CD44 variant 6 is involved in the attachment and invasion of endometrial cells to peritoneum

Luoshi Neiyi Prescription inhibits estradiol synthesis and inflammation in endometriosis through the HIF1A/EZH2/SF-1 pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Endometriosis (EMS) is a common gynecological disease that causes dysmenorrhea, chronic pelvic pain and infertility. Luoshi Neiyi Prescription (LSNYP), a traditional Chinese medicine (TCM) formula, is used to relieve EMS in the clinic.

AIMS

This study aimed to examine the active components of LSNYP and the possible mechanism involved in its treatment of EMS.

MATERIALS AND METHODS

Ultrahigh-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS) was used to identify the chemical components of LSNYP. Human primary ectopic endometrial stromal cells (ecESCs) and eutopic endometrial stromal cells (euESCs) were isolated, and the expression levels of hypoxia inducible factor 1A (HIF1A), enhancer of zeste homolog 2 (EZH2) and steroidogenic factor 1 (SF-1) were detected by immunofluorescence and qPCR. Cobalt chloride (CoCl2) was utilized to construct an in vitro hypoxic environment, and lentiviruses were engineered to downregulate HIF1A and EZH2 and upregulate EZH2. Subsequently, the expression levels of HIF1A, EZH2, and SF-1 were measured using qPCR or western blotting. The binding of EZH2 to the SF-1 locus in ESCs was examined via ChIP. Furthermore, the effects of LSNYP on the HIF1A/EZH2/SF-1 pathway were evaluated both in vitro and in vivo.

RESULTS

A total of 185 components were identified in LSNYP. The protein and gene expression levels of HIF1A and SF-1 were increased, whereas those of EZH2 were decreased in ecESCs. After treating euESCs with 50 μmol L-1 CoCl2 for 24 h, cell viability and estradiol (E2) production were enhanced. Hypoxia decreased EZH2 protein expression, while si-HIF1A increased it. SF-1 was increased when EZH2 was downregulated in normal and hypoxic environments, whereas the overexpression of EZH2 led to a decrease in SF-1 expression. ChIP revealed that hypoxia reduced EZH2 binding to the SF-1 locus in euESCs. In vitro, LSNYP-containing serum decreased E2 and prostaglandin E2 (PGE2) production, inhibited cell proliferation and invasion, and reduced the expression of HIF1A, SF-1, steroidogenic acute regulatory protein (StAR), and aromatase cytochrome P450 (P450arom). In vivo, LSNYP suppressed inflammation and adhesion and inhibited the HIF1A/EZH2/SF-1 pathway in endometriotic tissues.

CONCLUSIONS

LSNYP may exert pharmacological effects on EMS by inhibiting E2 synthesis and inflammation through regulation of the HIF1A/EZH2/SF-1 pathway. These results suggest that LSNYP may be a promising candidate for the treatment of EMS.

Proteomics approach to discovering non-invasive diagnostic biomarkers and understanding the pathogenesis of endometriosis: a systematic review and meta-analysis

BACKGROUND

Endometriosis is one of the most common gynaecological diseases, yet it lacks efficient biomarkers for early detection and unravels disease mechanisms. Proteomic profiling has revealed diverse patterns of protein changes in various clinical samples. Integrating and systematically analysing proteomics data can facilitate the development of biomarkers, expediting diagnosis and providing insights for potential clinical and therapeutic applications. Hence, this systematic review and meta-analysis aimed to explore potential non-invasive diagnostic biomarkers in various biological samples and therapeutic targets for endometriosis.

METHODS

Online databases, including Scopus, PubMed, Web of Science, MEDLINE, Embase via Ovid, and Google Scholar, were searched using MeSH terms. Two independent authors screened the articles, extracted the data, and assessed the methodological quality of the included studies. GO and KEGG analyses were performed to identify the pathways that were significantly enriched. Protein‑protein interaction and hub gene selection analyses were also conducted to identify biomarker networks for endometriosis.

RESULTS

Twenty-six observational studies with a total of 2,486 participants were included. A total of 644 differentially expressed proteins (180 upregulated and 464 downregulated) were identified from 9 studies. Proteins in peripheral blood exhibited a sensitivity and specificity of 38-100% and 59-99%, respectively, for detecting endometriosis, while proteins in urine had a sensitivity of 58-91% and specificity of 76-93%. Alpha-1-antitrypsin, albumin, and vitamin D binding proteins were significantly DEPs in both serum and urine. Complement C3 is commonly expressed in serum, menstrual blood, and cervical mucus. Additionally, S100-A8 is commonly expressed in both menstrual blood and cervical mucus. Haptoglobin is commonly detected in both serum and plasma, whereas cathepsin G is found in urine, serum, and plasma. GO and KEGG enrichment analyses revealed that proteoglycans in cancer pathways, which regulate cell-to-cell interactions, modulate the extracellular matrix, and promote the proliferation and invasion of endometrial cells, are commonly enriched in serum and urine.

CONCLUSION

This comprehensive study revealed potential proteomes that were significantly differentially expressed in women with endometriosis utilizing various non-invasive clinical samples. Exploring common differentially expressed proteins in various biological samples provides insights into the diagnosis and pathophysiology of endometriosis, as well as potential clinical and therapeutic applications.

Bone Marrow Mesenchymal Stem Cells (BMSCs) Enhance the In Vitro Activities of Endometrial Cells via Strengthening the Phosphorylation and Activation of Phosphoinositide 3-Kinase (PI3K)

Mancozeb (ethylene bis-dithiocarbamate) is an organometallic fungicide and is widely used in agriculture and is related to women’s spontaneous abortion and menstrual abnormalities. Bone marrow mesenchymal stem cells (BMSCs) can impede endometrial fibrosis via suppressing PI3K pathway, but its effect on the activity of endometrial cells induced by mancozeb/EDU is unclear. This study intends to explore the protective effects of co-culture with BMSCs on endometrial cells after mancozeb/EDU treatment. Endometrial cells were randomized into control group, mancozeb/EDU group (mancozeb/EDU treatment), BMSCs group (cells were co-cultured with BMSCs after mancozeb/EDU treatment), and inhibitor group (treated with PI3K-Akt-mTOR inhibitor) followed by analysis of the expression of PI3K-Akt-mTOR pathway-related proteins, cell viability by MTT and cell invasion and migration by Transwell and scratch test. Mancozeb/EDU treatment significantly inhibited PI3K-Akt-mTOR signals and cell proliferation, increased apoptosis and decreased cell invasion and migration, which were all reversed by co-culture with BMSCs. Additionally, the co-culture with BMSCs modulated the In Vitro viability of endometrial cells by influencing PI3K-Akt-mTOR signal transduction pathway, which can be inverted by PI3K-Akt-mTOR pathway-specific antagonists. In conclusion, BMSCs exerted a protective effect on the In Vitro viability of endometrial cells by manipulating the PI3K/Akt/mTOR signal transduction, which helped to protect endometrial cells from damage caused by mancozeb/ETU treatment.