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Menzies FM. Immunology of Pregnancy and Systemic Consequences. Curr Top Microbiol Immunol 2023; 441:253-280. [PMID: 37695432 DOI: 10.1007/978-3-031-35139-6_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Pregnancy is an immunological paradox, with renowned Nobel Prize winning transplantation biologist Sir Peter Brian Medawar being the first to introduce this concept back in 1953. This concept considers how the maternal immune system can tolerate the developing fetus, which is 50% antigenically foreign to the uterus. There have been significant advances in our understanding of the immune system in regulating fertility, pregnancy and in complications of these, and what was once considered a paradox can be seen as a highly evolved system. Indeed, the complexity of the maternal-fetal interface along with our ever-advancing knowledge of immune cells and mediators means that we have a better understanding of these interactions, with gaps still present. This chapter will summarise the key aspects of the role of the immune system at each stage of pregnancy and highlight the recent advances in our knowledge.
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Affiliation(s)
- Fiona M Menzies
- School of Health and Life Sciences, University of the West of Scotland, Lanarkshire, UK.
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2
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Koo HS, Yoon MJ, Hong SH, Ahn J, Cha H, Lee D, Ko JE, Kwon H, Choi DH, Lee KA, Ko JJ, Kang YJ. CXCL12 enhances pregnancy outcome via improvement of endometrial receptivity in mice. Sci Rep 2021; 11:7397. [PMID: 33795831 PMCID: PMC8016928 DOI: 10.1038/s41598-021-86956-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/22/2021] [Indexed: 02/08/2023] Open
Abstract
Successful pregnancy inevitably depends on the implantation of a competent embryo into a receptive endometrium. Although many substances have been suggested to improve the rate of embryo implantation targeting enhancement of endometrial receptivity, currently there rarely are effective evidence-based treatments to prevent or cure this condition. Here we strongly suggest minimally-invasive intra-uterine administration of embryo-secreted chemokine CXCL12 as an effective therapeutic intervention. Chemokine CXCL12 derived from pre- and peri-implanting embryos significantly enhances the rates of embryo attachment and promoted endothelial vessel formation and sprouting in vitro. Consistently, intra-uterine CXCL12 administration in C57BL/6 mice improved endometrial receptivity showing increased integrin β3 and its ligand osteopontin, and induced endometrial angiogenesis displaying increased numbers of vessel formation near the lining of endometrial epithelial layer with higher CD31 and CD34 expression. Furthermore, intra-uterine CXCL12 application dramatically promoted the rates of embryo implantation with no morphologically retarded embryos. Thus, our present study provides a novel evidence that improved uterine endometrial receptivity and enhanced angiogenesis induced by embryo-derived chemokine CXCL12 may aid to develop a minimally-invasive therapeutic strategy for clinical treatment or supplement for the patients with repeated implantation failure with less risk.
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Affiliation(s)
- Hwa Seon Koo
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Min-Ji Yoon
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Seon-Hwa Hong
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Jungho Ahn
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Hwijae Cha
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Danbi Lee
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Ji-Eun Ko
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Hwang Kwon
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Dong Hee Choi
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Kyung-Ah Lee
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Jung-Jae Ko
- Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea
| | - Youn-Jung Kang
- CHA Fertility Center Bundang, CHA University, Seongnam-si, Gyunggi-do, South Korea. .,Department of Biomedical Science, School of Life Science, CHA University, Seongnam-si, Gyunggi-do, South Korea. .,Department of Biochemistry, School of Medicine, CHA University, Seongnam-si, Gyunggi-do, South Korea.
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3
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Zanetti BF, Braga DPDAF, Setti AS, Iaconelli A, Borges E. Effect of GnRH analogues for pituitary suppression on oocyte morphology in repeated ovarian stimulation cycles. JBRA Assist Reprod 2020; 24:24-29. [PMID: 31436072 PMCID: PMC6993161 DOI: 10.5935/1518-0557.20190050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To compare the effect of pituitary suppression regimens on oocyte morphology in consecutive ICSI cycles of the same patients. METHODS Data was obtained from 200 matched consecutive intracytoplasmic sperm injection (ICSI) cycles performed in 100 couples undergoing the first cycle with the GnRH agonist and the following cycle with the GnRH antagonist regimen, from January 2010 to August 2016, in a private university-affiliated IVF centre. The effects of the pituitary suppression type on oocyte morphology were assessed by multivariate General Linear Models. RESULTS Mean interval between cycles was 185.32±192.85 days. Maternal age, body mass index, and total FSH dose administered were similar in both patients' cycles. Antagonist cycles presented lower incidence of dark cytoplasm (0.69±3.28% vs. 4.40±17.70%, p=0.047), Smooth endoplasmic reticulum (SER cluster (4.37±11.62% vs. 7.36±17.17%, p=0.046), and ZP defects (6.05±14.76% vs. 11.84±25.13%, p=0.049). Similar numbers of follicles retrieved oocytes, and mature oocytes were observed between the GnRH groups, as well as the fertilisation rate, number of obtained embryos, high-quality embryo rates, and the clinical outcomes. CONCLUSION GnRH antagonist's inhibitory effect on the ovaries in consecutive ICSI cycles results in improved oocyte maturity and morphology, despite similar laboratory and clinical outcomes, compared to the GnRH agonist treatment.
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Affiliation(s)
- Bianca Ferrarini Zanetti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
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4
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Braga DPDAF, Borges E, Godoy AT, Montani DA, Setti AS, Zanetti BF, Figueira RDCS, Eberlin MN, Lo Turco EG. Lipidomic profile as a noninvasive tool to predict endometrial receptivity. Mol Reprod Dev 2018; 86:145-155. [PMID: 30418697 DOI: 10.1002/mrd.23088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/05/2018] [Indexed: 12/28/2022]
Abstract
For the present study we asked whether the endometrial fluid lipidomic may be a useful approach to predict endometrial receptivity in freeze-all cycles. For this case-control study, endometrial fluid samples were collected from 41 patients undergoing freeze-all cycles. Samples were split depending on the pregnancy outcome: positive group (n = 24) and negative group (n = 17). Data were acquired by the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were applied. A list of potential biomarker ion ratios was obtained and the values were used to build a receiver operating characteristic (ROC) curve to predict pregnancy success. The lipid categories were attributed by LIPID MAPS database. Ion ratios were established according to their correlations and used for the analysis. The PCA showed a tendency of separation between the studied groups, whereas the PLS-DA was able to clearly distinguish them. Fifteen ratios (13 hyper-represented in the negative and two hyper-represented in the positive group) were selected according to their importance for model prediction. These ratios were used to build the ROC curve, which presented an area under curve of 84.0% (95%CI: 69.2-97.4%; p = 0.009). These findings suggest that lipidomic profiling of endometrial fluid may be a valuable tool for identifying the time interval comprising the window of implantation.
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Affiliation(s)
- Daniela Paes de Almeida Ferreira Braga
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil.,Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | - Edson Borges
- Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | - Adriana Teixeira Godoy
- Laboratorio ThoMSon de Espectrometria de Massas, Universidade de Campinas-UNICAMP, Rua Sérgio Buarque de Holanda, S/N - Cidade Universitária, Campinas, Brazil
| | - Daniela Antunes Montani
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | | | | | - Marcos Nogueira Eberlin
- Laboratorio ThoMSon de Espectrometria de Massas, Universidade de Campinas-UNICAMP, Rua Sérgio Buarque de Holanda, S/N - Cidade Universitária, Campinas, Brazil
| | - Edson Guimarães Lo Turco
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil
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5
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Rahimipour M, Salehnia M, Jafarabadi M. Morphological, Ultrastructural, and Molecular Aspects of In Vitro Mouse Embryo Implantation on Human Endometrial Mesenchymal Stromal Cells in The Presence of Steroid Hormones as An Implantation Model. CELL JOURNAL 2018; 20:369-376. [PMID: 29845791 PMCID: PMC6004996 DOI: 10.22074/cellj.2018.5221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/08/2017] [Indexed: 12/04/2022]
Abstract
Objective This experimental study aimed to evaluate the effects of 17β-estradiol (E2) and progesterone (P4) on the interaction
between mouse embryo and human endometrial mesenchymal stromal cells, and gene expressions related to implantation
[αV and β3 integrins, interleukin-1 receptor (IL-1R), and leukemia inhibitory factor receptor (LIFR)] using an in vitro two-
dimensional model.
Materials and Methods In this experimental study, the endometrial stromal cells were isolated enzymatically and
mechanically, and cultured to the fourth passage. Next, their immunophenotype was confirmed by flow cytometric
analysis as mesenchymal stromal cells. The cells were cultured as either the experimental group in the presence of E2
(0.3 nmol) and P4 (63.5 nmol) or control group without any hormone treatment. Mouse blastocysts were co-cultured
with endometrial mesenchymal stromal cells in both groups for 48 hours. Their interaction was assessed under an
inverted microscope and scanning electron microscopy (SEM). Expressions of αV and β3 integrins, LIFR, and IL-1R
genes were analyzed by real-time reverse transcription-polymerase chain reaction (RT-PCR).
Results Similar observations were seen in both groups by light microscopy and SEM. We observed the presence of
pinopode-like structures and cell secretions on the apical surfaces of endometrial mesenchymal stromal cells in both
groups. The trophoblastic cells expanded and interacted with the mesenchymal monolayer cells. At the molecular
level, expression of IL-1R significantly increased in the hormonal treated group compared to the control (P≤0.05).
Expressions of the other genes did not differ.
Conclusion This study has shown that co-culture of endometrial mesenchymal stromal cells with mouse embryo in
media that contained E2 (0.3 nmol) and P4 (63.5 nmol) could effectively increase the expression of IL-1R, which is
involved in embryo implantation. However, there were no significant effects on expressions of αV and β3 integrins,
LIFR, and on the morphology and ultrastructure of endometrial mesenchymal stromal cells.
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Affiliation(s)
- Marzieh Rahimipour
- Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mojdeh Salehnia
- Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mina Jafarabadi
- Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic Address:
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Zanetti BF, Braga DPAF, Provenza RR, Figueira RCS, Iaconelli A, Borges E. Sperm morphological normality under high magnification is correlated to male infertility and predicts embryo development. Andrology 2018; 6:420-427. [PMID: 29457367 DOI: 10.1111/andr.12473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/23/2023]
Abstract
Human sperm morphology has been described as an essential parameter for the diagnosis of male infertility and a prognostic indicator of natural or assisted pregnancies. Nevertheless, standard morphological assessment remains a subjective analysis and its impact on intracytoplasmic sperm injection (ICSI) is also of limited value. The objective of this prospective cohort study was to investigate whether motile sperm organelle morphology examination (MSOME) can improve semen analysis by better defining male infertility and providing a better prognosis for ICSI up to a year later. Data were obtained from 483 patients undergoing conventional semen analysis from June 2015 to June 2017 in a private university-affiliated in vitro fertilization (IVF) center. The correlation of MSOME with seminal parameters was evaluated. One hundred and thirty patients underwent ICSI up to a year later, and the correlation between MSOME and ICSI outcomes was established. Except for volume, all seminal parameters were positively correlated with MSOME I+II. MSOME was also distinct between World Health Organization (WHO) classification groups, with normozoospermic and oligoasthenoteratozoospermic presenting the higher and the lower proportion of MSOME I+II, respectively. MSOME I+II was prognostic for fertilization rate, high-quality cleavage-stage embryos rate, and blastocyst rate. The normality cutoff value based on blastocyst rate was MSOME I+II≥ 5.5%. MSOME could be a useful tool for the diagnosis of infertility severity as it is correlated with sperm morphology, motility, and concentration. Men who had higher MSOME I+II had better ICSI outcomes. The future use of MSOME as a routine method for semen analysis may be a reliable form of assessing male infertility.
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Affiliation(s)
- B F Zanetti
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - D P A F Braga
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | | | | | - A Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - E Borges
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
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Nada AM, El-Noury A, Al-Inany H, Bibars M, Taha T, Salama S, Hassan F, Zein E. Effect of laser-assisted zona thinning, during assisted reproduction, on pregnancy outcome in women with endometriosis: randomized controlled trial. Arch Gynecol Obstet 2018; 297:521-528. [PMID: 29214348 DOI: 10.1007/s00404-017-4604-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the ICSI-ET outcomes in patients with endometriosis with or without laser-assisted zona pellucida thinning. DESIGN Randomized controlled trial. SETTING The study was conducted in the Obstetrics & Gynecology Department, Cairo University hospital, and two private IVF centers in Cairo & Beni-Suif from July 2015 to January 2017 upon infertile and known endometriosis patients who planned to do ICSI-ET. INTERVENTIONS Before randomization, all patients received the same ovarian stimulation preparation, oocyte retrieval procedures, and the same intracytoplasmic sperm injection procedures. After randomization, laser-assisted hatching was performed only for embryos of 158 patients, while the other group (n = 150) no laser-assisted hatching was made. The verification of pregnancy was achieved by the serum hCG concentration 14 days after the embryo transfer, and the clinical pregnancy was confirmed 2 weeks later by the presence of gestational sac with pulsating fetal pole on vaginal ultrasonography. MEASUREMENTS The main outcome measures were the clinical pregnancy rate and the clinical implantation rate. MAIN RESULTS Both groups were comparable with regard their baseline characteristics, baseline hormonal profile, the ovarian stimulation characteristics, and the ovulation characteristics. The mean number of embryos developed per patient and the mean transferred number of embryos per patient were comparable between groups (p value > 0.05). The implantation rate was significantly higher (p value 0.002) in the study group than the control group with an odds ratio of 1.86 (CI 95% 1.24-2.80) and NNT 13.81 (CI 95% 8.35-39.94). The clinical pregnancy rate, was significantly (p value 0.022) higher in the study group than in the control group with an odds ratio of 1.79 (CI 95% 1.05-3.06) and NNT 9.57 (CI 95% 5.03-98.99). CONCLUSION That laser-assisted hatching by thinning of the zona pellucida may be a suitable method to improve the ICSI-ET outcomes, in term of the implantation and the pregnancy rates, in cases of endometriosis. CLINICAL TRIAL REGISTRATION Pan African Clinical Trials Registry (PACTR), http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201502001022393 , PACTR201602001467322.
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Affiliation(s)
- Adel Mohamed Nada
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, 4A/19 Division 3-Zahraa Almaady, 11555, Cairo, Egypt.
| | - Amr El-Noury
- Obstetrics and Gynecology, National Laser Institute (NLI), Cairo University, Cairo, Egypt
| | - Hesham Al-Inany
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, 4A/19 Division 3-Zahraa Almaady, 11555, Cairo, Egypt
| | | | - Tamer Taha
- National Research Center (NRC), Cairo, Egypt
| | | | | | - Eman Zein
- Department of Gynecology and Obstetrics, Faculty of Medicine, BeniSuif University, Beni Suef, Egypt
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8
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Borges E, Zanetti BF, Setti AS, Braga DP, Figueira RDCS, Iaconelli A. FSH dose to stimulate different patient' ages: when less is more. JBRA Assist Reprod 2017; 21:336-342. [PMID: 29105483 PMCID: PMC5714602 DOI: 10.5935/1518-0557.20170058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To determine the effect of FSH doses on intracytoplasmic sperm injection
(ICSI) outcomes according to the age of the patient. Methods Patients undergoing controlled ovarian stimulation (COS) for ICSI cycles in a
university-affiliated in vitro fertilization center were
split into age groups: ≤35 y.o. (n=1523); >35 and ≤38 y.o.
(n=652); >38 and ≤40 y.o. (n=332); and >40 y.o. (n=370). The
effect of FSH dose on COS, laboratorial and clinical outomes was determined
by linear regression models. Results The FSH dose didn't affect the ovarian response in terms of total number of
follicles, retrieved oocytes and mature oocytes within the age groups, but
we found that the lower the age, the lower the FSH dose needed per oocyte
retrieved. In the group of patients ≤35 y.o., we also found a
positive effect of the FSH dose on oocyte yield. Despite that, for patients
≤38 y.o. there was a negative effect of the FSH dose on embryo
quality and blastocyst formation rate, and an increase in the cycle's
cancelation rate. In patients ≥39 y.o., there were no effects of the
FSH doses on the analysed variables. Conclusions Ovarian stimulation with high doses of FSH is not recommended in younger
women (≤38 y.o.), once we found a decrease in embryo quality and an
increase in cycle's cancelation rate. Mild ovarian stimulation protocols may
be more appropriate; however, it may not be applicable for women in advanced
age, since a higher FSH dose is needed for oocyte retrieval in these
patients.
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Affiliation(s)
- Edson Borges
- Fertility - Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Bianca F Zanetti
- Fertility - Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Amanda S Setti
- Fertility - Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Daniela Paf Braga
- Fertility - Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil.,Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo. - UNIFESP
| | | | - Assumpto Iaconelli
- Fertility - Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
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9
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Namlı Kalem M, Akgun N, Kalem Z, Bakirarar B, Celik T. Chemokine (C-C motif) ligand-2 (CCL2) and oxidative stress markers in recurrent pregnancy loss and repeated implantation failure. J Assist Reprod Genet 2017; 34:1501-1506. [PMID: 28707148 DOI: 10.1007/s10815-017-0992-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 06/28/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The main purpose of this study is to evaluate the inflammatory response and oxidative stress together in the cases of recurrent pregnancy loss (RPL) and repeated implantation failure (RIF). METHODS This is a cross-sectional study conducted to compare infertile patients who have RIF and patients with RPL histories in terms of CCL2, TAS, TOS, and OSI. To this end, two study groups were formed by primary-infertile women with RIF history and women with nulliparous RPL history who consulted a university hospital between 2014 and 2016, and a control group was formed by multiparous women who had no pregnancy loss. With 30 women in each group, 90 women in total were included in the study. CCL2, TAS, and TOS blood levels were measured and oxidative stress index was calculated in all participants. RESULTS The patients with RPL and RIF had higher levels of CCL2 than those in the control group. The TOS, TAS, and OSI levels did not differ in RPL and RIF groups from the control group. No statistically significant relationship was found between CCL2 and the TOS, TAS, and OSI values. CONCLUSIONS Oxidative stress markers in the pregestational period did not have a predictive value in the RPL and RIF. CCL2 might be useful in risk prediction.
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Affiliation(s)
- Müberra Namlı Kalem
- Department of Obstetrics and Gynecology, Liv Hospital Ankara, Kavaklıdere, Bestekar sokak No: 8 066680, Çankaya, Ankara, Turkey.
| | - Nilufer Akgun
- Department of Obstetrics and Gynecology, American Hospital, Istanbul, Turkey
| | - Ziya Kalem
- Gurgan Clinic, IVF and Women Health Center, Department of IVF, Ankara, Turkey
| | | | - Tugrul Celik
- Department of Biochemistry, Cankaya Hospital, Ankara, Turkey
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10
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Iaconelli CAR, Setti AS, Braga DPAF, Maldonado LGL, Iaconelli A, Borges E, Aoki T. Concomitant use of FSH and low-dose recombinant hCG during the late follicular phase versus conventional controlled ovarian stimulation for intracytoplasmic sperm injection cycles. HUM FERTIL 2017; 20:285-292. [PMID: 28325095 DOI: 10.1080/14647273.2017.1303197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n = 178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n = 152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group. A significantly higher fertilization rate, high-quality embryo rate and blastocyst formation rate were observed in the low-dose hCG group as compared to the control group. The miscarriage rate was significantly higher in the control group compared to the low-dose hCG group. A significantly lower incidence of OHSS was observed in the low-dose hCG group. There was also a significantly lower gonadotropin cost in the low-dose hCG group as compared to the control group ($1235.0 ± 239.0×$1763.0 ± 405.3, p < 0.001). The concomitant use of low-dose hCG and FSH results in a lower abortion rate and increased number of mature oocytes retrieved, as well as improved oocyte quality, embryo quality and blastocyst formation and reduced FSH requirements.
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Affiliation(s)
- Carla Andrade Rebello Iaconelli
- a Fertility Medical Group, clinical department ; Sao Paulo , SP , Brazil.,b Faculdade de Ciências Médicas da Santa Casa de São Paulo, health sciences department ; Sao Paulo , SP , Brazil
| | - Amanda Souza Setti
- b Faculdade de Ciências Médicas da Santa Casa de São Paulo, health sciences department ; Sao Paulo , SP , Brazil.,c Instituto Sapientiae - Centro de Estudos e Pesquisa em Reproducão Assistida , Sao Paulo , SP , Brazil.,d Fertility Medical Group , scientific department ; Sao Paulo , SP , Brazil
| | - Daniela Paes Almeida Ferreira Braga
- c Instituto Sapientiae - Centro de Estudos e Pesquisa em Reproducão Assistida , Sao Paulo , SP , Brazil.,d Fertility Medical Group , scientific department ; Sao Paulo , SP , Brazil.,e Disciplina de Urologia, Area de Reproducão Humana, Departamento de Cirurgia , Universidade Federal de São Paulo , Sao Paulo , SP , Brazil
| | | | - Assumpto Iaconelli
- a Fertility Medical Group, clinical department ; Sao Paulo , SP , Brazil.,c Instituto Sapientiae - Centro de Estudos e Pesquisa em Reproducão Assistida , Sao Paulo , SP , Brazil.,d Fertility Medical Group , scientific department ; Sao Paulo , SP , Brazil
| | - Edson Borges
- a Fertility Medical Group, clinical department ; Sao Paulo , SP , Brazil.,c Instituto Sapientiae - Centro de Estudos e Pesquisa em Reproducão Assistida , Sao Paulo , SP , Brazil.,d Fertility Medical Group , scientific department ; Sao Paulo , SP , Brazil
| | - Tsutomu Aoki
- b Faculdade de Ciências Médicas da Santa Casa de São Paulo, health sciences department ; Sao Paulo , SP , Brazil
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11
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Borges E, Braga DPAF, Setti AS, Montanni DA, Cabral EC, Eberlin MN, Turco EGL, Iaconelli A. Non-invasive prediction of blastocyst implantation, ongoing pregnancy and live birth, by mass spectrometry lipid fingerprinting. JBRA Assist Reprod 2016; 20:227-231. [PMID: 28050958 PMCID: PMC5265622 DOI: 10.5935/1518-0557.20160044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To identify lipid markers of blastocyst implantation and ongoing pregnancy by
day three culture medium mass spectrometry (MS) fingerprinting. Methods For this study, 33 culture media samples were harvested on day three, from 22
patients undergoing day five embryo transfers. All embryos achieved the
blastocyst stage and were split into groups based on their implantation
(Negative Implantation, n= 14 and Positive Implantation, n= 19). The
positive implantation cycles resulted in successful ongoing pregnancies. The
lipid extraction was performed by the Bligh-Dyer protocol and mass spectra
were obtained with a direct infusion into a Q-Tof mass spectrometer. The
data obtained was analyzed by Principal Component Analysis (PCA) and Partial
Least Square Discrimination Analysis (PLS-DA). The statistical analysis was
performed using the Metabo-Analyst 2.0. Results The variable importance in the projection (VIP) plot of the PLS-DA provided a
list of four ions, in the positive mode, with an area under the curve (AUC)
of 73.5%; and eight ions, in the negative mode, with and AUC of 72.0%. For
both positive and negative modes, possible biomarkers for the negative
implantation were identified by the lipidmaps: phosphoethanolamine,
dicarboxylic acids, glycerophosphoglycerol, glycerophosphocholine,
glicerophosphoinositol, phosphoethanolamine and unsaturated fat acids. The
other ions were not identified. These lipids are involved in the GPI anchor
biosynthesis and synthesis of lycerophospholipids and phosphate
inositol. Conclusion MS fingerprinting is useful to identify blastocysts that fail to implant, and
therefore this technique could be incorporated into the laboratory routine,
adjunct to morphology evaluation to identify embryos that should not be
transferred.
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Affiliation(s)
- Edson Borges
- Fertility Medical Group - São Paulo/SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida - São Paulo/SP - Brazil
| | - Daniela P A F Braga
- Fertility Medical Group - São Paulo/SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida - São Paulo/SP - Brazil.,Disciplina de Urologia, Departamento de Cirurgia, Setor de Reprodução Humana - UNIFESP/SP - Brazil
| | - Amanda Souza Setti
- Fertility Medical Group - São Paulo/SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida - São Paulo/SP - Brazil
| | - Daniela A Montanni
- Disciplina de Urologia, Departamento de Cirurgia, Setor de Reprodução Humana - UNIFESP/SP - Brazil
| | | | - Marcos N Eberlin
- Laboratório ThoMSon de Espectrometria de Massas - Instituto de Química - UNICAMP
| | - Edson G Lo Turco
- Disciplina de Urologia, Departamento de Cirurgia, Setor de Reprodução Humana - UNIFESP/SP - Brazil
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12
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Ramhorst R, Grasso E, Paparini D, Hauk V, Gallino L, Calo G, Vota D, Pérez Leirós C. Decoding the chemokine network that links leukocytes with decidual cells and the trophoblast during early implantation. Cell Adh Migr 2016; 10:197-207. [PMID: 26891097 DOI: 10.1080/19336918.2015.1135285] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Chemokine network is central to the innate and adaptive immunity and entails a variety of proteins and membrane receptors that control physiological processes such as wound healing, angiogenesis, embryo growth and development. During early pregnancy, the chemokine network coordinates not only the recruitment of different leukocyte populations to generate the maternal-placental interface, but also constitutes an additional checkpoint for tissue homeostasis maintenance. The normal switch from a pro-inflammatory to an anti-inflammatory predominant microenvironment characteristic of the post-implantation stage requires redundant immune tolerance circuits triggered by key master regulators. In this review we will focus on the recruitment and conditioning of maternal immune cells to the uterus at the early implantation period with special interest on high plasticity macrophages and dendritic cells and their ability to induce regulatory T cells. We will also point to putative immunomodulatory polypeptides involved in immune homeostasis maintenance at the maternal-placental interface.
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Affiliation(s)
- Rosanna Ramhorst
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Esteban Grasso
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Daniel Paparini
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Vanesa Hauk
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Lucila Gallino
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Guillermina Calo
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Daiana Vota
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
| | - Claudia Pérez Leirós
- a Immunopharmacology Laboratory, School of Sciences, University of Buenos Aires, IQUIBICEN-CONICET , Buenos Aires , Argentina
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13
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Bourdiec A, Ahmad SF, Lachhab A, Akoum A. Regulation of inflammatory and angiogenesis mediators in a functional model of decidualized endometrial stromal cells. Reprod Biomed Online 2015; 32:85-95. [PMID: 26602943 DOI: 10.1016/j.rbmo.2015.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 09/11/2015] [Accepted: 09/15/2015] [Indexed: 01/02/2023]
Abstract
The mechanisms involving the expression of interleukin (IL) 1 family members in the process of preparing the endometrium to receive an embryo remain unclear. In this study, decidualization differentially skewed the balance of IL1 family receptor expression in a pattern that increases endometrial stromal cell receptivity to IL1, IL18 and IL33. Additionally, endometrial cells showed increased expression of homeobox HOXA10 and HOXA11 and LIFR, which are known to be involved in endometrial embryo receptivity. Further analyses of decidual endometrial cells revealed a significant increase in the release of potent proinflammatory, remodelling and angiogenic factors implicated in the embryo invasion process, such as VEGF (P = 0.0305), MMP9 (P = 0.0003), TIMP3 (P = 0.0001), RANTES (P = 0.0020), MCP1 (P = 0.0001) and MIF (P = 0.0068). No significant changes in endogenous IL1B secretion were observed. Decreased secretion of IL18 and decidualization increased secretion of IL33. These findings reveal a significant modulation of endometrial cell receptivity to IL1 family members during endometrial stromal cell decidualization, and suggest that the involvement of IL1 family members is important in physiological processes of endometrial receptivity, including adaptive immunology. This may be relevant to establishing a favourable uterine microenvironment for embryo implantation.
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Affiliation(s)
- Amélie Bourdiec
- Endocrinologie de la reproduction, Centre de recherche-Hôpital Saint-François d'Assise, Centre Hospitalier Universitaire de Québec, Faculté de médecine, Université Laval, Québec, Canada.
| | - Syed-Furquan Ahmad
- Endocrinologie de la reproduction, Centre de recherche-Hôpital Saint-François d'Assise, Centre Hospitalier Universitaire de Québec, Faculté de médecine, Université Laval, Québec, Canada
| | - Asmaa Lachhab
- Endocrinologie de la reproduction, Centre de recherche-Hôpital Saint-François d'Assise, Centre Hospitalier Universitaire de Québec, Faculté de médecine, Université Laval, Québec, Canada
| | - Ali Akoum
- Endocrinologie de la reproduction, Centre de recherche-Hôpital Saint-François d'Assise, Centre Hospitalier Universitaire de Québec, Faculté de médecine, Université Laval, Québec, Canada
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14
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Endometrial gene expression profile of pregnant sows with extreme phenotypes for reproductive efficiency. Sci Rep 2015; 5:14416. [PMID: 26435523 PMCID: PMC5155628 DOI: 10.1038/srep14416] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/19/2015] [Indexed: 12/22/2022] Open
Abstract
Prolificacy can directly impact porcine profitability, but large genetic variation and low heritability have been found regarding litter size among porcine breeds. To identify key differences in gene expression associated to swine reproductive efficiency, we performed a transcriptome analysis of sows' endometrium from an Iberian x Meishan F2 population at day 30-32 of gestation, classified according to their estimated breeding value (EBV) as high (H, EBV > 0) and low (L, EBV < 0) prolificacy phenotypes. For each sample, mRNA and small RNA libraries were RNA-sequenced, identifying 141 genes and 10 miRNAs differentially expressed between H and L groups. We selected four miRNAs based on their role in reproduction, and five genes displaying the highest differences and a positive mapping into known reproductive QTLs for RT-qPCR validation on the whole extreme population. Significant differences were validated for genes: PTGS2 (p = 0.03; H/L ratio = 3.50), PTHLH (p = 0.03; H/L ratio = 3.69), MMP8 (p = 0.01; H/L ratio =4.41) and SCNN1G (p = 0.04; H/L ratio = 3.42). Although selected miRNAs showed similar expression levels between H and L groups, significant correlation was found between the expression level of ssc-miR-133a (p < 0.01) and ssc-miR-92a (p < 0.01) and validated genes. These results provide a better understanding of the genetic architecture of prolificacy-related traits and embryo implantation failure in pigs.
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15
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Abstract
Most of the key physiological processes in the human reproductive tract involve a significant inflammatory component. These processes include follicle development, ovulation, implantation, pregnancy, labor, postpartum, remodeling and menstruation. In this context, the term 'inflammation' usually means an influx of leukocytes ('immune cells'), often of different types, into a reproductive tract tissue. These examples of inflammation are not overtly associated with any infective process. There may also be evidence that these invading leukocytes have altered their functions to take on specific and relevant local regulatory roles. Specific sequential changes in different leukocytes can be demonstrated within human endometrium during the different phases of the normal menstrual cycle. Leukocytes are fairly sparse in numbers through the proliferative phase, but increase substantially into and through the secretory phase, so much so that around 40% of all stromal cells in the premenstrual phase are leukocytes, mainly uterine natural killer cells, a large granulated lymphocyte. Other leukocytes which play key roles in menstruation appear to be macrophages, mast cells, dendritic cells, neutrophils, eosinophils and regulatory T cells. Premenstrual withdrawal of progesterone increases the endometrial expression of inflammatory mediators, including IL-8 and MCP-1, which are believed to drive endometrial leukocyte recruitment at this time. Macrophages and neutrophils are rich sources of defensins and whey acid protein motif proteins, which play important roles in ensuring microbial protection while the epithelial barrier is disrupted. Mast cells are increasingly activated as the menstrual phase approaches, and leukocyte proteases trigger a cascade of matrix metalloproteinases and degradation of extracellular matrix. Dendritic cells and other antigen-presenting cells (e.g. macrophages) almost certainly facilitate clearance of cellular debris from the uterine cavity, and reduce the amount of viable cellular material transiting the Fallopian tubes. All of these processes are influenced or controlled by regulatory T cells. Many of these leukocytes also have the potential to release regulatory molecules which stimulate endometrial repair mechanisms. Increasing recent evidence also implicates disturbances of immune cells and their cytokine mediators in contributing to symptoms of abnormal uterine bleeding and pelvic pain. These recent findings all point towards the importance of the 'inflammatory process' in both normal and abnormal endometrial bleeding.
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Affiliation(s)
- M Berbic
- Queen Elizabeth II Research Institute for Mothers and Infants, Department of Obstetrics, Gynaecology and Neonatology, The University of Sydney , Sydney , Australia
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16
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Caballero-Campo P, Buffone MG, Benencia F, Conejo-García JR, Rinaudo PF, Gerton GL. A role for the chemokine receptor CCR6 in mammalian sperm motility and chemotaxis. J Cell Physiol 2013; 229:68-78. [PMID: 23765988 DOI: 10.1002/jcp.24418] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 06/06/2013] [Indexed: 12/22/2022]
Abstract
Although recent evidence indicates that several chemokines and defensins, well-known as inflammatory mediators, are expressed in the male and female reproductive tracts, the location and functional significance of chemokine networks in sperm physiology and sperm reproductive tract interactions are poorly understood. To address this deficiency in our knowledge, we examined the expression and function in sperm of CCR6, a receptor common to several chemoattractant peptides, and screened several reproductive tract fluids for the presence of specific ligands. CCR6 protein is present in mouse and human sperm and mainly localized in the sperm tail with other minor patterns in sperm from mice (neck and acrosomal region) and men (neck and midpiece regions). As expected from the protein immunoblotting and immunofluorescence results, mouse Ccr6 mRNA is expressed in the testis. Furthermore, the Defb29 mRNA encoding the CCR6 ligand, β-defensin DEFB29, is expressed at high levels in the epididymis. As determined by protein chip analysis, several chemokines (including some that act through CCR6, such as CCL20/MIP-3α (formerly macrophage inflammatory protein 3α) and protein hormones were present in human follicular fluid, endometrial secretions, and seminal plasma. In functional chemotaxis assays, capacitated human sperm exhibited a directional movement towards CCL20, and displayed modifications in motility parameters. Our data indicate that chemokine ligand/receptor interactions in the male and female genital tracts promote sperm motility and chemotaxis under non-inflammatory conditions. Therefore, some of the physiological reactions mediated by CCR6 ligands in male reproduction extend beyond a pro-inflammatory response and might find application in clinical reproduction and/or contraception.
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Affiliation(s)
- Pedro Caballero-Campo
- Unidad de Reproducción Humana, Clínica Tambre, Madrid, Spain; Department of Obstetrics, Gynecology, & Reproductive Sciences, School of Medicine, University of California, San Francisco, CA
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17
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Transcriptome analysis reveals new insights into the modulation of endometrial stromal cell receptive phenotype by embryo-derived signals interleukin-1 and human chorionic gonadotropin: possible involvement in early embryo implantation. PLoS One 2013; 8:e64829. [PMID: 23717664 PMCID: PMC3661534 DOI: 10.1371/journal.pone.0064829] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 04/19/2013] [Indexed: 01/08/2023] Open
Abstract
The presence of the conceptus in uterine cavity necessitates an elaborate network of interactions between the implanting embryo and a receptive endometrial tissue. We believe that embryo-derived signals play an important role in the remodeling and the extension of endometrial receptivity period. Our previous studies provided original evidence that human Chorionic Gonadotropin (hCG) modulates and potentiates endometrial epithelial as well as stromal cell responsiveness to interleukin 1 (IL1), one of the earliest embryonic signals, which may represent a novel pathway by which the embryo favors its own implantation and growth within the maternal endometrial host. The present study was designed to gain a broader understanding of hCG impact on the modulation of endometrial cell receptivity, and in particular, cell responsiveness to IL1 and the acquisition of growth-promoting phenotype capable of receiving, sustaining, and promoting early and crucial steps of embryonic development. Our results showed significant changes in the expression of genes involved in cell proliferation, immune modulation, tissue remodeling, apoptotic and angiogenic processes. This points to a relevant impact of these embryonic signals on the receptivity of the maternal endometrium, its adaptation to the implanting embryo and the creation of an environment that is favorable for the implantation and the growth of this latter within a new and likely hostile host tissue. Interestingly our data further identified a complex interaction between IL1 and hCG, which, despite a synergistic action on several significant endometrial target genes, may encompass a tight control of endogenous IL1 and extends to other IL1 family members.
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18
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Sela H, Goldman-Wohl D, Haimov-Kochman R, Greenfield C, Natanson-Yaron S, Hamani Y, Revel A, Lavy Y, Singer O, Yachimovich-Cohen N, Turetsky T, Mandelboim O, Reubinoff B, Yagel S. Human trophectoderm apposition is regulated by interferon γ-induced protein 10 (IP-10) during early implantation. Placenta 2013; 34:222-30. [DOI: 10.1016/j.placenta.2012.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 11/29/2022]
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19
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Vilella F, Ramirez LB, Simón C. Lipidomics as an emerging tool to predict endometrial receptivity. Fertil Steril 2013; 99:1100-6. [DOI: 10.1016/j.fertnstert.2012.12.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/18/2012] [Accepted: 12/19/2012] [Indexed: 01/03/2023]
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20
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Segerer SE, Martignoni F, Bogdan A, Müller N, Kapp M, Dietl J, Rieger L, Kämmerer U. Thrombopoietin modulates the proliferation, migration and cytokine profile of decidual cell subsets during early gestation. Mol Hum Reprod 2013; 19:361-8. [PMID: 23340480 DOI: 10.1093/molehr/gat005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
During early gestation, a considerable increase in different leukocyte subsets can be observed in the decidualized endometrium concomitantly to the invasion of cytotrophoblast cells (CTB). To date, it is still in question which factors induce this accumulation of immune cells and whether it is evoked by an in situ proliferation or by a migratory process. Studies on hepatoblastoma cells identified thrombopoietin (TPO) as a novel factor, which elicits dose-dependent chemotactic and chemokinetic effects. However, the impact and function of TPO on decidual cells has not been clarified yet. This study analyses the expression and function of TPO and its receptor c-Mpl in decidua during early gestation. Applying western blot analysis, we detected that TPO is expressed by decidual immune cells (uNK cells and CD14+ monocytes) as well as CTB and decidual stromal cells (DSCs). Expression of the different isoforms of c-Mpl was found in uNK cells, CD14+ monocytes and DSC. Studying the signalling pathway proteins in the uNK cells, an activation of STAT3/Tyr by TPO, was detected. The investigation of the proliferative effects of TPO on the decidual cell subsets revealed that TPO enhances the proliferation of uNK cells and CTB. No change of the proliferative activity after TPO incubation was found in DSC and even a decrease in CD14+ monocytes. In addition, TPO was observed to induce significantly the migratory activity of uNK cells, CD14+ monocytes and CTB. Investigating the effects of TPO on the cytokine profile of the isolated decidual cells, we observed a decrease in the secretion of IL-8, IL-10 and IL-1β of isolated uNK cells, CD14+ monocytes and CTB, although these changes did not reach statistical significance. Thus, we here identified TPO as a novel factor modulating the proliferation, migration and possibly cytokine secretion of decidual cell subsets.
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Affiliation(s)
- S E Segerer
- Department of Obstetrics and Gynaecology, University of Würzburg, Josef-Schneider-Str 4, Würzburg D-97080, Germany.
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21
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Van Sinderen M, Menkhorst E, Winship A, Cuman C, Dimitriadis E. Preimplantation human blastocyst-endometrial interactions: the role of inflammatory mediators. Am J Reprod Immunol 2012; 69:427-40. [PMID: 23176081 DOI: 10.1111/aji.12038] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 10/15/2012] [Indexed: 01/24/2023] Open
Abstract
Immune factors such as cytokines, chemokines, and growth factors are known to play important roles in the preimplantation interactions and communication between the blastocyst and receptive endometrium. This crucial dialog occurs during the stages when the blastocyst is in the uterine cavity immediately preceding implantation and the establishment of pregnancy. Human preimplantation processes are difficult to study due to restrictions on tissue availability. This review focuses on the expression and role of immune factors in human blastocyst-endometrial dialog during the very early stages of implantation. It highlights the importance of immune regulators and the need to develop new models to study human implantation.
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22
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Tawfeek MA, Eid MA, Hasan AM, Mostafa M, El-Serogy HA. Assessment of leukemia inhibitory factor and glycoprotein 130 expression in endometrium and uterine flushing: a possible diagnostic tool for impaired fertility. BMC WOMENS HEALTH 2012; 12:10. [PMID: 22520363 PMCID: PMC3448518 DOI: 10.1186/1472-6874-12-10] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 02/20/2012] [Indexed: 11/16/2022]
Abstract
Background Uterine receptivity and implantation are complex processes requiring coordinated expression of molecules by zygote and uterus. Our objective was to evaluate the role of the endometrial expression of leukemia inhibitory factor (LIF) and its glycoprotein 130 (gp130) receptor molecules and their secretion in uterine flushing during the window of implantation in cases of primary unexplained infertility Case presentation The study was conducted on 25 infertile women with unexplained infertility for at least two years and 10 normal fertile women as a control group . Endometrial tissue and uterine flushing were obtained. Each tissue specimen was divided into two pieces; one piece was used for histological dating of the endometrium and for immunostaining of progesterone receptors, and the second was used for RNA extraction and PCR assay of LIF and gp130 mRNA expression. Serum estrogen and progesterone were measured for all subjects. LIF mRNA was expressed in the endometrium of all normal fertile women but significantly decreased in infertile women. LIF was not detectable in 88% of infertile women while it was fairly detectable in 12% of them. Gp130 mRNA was hardly detectable in both fertile and infertile women with no difference between them. Infertile women secreted significantly less LIF and gp130 molecules in the uterine flushing compared with normal fertile women. Conclusions Expression of LIF mRNA in endometrium could be used as a molecular marker of unexplained infertility. Assessment of secreted LIF and gp130 molecules in uterine flushing could be another useful and safe method for predicting successful implantation as well as for diagnosing and eventually treating women with impaired fertility using recombinant human LIF.
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Affiliation(s)
- Manal A Tawfeek
- Faculty of Medicine, Department of Clinical Pathology, Tanta University, Egypt
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23
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Prapas Y, Petousis S, Panagiotidis Y, Gullo G, Kasapi L, Papadeothodorou A, Prapas N. Injection of embryo culture supernatant to the endometrial cavity does not affect outcomes in IVF/ICSI or oocyte donation cycles: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2012; 162:169-73. [PMID: 22464209 DOI: 10.1016/j.ejogrb.2012.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 12/23/2011] [Accepted: 03/05/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate whether intrauterine injection of embryo culture supernatant before embryo transfer has any impact on pregnancy and implantation rates. STUDY DESIGN A total of 400 cycles, of which 200 IVF/ICSI and 200 oocyte donor (OD), were randomly assigned to have their uterine cavity injected (group I) or not (group II). Primary endpoints to be studied were pregnancy and implantation rates. RESULTS Clinical pregnancy rate per transfer (47.87%, 90/188 versus 48.45%, 94/194) based on transvaginal scan findings at 7 weeks of gestation and implantation rate (25.6% versus 26.5%) were similar in the two groups. The day of embryo transfer, day 3 or day 5, did not affect the final outcome. CONCLUSION Injection of embryo culture supernatant into the uterine cavity, 30 min before the embryo transfer on either day 3 or 5, neither improves nor adversely affects the pregnancy rate in IVF/ICSI or oocyte donation cycles.
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Affiliation(s)
- Yannis Prapas
- Iakentro IVF Center, Agiou Vasileiou 4, 54250 Thessaloniki, Greece
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24
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Holmberg JC, Haddad S, Wünsche V, Yang Y, Aldo PB, Gnainsky Y, Granot I, Dekel N, Mor G. An in vitro model for the study of human implantation. Am J Reprod Immunol 2012; 67:169-78. [PMID: 22151560 PMCID: PMC3703643 DOI: 10.1111/j.1600-0897.2011.01095.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PROBLEM Implantation remains the rate-limiting step for the success of in vitro fertilization. Appropriate models to study the molecular aspects of human implantation are necessary in order to improve fertility. METHODS First trimester trophoblast cells are differentiated into blastocyst-like spheroids (BLS) by culturing them in low attachment plates. Immortalized human endometrial stromal cells and epithelial cells (ECC-1) were stably transfected with GFP or tdTomato. Co-culture experiments were monitored using Volocity imaging analysis system. RESULTS This method demonstrates attachment and invasion of BLS, formed by trophoblast cells, into stromal cells, but not to uterine epithelial cells. CONCLUSION We have developed an in vitro model of uterine implantation. The manipulation of this system allows for dual color monitoring of the cells over time. Additionally, specific compounds can be added to the culture media to test how this may affect implantation and invasion. This model is a helpful tool in understanding the complexity of human implantation.
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Affiliation(s)
- Jennie C. Holmberg
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
| | - Severina Haddad
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
| | - Vera Wünsche
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
| | - Yang Yang
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
| | - Paulomi B. Aldo
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
| | - Yulia Gnainsky
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, 76100 Israel
| | - Irit Granot
- Department of Obstetrics and Gynecology, IVF Unit, Kaplan Medical Center, Rehovot, 76100 Israel
| | - Nava Dekel
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, 76100 Israel
| | - Gil Mor
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven CT 06510
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25
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Maybin JA, Critchley HOD, Jabbour HN. Inflammatory pathways in endometrial disorders. Mol Cell Endocrinol 2011; 335:42-51. [PMID: 20723578 DOI: 10.1016/j.mce.2010.08.006] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 08/11/2010] [Accepted: 08/11/2010] [Indexed: 01/19/2023]
Abstract
Complex interactions between the endocrine and immune systems govern the key endometrial events of implantation and menstruation. In contrast to other tissue sites, cyclical endometrial inflammation is physiological. However, dysregulation of this inflammatory response can lead to endometrial disorders. This review examines the inflammatory processes occurring in the normal endometrium during menstruation and implantation, highlighting recent advances in our understanding and gaps in current knowledge. Subsequently, the role of inflammatory pathways in the pathology of various common endometrial conditions is discussed, including heavy menstrual bleeding, dysmenorrhoea (painful periods), uterine fibroids, endometriosis and recurrent miscarriage.
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Affiliation(s)
- Jacqueline A Maybin
- University of Edinburgh Centre for Reproductive Biology, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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Ruiz A, Salvo VA, Ruiz LA, Báez P, García M, Flores I. Basal and steroid hormone-regulated expression of CXCR4 in human endometrium and endometriosis. Reprod Sci 2010; 17:894-903. [PMID: 20720261 PMCID: PMC4495731 DOI: 10.1177/1933719110379920] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Endometriosis is associated with activation of local and systemic inflammatory mechanisms, including increased levels of chemokines and other proinflammatory cytokines. We have previously reported increased gene expression of chemokine receptor 4 (CXCR4), the receptor for CXCL12, in lesions of the rat model of endometriosis. The CXCR4-CXCL12 axis has been shown to have both immune (HIV infection, lymphocyte chemotaxis) and nonimmune functions, including roles in tissue repair, angiogenesis, invasion, and migration. There is evidence indicating that these mechanisms are also at play in endometriosis; therefore, we hypothesized that activation of the CXCR4-CXCL12 axis could be responsible, at least in part, for the survival and establishment of endometrial cells ectopically. Immunohistochemistry (IHC) showed that CXCR4 protein levels were significantly higher in endometriotic lesions compared to the endometrium of controls. Next, we determined basal gene and protein expression of CXCR4 and CXCL12 and regulation by estradiol (E2) and/or progesterone (P4) in endometrial cell lines using quantitative polymerase chain reaction (qPCR), and Western blots. Basal CXCR4 gene expression levels were higher in epithelial versus stromal cells; conversely, CXCL12 was expressed at higher levels in stromal vs epithelial cells. CXCR4 gene expression was significantly downregulated by ovarian steroid hormones in endometrial epithelial. These data suggest that steroid modulation of CXCR4 is defective in endometriosis, although the specific mechanism involved remains to be elucidated. These findings have implications for future therapeutic strategies specifically targeting the inflammatory component in endometriosis.
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Affiliation(s)
- Abigail Ruiz
- Department of Microbiology, Ponce School of Medicine, Ponce, PR, USA
| | - Virgilio A. Salvo
- Department of Physiology, Pharmacology and Toxicology, Ponce School of Medicine, Ponce, PR, USA
| | - Lynnette A. Ruiz
- Department of Microbiology, Ponce School of Medicine, Ponce, PR, USA
| | - Perla Báez
- Department of Microbiology, Ponce School of Medicine, Ponce, PR, USA
| | - Miosotis García
- Department of Pathology, Ponce School of Medicine, Ponce, PR, USA
| | - Idhaliz Flores
- Department of Microbiology, Ponce School of Medicine, Ponce, PR, USA
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Mansouri-Attia N, Aubert J, Reinaud P, Giraud-Delville C, Taghouti G, Galio L, Everts RE, Degrelle S, Richard C, Hue I, Yang X, Tian XC, Lewin HA, Renard JP, Sandra O. Gene expression profiles of bovine caruncular and intercaruncular endometrium at implantation. Physiol Genomics 2009; 39:14-27. [PMID: 19622795 DOI: 10.1152/physiolgenomics.90404.2008] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
At implantation the endometrium undergoes modifications necessary for its physical interactions with the trophoblast as well as the development of the conceptus. We aim to identify endometrial factors and pathways essential for a successful implantation in the caruncular (C) and the intercaruncular (IC) areas in cattle. Using a 13,257-element bovine oligonucleotide array, we established expression profiles at day 20 of the estrous cycle or pregnancy (implantation), revealing 446 and 1,295 differentially expressed genes (DEG) in C and IC areas, respectively (false discovery rate = 0.08). The impact of the conceptus was higher on the immune response function in C but more prominent on the regulation of metabolism function in IC. The C vs. IC direct comparison revealed 1,177 and 453 DEG in cyclic and pregnant animals respectively (false discovery rate = 0.05), with a major impact of the conceptus on metabolism and cell adhesion. We selected 15 genes including C11ORF34, CXCL12, CXCR4, PLAC8, SCARA5, and NPY and confirmed their differential expression by quantitative RT-PCR. The cellular localization was analyzed by in situ hybridization and, upon pregnancy, showed gene-specific patterns of cell distribution, including a high level of expression in the luminal epithelium for C11ORF34 and MX1. Using primary cultures of bovine endometrial cells, we identified PTN, PLAC8, and CXCL12 as interferon-tau (IFNT) target genes and MSX1 and CXCR7 as IFNT-regulated genes, whereas C11ORF34 was not an IFNT-regulated gene. Our transcriptomic data provide novel molecular insights accounting for the biological functions related to the C or IC endometrial areas and may contribute to the identification of potential biomarkers for normal and perturbed early pregnancy.
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Affiliation(s)
- Nadéra Mansouri-Attia
- Institut National de la Recherche Agronomique, Unité Mixte de Recherche (UMR) 1198 Biologie du Développement et Reproduction, Jouy-en-Josas, France
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McEwan M, Lins RJ, Munro SK, Vincent ZL, Ponnampalam AP, Mitchell MD. Cytokine regulation during the formation of the fetal-maternal interface: focus on cell-cell adhesion and remodelling of the extra-cellular matrix. Cytokine Growth Factor Rev 2009; 20:241-9. [PMID: 19487153 DOI: 10.1016/j.cytogfr.2009.05.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The establishment of human pregnancy requires the orchestration of substantial cell differentiation and tissue remodelling processes in the context of a complex dialogue between the receptive endometrium and the implanting blastocyst, and is therefore dependent upon a complex sequence of signalling events. Cytokines play an important role in each step of implantation, modulating expression of adhesion molecules on both the fetal and maternal surfaces, regulating expression of the proteases that remodel the extra-cellular matrix, and promoting invasion and differentiation of trophoblasts. Here we review the role of cytokines in regulating the establishment of the fetal-maternal interface, with a particular focus on regulation of the functional expression of CAMs, the ECM and of the proteinases that modulate their function.
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Affiliation(s)
- Miranda McEwan
- The Liggins Institute and National Research Centre for Growth and Reproduction, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Injection of day 2 embryo culture supernatant into the uterine cavity did not improve the pregnancy rate of day 3 embryo transfer in patients who underwent in vitro fertilization-embryo transfer: a randomized clinical trial. Fertil Steril 2009; 93:2216-21. [PMID: 19439284 DOI: 10.1016/j.fertnstert.2009.01.098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 01/11/2009] [Accepted: 01/14/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of uterine cavity injection of day 2 embryo culture supernatant before day 3 embryo transfer in patients who are undergoing in vitro fertilization-embryo transfer. DESIGN Randomized controlled trial. SETTING A reproductive medical centre. PATIENT(S) A total of 90 infertile women, 45 of them in the study group and 45 in the control group. INTERVENTION(S) Uterine cavity infection of day 2 embryo culture supernatant before day 3 embryo transfer. MAIN OUTCOME MEASURE(S) Embryo implantation rate and pregnancy rate. RESULT(S) The pregnancy versus implantation rates in the study group and control group were 48.9% versus 44.4% and 27.3% versus 22.1%, respectively. Although both pregnancy and implantation rates in the study group were higher than those in the control group, no statistically significant differences were found in these two parameters. CONCLUSION(S) Injection of day 2 embryo culture supernatant into the uterine cavity cannot improve the implantation and pregnancy rates of day 3 embryo transfer.
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Boomsma C, Kavelaars A, Eijkemans M, Lentjes E, Fauser B, Heijnen C, Macklon N. Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF. Hum Reprod 2009; 24:1427-35. [DOI: 10.1093/humrep/dep011] [Citation(s) in RCA: 158] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Early serum interleukin-8 evaluation may prove useful in localizing abnormally implanted human gestations after in vitro fertilization. Fertil Steril 2008; 90:2068-72. [DOI: 10.1016/j.fertnstert.2007.10.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2007] [Revised: 10/08/2007] [Accepted: 10/08/2007] [Indexed: 11/19/2022]
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Dominguez F, Martínez S, Quiñonero A, Loro F, Horcajadas JA, Pellicer A, Simón C. CXCL10 and IL-6 induce chemotaxis in human trophoblast cell lines. Mol Hum Reprod 2008; 14:423-30. [PMID: 18495678 DOI: 10.1093/molehr/gan032] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The investigation of trophoblast chemoattractive molecules in humans is of high interest for the reproductive field. Current evidence in ruminants demonstrates that CXCL10, formerly the interferon-gamma-inducible protein 10 (IP-10), is a potent chemotactic molecule implicated in the migration of trophoblast cells during early gestation. The aim of this work was to explore the existence of CXCL10/CXCR3 in the human model. Furthermore, chemotaxis assays were performed to demonstrate CXCL10 chemotactic activity in the human trophoblast cell lines JEG-3 and AC-1M88. Surprisingly, the conditioned media from epithelial endometrial cells (EEC) induced the highest trophoblast migration rate. Cytokine and chemokine membrane protein arrays were used to identify the secreted protein profile of EEC-conditioned media, and IL-6 was found to be the most abundant and CXCL13 the second most abundant molecule. Using a chemotaxis assay on AC-IM88, IL-6 antibody blocked the effect of EEC, indicating IL-6 to be an effective chemoattractive factor for trophoblast cells in the human model.
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Affiliation(s)
- F Dominguez
- Fundación Instituto Valenciano de Infertilidad (FIVI), University of Valencia, C/ Guadassuar 1, Bajo, 46015 Valencia, Spain
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Levy O. Innate immunity of the newborn: basic mechanisms and clinical correlates. Nat Rev Immunol 2007; 7:379-90. [PMID: 17457344 DOI: 10.1038/nri2075] [Citation(s) in RCA: 854] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The fetus and newborn face a complex set of immunological demands, including protection against infection, avoidance of harmful inflammatory immune responses that can lead to pre-term delivery, and balancing the transition from a sterile intra-uterine environment to a world that is rich in foreign antigens. These demands shape a distinct neonatal innate immune system that is biased against the production of pro-inflammatory cytokines. This bias renders newborns at risk of infection and impairs responses to many vaccines. This Review describes innate immunity in newborns and discusses how this knowledge might be used to prevent and treat infection in this vulnerable population.
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Affiliation(s)
- Ofer Levy
- Department of Medicine, Division of Infectious Diseases, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
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Kralickova M, Sima R, Vanecek T, Sima P, Rokyta Z, Ulcova-Gallova Z, Sucha R, Uher P, Hes O. Leukemia inhibitory factor gene mutations in the population of infertile women are not restricted to nulligravid patients. Eur J Obstet Gynecol Reprod Biol 2006; 127:231-5. [PMID: 16545901 DOI: 10.1016/j.ejogrb.2006.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2005] [Revised: 01/22/2006] [Accepted: 02/13/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Leukemia inhibitory factor (LIF) is one of the key cytokines in the embryo implantation regulation. We investigated the prevalence of the LIF gene mutations in the population of infertile women that consisted of nulligravid and secondary infertile patients. STUDY DESIGN We designed a LIF gene mutation screening method that is based on the Temperature Gradient Gel Electrophoresis (TGGE). The population to screen consisted of 176 infertile women including group A of 147 nulligravid women and group B of 29 women with secondary infertility that had a history of either miscarriage or an ectopic pregnancy but no live births. The control population was comprised of 75 healthy fertile subjects. The groups of fertile controls and infertile patients were compared for statistically significant differences using the t-test. RESULTS Six potentially functional LIF gene mutations, the G to A transitions at the position 3400 leading to the valin to methionin exchange at codon 64 (V64M) in the AB loop region of the LIF protein, were detected. All of the six positive women were infertile. Four of them were nulligravid and two of them had history of spontaneous conception followed by early miscarriage. No positive TGGE samples were identified in the control group, which means that the frequency of functionally relevant mutations of the LIF gene in infertile women is significantly enhanced in comparison with controls (P<0.05, t-test). CONCLUSION The results suggest that the LIF gene mutations affect fertility. Even though they occur infrequently, their impact on molecular events during early phases of pregnancy should be further established.
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Affiliation(s)
- Milena Kralickova
- Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Capkovo namesti 1, Plzen CZ-326 00, Czech Republic.
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Abstract
Hox genes have a well-characterized role in embryonic development, where they determine identity along the anteroposterior body axis. Hox genes are expressed not only during embryogenesis but also in the adult, where they are necessary for functional differentiation. Despite the known function of these genes as transcription factors, few regulatory mechanisms that drive Hox expression are known. Recently, several hormones and their cognate receptors have been shown to regulate Hox gene expression and thereby mediate development in the embryo as well as functional differentiation in the adult organism. Estradiol, progesterone, testosterone, retinoic acid, and vitamin D have been shown to regulate Hox gene expression. In the embryo, the endocrine system directs axial Hox gene expression; aberrant Hox gene expression due to exposure to endocrine disruptors contributes to the teratogenicity of these compounds. In the adult, endocrine regulation of Hox genes is necessary to enable such diverse functions as hematopoiesis and reproduction; endocrinopathies can result in dysregulated HOX gene expression affecting physiology. By regulating HOX genes, hormonal signals utilize a conserved mechanism that allows generation of structural and functional diversity in both developing and adult tissues. This review discusses endocrine Hox regulation and its impact on physiology and human pathology.
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Affiliation(s)
- Gaurang S Daftary
- Division of Reproductive Endocrinology, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208063, New Haven, Connecticut 06520-8063, USA
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36
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Laird SM, Tuckerman EM, Li TC. Cytokine expression in the endometrium of women with implantation failure and recurrent miscarriage. Reprod Biomed Online 2006; 13:13-23. [PMID: 16820103 DOI: 10.1016/s1472-6483(10)62011-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
One potential cause of reproductive failure such as infertility and recurrent miscarriage may be an endometrial defect. Numerous studies in mice have suggested the importance of various different cytokines in successful pregnancy outcome. This article reviews the literature available on the role of T helper cytokines and IL-1, IL-11, LIF, IL-12 and IL-18 in infertility and recurrent miscarriage, with particular emphasis on the role that endometrial cytokines may play. Although there are numerous studies on cytokines in recurrent miscarriage, much less has been reported on their role in infertility with or without failure after IVF. There is also considerable variation in the results obtained from various different studies, which may be due to different populations studied, the different timing of the sample collection, and whether the cytokines were measured in whole tissue or a specific cell population. The presence of complicated networks of cytokines and their overlapping biological activities means that alteration of one cytokine is likely to affect others and this also makes the study of their role in implantation failure very difficult. There is an urgent need to re-examine the role played by various cytokines in reproductive failure through carefully planned and vigorously designed studies and to compare the different types of reproductive failure.
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Affiliation(s)
- S M Laird
- BMRC, Sheffield Hallam University, City Campus, Sheffield, S1 1WB, UK.
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Králícková M, Síma P, Rokyta Z. Role of the leukemia-inhibitory factor gene mutations in infertile women: the embryo-endometrial cytokine cross talk during implantation--a delicate homeostatic equilibrium. Folia Microbiol (Praha) 2005; 50:179-86. [PMID: 16295654 DOI: 10.1007/bf02931563] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Locally secreted cytokines of both the embryonic and the endometrial origin control the implantation process. The defects in their signaling that lead to unfavorable environment within the uterus may cause embryo implantation failure. The leukemia inhibitory factor (LIF), interleukin-11 (IL-11) as well as IL-12/IL-15/IL-18 system are regarded to be important signaling vectors. LIF plays an essential role in the preimplantation embryo development and the blastocyst implantation and its gene mutations in women contribute to the implantation failure and subsequent infertility. IL-11 signaling has been shown to be required for the uterine decidualization response as well as for the hatching and attachment of blastocysts. The IL-12/IL-15/IL-18 system interacts with endometrial leukocytes, particularly with NK cells, and influences directly the local angiogenesis and tissue remodeling. Differences in the levels of endometrial leukocytic subpopulations and in the patterns of intra-uterine cytokine concentrations that are observed between fertile and infertile women contribute to infertility probably by affecting the embryonic maternal dialogue during the implantation and early placentation period. Focusing on this cross talk promises to open new era in assisted reproduction techniques that will be based on diagnostics of missing signaling molecules and impairments of uterine receptivity as well as on therapeutic applications of individualized embryo culture and transfer media.
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Affiliation(s)
- M Králícková
- Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czechia.
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Dimitriadis E, White CA, Jones RL, Salamonsen LA. Cytokines, chemokines and growth factors in endometrium related to implantation. Hum Reprod Update 2005; 11:613-30. [PMID: 16006437 DOI: 10.1093/humupd/dmi023] [Citation(s) in RCA: 347] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The complexity of the events of embryo implantation and placentation is exemplified by the number and range of cytokines with demonstrated roles in these processes. Disturbance of the normal expression or action of these cytokines results in complete or partial failure of implantation and abnormal placental formation in mice or humans. Of known importance are members of the gp130 family such as interleukin-11 (IL-11) and leukaemia inhibitory factor (LIF), the transforming growth factor beta (TGFbeta) superfamily including the activins, the colony-stimulating factors (CSF), the IL-1 system and IL-15 system. New data are also emerging for roles for a number of chemokines (chemoattractive cytokines) both in recruiting specific cohorts of leukocytes to implantation sites and in trophoblast differentiation and trafficking. This review focuses on those cytokines and chemokines whose expression pattern in the human endometrium is consistent with a potential role in implantation and placentation and for which some relevant actions are known. It examines what is known of their regulation and action along with alterations in clinically relevant situations.
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Affiliation(s)
- E Dimitriadis
- Prince Henry's Institute of Medical Research, P.O. Box 5152, Clayton, Victoria 3168, Australia.
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Fahey JV, Schaefer TM, Channon JY, Wira CR. Secretion of cytokines and chemokines by polarized human epithelial cells from the female reproductive tract. Hum Reprod 2005; 20:1439-46. [PMID: 15734755 DOI: 10.1093/humrep/deh806] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pro-inflammatory chemokines that attract and cytokines that activate immune cells contribute to normal physiological homeostasis in the female reproductive tract, and are needed to deal effectively with potential pathogenic microbes. Mucosal epithelial cells are capable of producing these factors that communicate with cells of the innate and adaptive immune systems. METHODS Epithelial cells from Fallopian tube, endometrium and endocervix were isolated and grown to high transepithelial resistance in cell inserts from seven patients who had hysterectomies. Interleukin (IL)-8, IL-6, granulocyte colony-stimulating factor (G-CSF), monocyte chemoattractant protein-1 (MCP-1), granulocyte-macrophage colony-stimulating factor (GM-CSF), tumour necrosis factor-alpha (TNF-alpha) and macrophage inflammatory peptide-1beta (MIP-1beta) were assessed by Luminex bead analysis or enzyme-linked immunosorbent assay (ELISA) in epithelial cell conditioned media from the apical and basolateral compartments. RESULTS With the exception of MCP-1, the seven chemokines/cytokines constitutively produced by the polarized epithelial cells were preferentially secreted apically. A concentration pattern was found in all cases, with IL-8 and IL-6 produced in the greatest quantity. CONCLUSIONS The concentrations of IL-8, IL-6, G-CSF and MCP-1 are similar to the levels found in reproductive tract fluids of patients with infection. The constitutive secretion and compartmentalization of large quantities of bioactive chemokines and cytokines provide additional evidence for the role of epithelial cells as gatekeepers of innate immune protection in the female reproductive tract.
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Affiliation(s)
- J V Fahey
- Department of Physiology, Dartmouth Medical School, Lebanon, NH 03756, USA.
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40
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Abstract
A wealth of publications proposes that endometriosis and inflammation may have an unfavorable influence on fertility. A recent meta-analysis of assisted reproductive technologies demonstrated that, once confounding factors are controlled for, the pregnancy rate in women with endometriosis is approximately 50% of the rate of women with tubal factor infertility. Peritoneal fluid of women with endometriosis contains elevated amounts of macrophages and their secreted products, such as growth factors, cytokines, and angiogenic factors. Because reproductive organs are bathed in and thus will be influenced by peritoneal fluid, these proinflammatory mediators would affect various aspects of reproduction in women with endometriosis. Advanced stages of endometriosis may have easily understandable factors, such as distortion of the anatomy, causing infertility. On the other hand, in minimal or mild endometriosis mechanisms underlying reproductive failure are subtle and remain controversial. Recent reports suggest that inflammatory factors play a role in this endometriosis-associated reproductive failure. This review provides an overview of recent data on the effects of endometriosis-associated inflammation on fertility.
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Affiliation(s)
- Gülden Halis
- Endometriosezentrum Berlin, Department of Obstetrics and Gynecology, CBF, Charité-Universitätsmedizin, Berlin, Germany
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