenting to a pelvic pain-focused gynecology clinic.

INTERVENTIONS

Endometrial tissue, detailed patient questionnaires, pathology, and surgical notes were collected. Sonographic data from tertiary ultrasounds performed up to 12 months before surgery were retrospectively added (n = 234, researchers blinded to surgical and pathological findings). Gene array data from endometrial biopsies (n = 41) were used to analyze differential gene expression; patients were divided into 2 groups according to the presence or absence of SEOA.

MEASUREMENTS AND MAIN RESULTS

Of the 588 patients recruited, 234 (40%) had an available pelvic scan and were included in this study. The average age of the included women was 30.6 years, with 35% having SEOA. Patients with SEOA were 5.4 years older (p = .02). There was no significant difference in the rates of endometriosis between groups; however, patients with SEOA were more likely to have stage IV endometriosis (41% vs 9.8%, p <.001). Patients with SEOA were also more likely to have other markers of severe endometriosis such as endometriomas and deep infiltrating endometriosis (p <.001). No significant difference was observed in endometrial gene expression between adenomyosis cases and controls after adjusting for menstrual c`ycle phases and the presence/absence of endometriosis.

CONCLUSION

Sonographic features of adenomyosis may be included as a component of the clinical assessment when attempting to predict the presence of severe endometriosis. No differences in gene expression were observed. Further research is needed to characterize uterine adenomyosis and to explore molecular pathways involved in its pathogenesis.