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Ji W, Hou B, Lin W, Wang L, Zheng W, Li W, Zheng J, Wen X, He P. 3D Bioprinting a human iPSC-derived MSC-loaded scaffold for repair of the uterine endometrium. Acta Biomater 2020; 116:268-284. [PMID: 32911103 DOI: 10.1016/j.actbio.2020.09.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/29/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022]
Abstract
Common events in the clinic, such as uterine curettage or inflammation, may lead to irreversible endometrial damage, often resulting in infertility in women of childbearing age. Currently, tissue engineering has the potential to achieve tissue manipulation, regeneration, and growth, but personalization and precision remain challenges. The application of "3D cell printing" is more in line with the clinical requirements of tissue repair. In this study, a porous grid-type human induced pluripotent stem cell-derived mesenchymal stem cell (hiMSC)-loaded hydrogel scaffold was constructed using a 3D bioprinting device. The 3D-printed hydrogel scaffold provided a permissive in vitro living environment for hiMSCs and significantly increased the survival duration of transplanted hiMSCs when compared with hiMSCs administered locally in vivo. Using an endometrial injury model, we found that hiMSC transplantation can cause early host immune responses (the serological immune response continued for more than 1 month, and the local immune response continued for approximately 1 week). Compared with the sham group, although the regenerative endometrium failed to show full restoration of the normal structure and function of the lining, implantation of the 3D-printed hiMSC-loaded scaffold not only promoted the recovery of the endometrial histomorphology (endometrial tissue and gland regeneration) and the regeneration of endometrial cells (stromal cells and epithelial cells) and endothelial cells but also improved endometrial receptivity functional indicators, namely, pinopode formation and leukemia inhibitory factor and αvβ3 expression, which partly restored the embryo implantation and pregnancy maintenance functions of the injured endometrium. These indicators were significantly better in the 3D-printed hiMSC-loaded scaffold group than in the unrepaired (empty) group, the hiMSCs alone group and the 3D scaffold group, and the empty group showed the worst repair results. Our study confirm that the 3D-printed hiMSC-loaded hydrogel scaffold may be a promising material for endometrial repair.
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Affiliation(s)
- Wanqing Ji
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, 510623, China
| | - Bo Hou
- Departments of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, 510630, China
| | - Weige Lin
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, 510623, China
| | - Linli Wang
- Guangzhou Regenerative Medicine Research Center, Future Homo sapiens Research Institute Co., Ltd., China
| | - Wenhan Zheng
- Departments of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, 510630, China
| | - Weidong Li
- Department of Maternal and Child Health Information, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jie Zheng
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, 510623, China
| | - Xuejun Wen
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA 23220, USA.
| | - Ping He
- Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, 510623, China.
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D’Ippolito S, Di Nicuolo F, Papi M, Castellani R, Palmieri V, Masciullo V, Arena V, Tersigni C, Bernabei M, Pontecorvi A, Scambia G, Di Simone N. Expression of Pinopodes in the Endometrium from Recurrent Pregnancy Loss Women. Role of Thrombomodulin and Ezrin. J Clin Med 2020; 9:E2634. [PMID: 32823767 PMCID: PMC7464296 DOI: 10.3390/jcm9082634] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pinopode expression has been suggested as a marker of endometrial receptivity. METHODS We set up an experimental study comparing endometrial tissue from recurrent pregnancy loss (RPL, n = 30) and fertile control (CTR, n = 20) women in terms of pinopode expression/morphology; expression of thrombomodulin (TM) and ezrin; cytoskeletal organization. Endometrial samples were collected during implantation window and evaluated by scanning electron microscopy, western blot, and immunofluorescence. RESULTS We found that RPL endometrial tissue showed: (i) increased pinopodes density (* p < 0.05); (ii) a reduced diameter of pinopodes (* p < 0.05); (iii) a decreased TM and ezrin expression (p < 0.05). Additionally, confocal images showed a significantly reduced expression of phosphorylated (p)-ezrin, confirming the results obtained through immunoblot analysis. Immunofluorescence staining showed that in CTR samples, junctions between cells are intact and clearly visible, whereas actin filaments appear completely lost in RPL endometrial samples; this suggests that, due to the impaired expression and activity of TM and ezrin, actin does not bind to plasma membrane in order to orchestrate the cytoskeletal actin filaments. CONCLUSIONS Our findings suggest that an impaired expression of TM and expression/activation of ezrin may affect the connection between the TM and actin cytoskeleton, impairing the organization of cytoskeleton and, eventually, the adequate pinopode development.
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Affiliation(s)
- Silvia D’Ippolito
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
| | - Fiorella Di Nicuolo
- Paolo VI International Scientific Institute, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.D.N.); (A.P.)
| | - Massimiliano Papi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (M.P.); (V.P.)
| | - Roberta Castellani
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Valentina Palmieri
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (M.P.); (V.P.)
| | - Valeria Masciullo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
| | - Vincenzo Arena
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
| | - Chiara Tersigni
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
| | - Micaela Bernabei
- Istituto di Anatomia e Istologia Patologica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Alfredo Pontecorvi
- Paolo VI International Scientific Institute, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.D.N.); (A.P.)
- Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy
- Istituto di Patologia Medica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Giovanni Scambia
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Nicoletta Di Simone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00168 Roma, Italy; (V.M.); (V.A.); (C.T.); (G.S.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
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Özatik O, Mungan MT, Dağ I, Musmul A. The effect of sperm activation on pinopod formation in endometrial epithelium. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Progesterone and ovarian stimulation control endometrial pinopode expression before implantation in mice. PATHOPHYSIOLOGY 2012; 19:131-5. [DOI: 10.1016/j.pathophys.2012.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/11/2012] [Indexed: 11/21/2022] Open
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Assessment of rat endometrial pinopodes in normal cycles and following HCG ovarian hyperstimulation with or without progesterone supplementation. ACTA ACUST UNITED AC 2012. [DOI: 10.1097/01.ehx.0000410863.90247.c4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tan O, Ornek T, Fadiel A, Carrick KS, Arici A, Doody K, Carr BR, Naftolin F. Expression and activation of the membrane-cytoskeleton protein ezrin during the normal endometrial cycle. Fertil Steril 2012; 97:192-9.e2. [PMID: 22192140 DOI: 10.1016/j.fertnstert.2011.10.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 10/24/2011] [Accepted: 10/31/2011] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine total ezrin expression (ezrin and phospho-ezrin) through the normal endometrial cycle and to correlate ezrin activation and localization with cytologic changes. DESIGN Experimental laboratory study. SETTING University medical centers. PATIENT(S) Reproductive-age women. INTERVENTION(S) A total of 36 samples of normal early, mid-, and late proliferative- and secretory-phase endometrium were studied for immunoreactive total ezrin (ir-T-ezrin) and phospho-ezrin (ir-p-ezrin) expression by histology, immunohistochemistry, and Western blotting. MAIN OUTCOME MEASURE(S) Total ezrin and phospho-ezrin expressions through the normal endometrial cycle. RESULT(S) Throughout the cycle ir-T-ezrin is present in the epithelium. The intensity and localization of both ir-ezrin and ir-p-ezrin vary greatly throughout the cycle. The main findings include the following: lateral localization of ir-ezrin/ir-p-ezrin in association with membrane specializations; dense staining around secretory vacuoles (secretory phase); dense staining of the apical surfaces, including microvilli and pinopodes of epithelial cells, especially during the mid- to late secretory phases; and the presence of ezrin in the glandular secretions. Immunoreactive total ezrin and ir-p-ezrin were not expressed by stromal fibroblasts. CONCLUSION(S) Ezrin is a prominent protein in the cycling endometrium. The most striking findings were the gravitation of ir-ezrin/ir-p-ezrin to the periphery of secretory vacuoles, localization on apical surfaces of the luminal epithelium, dense ezrin staining in secretory-phase epithelial cell plumes, and the presence of ir-ezrin/ir-p-ezrin in secretory-phase luminal secretions. These findings may have functional implications, especially for implantation biology.
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Affiliation(s)
- Orkun Tan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Quinn C, Casper R. Pinopodes: a questionable role in endometrial receptivity. Hum Reprod Update 2008; 15:229-36. [DOI: 10.1093/humupd/dmn052] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shimizu Y, Kabir-Salmani M, Azadbakht M, Sugihara K, Sakai K, Iwashita M. Expression and localization of galectin-9 in the human uterodome. Endocr J 2008; 55:879-87. [PMID: 18506087 DOI: 10.1507/endocrj.k08e-111] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Galectin-9 has been recently considered as a novel marker for the mid- and late-secretory phases of human endometrium and decidua. The aim of this study was to investigate the subcellular distribution of galectin-9 in the endometrial epithelium, especially during the frame of the implantation window. Endometrial biopsies in the proliferative, early, and mid-secretory phases from women with regular menstrual cycle were studied using several approaches, including scanning electron microscopy, immunostaining for light and transmission electron microscopies (TEM), immunoblotting, and statistical analysis of the area-related numerical densities of galectin-9-bound nanogold. Images of immunostaining for light microscopy demonstrated a strong expression of galectin-9 at the luminal and glandular endometrial epithelium in the mid-secretory phase compared to the proliferative and early secretory phases. Data of immunoblotting revealed a molecular weight of 36 kDa band with high intensity in the mid-secretory samples. Photomicrographs of immunogold staining for TEM illustrated the localization of galectin-9 in the uterodomes. Statistical and morphometric analysis showed a significantly higher area-related numerical density of galectin-9-bound nano-golds in the uterodomes compared to that of the uterodome-free areas of the luminal epithelium (p<0.001). This is the first demonstration of the molecular localization of galectin-9 in the bulbous ultrastructure of the human endometrial epithelium, called uterodomes. High expression of galectin-9 at uterodomes during the frame of implantation window suggests that galectin-9 can be considered as a marker of endometrial receptivity and should play an important role during the initial events of human embryo implantation.
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Affiliation(s)
- Yuji Shimizu
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan
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Oehninger S. Revealing the enigmas of implantation: what is the true impact of ovarian hyperstimulation? Fertil Steril 2008; 89:27-30. [PMID: 17678916 DOI: 10.1016/j.fertnstert.2007.04.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 04/19/2007] [Accepted: 04/20/2007] [Indexed: 11/15/2022]
Abstract
It is agreed that ovarian stimulation results in histopathologic changes and variations in gene expression when compared to natural cycles. However, the enigma is still present: What is the true impact of variable degrees of embryo-endometrium developmental asynchrony in the presence of high clinical embryo implantation rates in IVF? It is postulated that the temporal characterization of gene expression and protein profiles of isolated endometrial compartments might unveil patterns that are critical for the establishment of the window of implantation.
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Affiliation(s)
- Sergio Oehninger
- The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
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Quinn CE, Detmar J, Casper RF. Pinopodes are present in Lif null and Hoxa10 null mice. Fertil Steril 2007; 88:1021-8. [PMID: 17313947 DOI: 10.1016/j.fertnstert.2006.11.157] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 11/27/2006] [Accepted: 11/27/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess pinopode formation in Lif null and Hoxa10 null mice with infertility secondary to failed implantation. DESIGN Controlled animal experiment. SETTING Animal research and laboratory facility. ANIMAL(S) Lif null, Hoxa10 null, and ICR mice and Sprague-Dawley rats. INTERVENTION(S) Endometrial tissue was collected during the peri-implantation period and after ovariectomy. MAIN OUTCOME MEASURE(S) Endometrial epithelial tissue was examined under scanning-electron microscopy and assigned a score depending on the number of pinopodes present. RESULT(S) Pinopode scores in ICR, Lif null, and Hoxa10 null mice were comparable throughout the peri-implantation period, rising on day 3.5 of pregnancy and remaining elevated through to day 7.5, suggesting that pinopodes are not a good indicator of receptivity in mice. In contrast, pinopode scores in rats clearly demarcated the window of receptivity, appearing on day 4 of pregnancy and declining sharply on day 6. Pinopode scores were low in E(2)-treated ovariectomized mice, but unexpectedly, pinopode scores in vehicle-injected ovariectomized ICR mice were markedly elevated. CONCLUSION(S) Lif null and Hoxa10 null mice, in which implantation is impaired, have a similar number of pinopodes to fertile ICR mice. Pinopodes do not define a window of implantation in mice.
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Affiliation(s)
- Claire E Quinn
- Division of Reproductive Sciences, Samuel Lunenfeld Research Institute, and the Fran and Lawrence Bloomberg Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Institute of Medical Sciences, Toronto, Ontario, Canada
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Achache H, Revel A. Endometrial receptivity markers, the journey to successful embryo implantation. Hum Reprod Update 2006; 12:731-46. [PMID: 16982667 DOI: 10.1093/humupd/dml004] [Citation(s) in RCA: 533] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human embryo implantation is a three-stage process (apposition, adhesion and invasion) involving synchronized crosstalk between a receptive endometrium and a functional blastocyst. This ovarian steroid-dependent phenomenon can only take place during the window of implantation, a self-limited period of endometrial receptivity spanning between days 20 and 24 of the menstrual cycle. Implantation involves a complex sequence of signalling events, consisting in the acquisition of adhesion ligands together with the loss of inhibitory components, which are crucial to the establishment of pregnancy. Histological evaluation, now considered to add little clinically significant information, should be replaced by functional assessment of endometrial receptivity. A large number of molecular mediators have been identified to date, including adhesion molecules, cytokines, growth factors, lipids and others. Thus, endometrial biopsy samples can be used to identify molecules associated with uterine receptivity to obtain a better insight into human implantation. In addition, development of functional in vitro systems to study embryo-uterine interactions will lead to better definition of the interactions existing between the molecules involved in this process. The purpose of this review was not only to describe the different players of the implantation process but also to try to portray the relationship between these factors and their timing in the process of uterine receptivity.
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Affiliation(s)
- Hanna Achache
- Department of Obstetrics and Gynecology, Hadassah University Hospital, Jerusalem, Israel
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Stavreus-Evers A, Mandelin E, Koistinen R, Aghajanova L, Aghajnova L, Hovatta O, Seppälä M. Glycodelin is present in pinopodes of receptive-phase human endometrium and is associated with down-regulation of progesterone receptor B. Fertil Steril 2006; 85:1803-11. [PMID: 16759928 DOI: 10.1016/j.fertnstert.2005.12.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Revised: 12/01/2005] [Accepted: 12/01/2005] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To test the hypothesis that glycodelin is localized on pinopodes and correlates with temporal immunostaining of leukemia inhibitory factor (LIF), LIF receptor (LIFR), and progesterone receptor B (PRB). DESIGN Prospective clinical study. SETTING Hospital-based reproductive health unit and research laboratories. PATIENT(S) Twenty-five healthy fertile women with normal menstrual cycles. INTERVENTION(S) Endometrial biopsy specimens were obtained from healthy fertile women in the luteal phase of the menstrual cycle. MAIN OUTCOME MEASURE(S) Immunohistochemical staining of glycodelin, ultrastructural immunostaining of glycodelin, and double staining of glycodelin and PRB. RESULT(S) Glycodelin is present in the glands when pinopodes appear. Glycodelin is localized on pinopodes but is also secreted from luminal epithelial cells regardless of pinopode formation. There was a negative correlation between glycodelin secretion from the glands and PRB staining. A weak correlation between the presence of LIFR (but not LIF) and glycodelin was found. CONCLUSION(S) Pinopode appearance, intense staining of LIFR in pinopodes and glycodelin staining in the glands are synchronized events. Down-regulation of PRB in the endometrium is concomitant with the presence of glycodelin in the endometrium, suggesting interaction.
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Affiliation(s)
- Anneli Stavreus-Evers
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
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Ordi J, Creus M, Casamitjana R, Cardesa A, Vanrell JA, Balasch J. Endometrial pinopode and alphavbeta3 integrin expression is not impaired in infertile patients with endometriosis. J Assist Reprod Genet 2003; 20:465-73. [PMID: 14714826 PMCID: PMC3455642 DOI: 10.1023/b:jarg.0000006709.61216.6f] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To investigate endometrial receptivity in terms of pinopode formation and alphavbeta3 integrin expression in infertile women with endometriosis during natural cycles. METHODS We investigated the expression of alphavbeta3 integrin and pinopode formation in the endometrium of 12 infertile patients with stage I or II endometriosis as the only cause of infertility, 12 infertile patients having unexplained infertility, and 12 fertile women who were undergoing tubal sterilization. Two endometrial biopsies (postovulatory day +7 to +8 and 4 days later) were performed during a single menstrual cycle in each subject. RESULTS No statistically significant difference regarding alphavbeta3 integrin expression and pinopode formation was found between infertile patients with endometriosis and the two control groups. CONCLUSION alphavbeta3 integrin expression and pinopode formation are not reduced during the window of implantation in patients with stage I-II endometriosis. Whether these results imply normal endometrial receptivity in such patients or add to the increasing uncertainty about the clinical value of assessing the endometrium with those markers of implantation, warrants further studies.
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Affiliation(s)
- Jaume Ordi
- Department of Pathology, Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Montserrat Creus
- Institut Clinic of Gynaecology, Obstetrics and Neonatology, Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Roser Casamitjana
- Hormonal Laboratory Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonio Cardesa
- Department of Pathology, Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan A. Vanrell
- Institut Clinic of Gynaecology, Obstetrics and Neonatology, Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Balasch
- Institut Clinic of Gynaecology, Obstetrics and Neonatology, Faculty of Medicine—University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Usadi RS, Murray MJ, Bagnell RC, Fritz MA, Kowalik AI, Meyer WR, Lessey BA. Temporal and morphologic characteristics of pinopod expression across the secretory phase of the endometrial cycle in normally cycling women with proven fertility. Fertil Steril 2003; 79:970-4. [PMID: 12749439 DOI: 10.1016/s0015-0282(02)04929-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the temporal and morphologic characteristics of pinopod expression on the surface of endometrium across the secretory phase, in LH-timed endometrial samples in normal, healthy women. DESIGN Prospective, randomized study. SETTING Academic teaching hospital. PATIENT(S) Sixty-eight healthy volunteers with proven fertility. INTERVENTION(S) Urinary LH-timed endometrial and blood sampling was performed on each subject on a randomly selected day of the secretory phase. MAIN OUTCOME MEASURE(S) Histologic dating, assessment of pinopods using scanning electron microscopy, and comparison with serum P levels. RESULT(S) Eighty-six endometrial tissue samples obtained from 68 subjects were evaluated under scanning electron microscopy. Pinopods were first observed on luteal day 5, corresponding with the onset of the midluteal phase increase in serum P levels. Pinopods persisted for the entire duration of the secretory phase, but their morphology changed as the cycle advanced. CONCLUSION(S) The present findings demonstrate that pinopods are a characteristic feature of the mid to late secretory phase endometrial epithelium, exhibit cycle-dependent changes in morphology, and are most prominent during the putative implantation interval.
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Affiliation(s)
- Rebecca S Usadi
- University of North Carolina, Department of Obstetrics and Gynecology, Chapel Hill, North Carolina, USA
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Nikas G, Aghajanova L. Endometrial pinopodes: some more understanding on human implantation? Reprod Biomed Online 2003; 4 Suppl 3:18-23. [PMID: 12470560 DOI: 10.1016/s1472-6483(12)60111-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Endometrial receptivity is a prerequisite for blastocyst implantation. During receptivity, the hairy-like epithelial cell microvilli transiently fuse to a single flower-like membrane projection called the 'pinopode'. Scanning electron microscopy in sequential endometrial biopsies shows that pinopodes appear about 1 week after ovulation, and they develop and regress within just 2 days. Interestingly, the cycle days when pinopodes appear can vary by up to 5 days between different individuals. On average, they occur on days 20-21 in natural cycles and earlier (days 19-20) in stimulated cycles. The abundance of pinopodes relates to implantation success and many patients with multiple implantation failures fail to produce pinopodes. Based on these findings, biopsies from candidate embryo recipients have been examined in mock cycles and pinopode numbers and timing of their appearance assessed. A similar cycle follows where embryos are replaced earlier or later, according to the reported timing of pinopode formation. If pinopodes are absent, the cycle can be modified. Accumulating evidence supports their clinical use as a marker to assess endometrial receptivity. Pinopode appearance, loss of steroid receptors and maximal expression of a(v)b(3) integrin, osteopontin and leukaemia inhibitory factor and receptor have been demonstrated in the same biopsy, showing a consistent association of pinopode appearance and other receptivity changes.
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Affiliation(s)
- George Nikas
- Second Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens, Greece.
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