Trimegestone differentially modulates the expression of matrix metalloproteinases in the endometrial stromal cell

Effects of progesterone treatment on expression of genes involved in uterine quiescence

An important action of progesterone during pregnancy is to maintain the uterus in a quiescent state and thereby prevent preterm labor. The causes of preterm labor are not well understood, so progesterone action on the myometrium can provide clues about the processes that keep the uterus from contracting prematurely. Accordingly, we have carried out Affymetrix GeneChip analysis of progesterone effects on gene expression in immortalized human myometrial cells cultured from a patient near the end of pregnancy. Progesterone appears to inhibit uterine excitability by a number of mechanisms, including increased expression of calcium and voltage-operated K(+) channels, which dampens the electrical activity of the myometrial cell, downregulation of agents, and receptors involved in myometrial contraction, reduction in cell signal components that lead to increased intracellular Ca(2+) concentrations in response to contractile stimuli, and downregulation of proteins involved in the cross-linking of actin and myosin filaments to produce uterine contractions.

Endometriotic epithelial cells induce MMPs expression in endometrial stromal cells via an NFkappaB-dependent pathway

OBJECTIVE

To explore the stroma-epithelium interactions in endometriosis and to identify the possible signalling pathways involved in this cross-talk.

DESIGN

Laboratory study via primary cultured endometrial stromal and epithelial cells.

SETTING

University Hospital.

PATIENTS

Fifteen patients with endometriosis confirmed by histopathology were recruited in the study, and 12 women free of endometriosis were used as control group.

INTERVENTION(S)

Specific NFkappaB inhibitor 1-Pyrrolidinecarbodithioic acid ammonium salt (PDTC) was used in cell cultures.

MAIN OUTCOME MEASURE(S)

The expression and secretion of MMP-2, MMP-9, TIMP-1, TIMP-2 and the DNA-binding activity of NFkappaB in normal endometrial stromal cells or in co-cultures with normal or endometriotic epithelial cells from patients with endometriosis.

RESULT(S)

Endometrial epithelial cells induced MMP-9 and MMP-2 expression in normal stromal cells in vitro. In co-cultures with endometriotic epithelial cells, normal endometrial stromal cells expressed and secreted higher MMP-2 (p < 0.05) and MMP-9 (p < 0.05). Specific inhibition of NFkappaB pathway in stromal cells abolished this induction effect by epithelial cells.

CONCLUSION(S)

Endometriotic epithelial cells induce MMPs expression and secretion in normal endometrial stromal cells via an NFkappaB-dependent pathway in vitro. This cross-talk between epithelial cells and stromal cells may facilitate the implantation and extension of the ectopic foci and favour the development of the disease.

Enhanced invasion of stromal cells from adenomyosis in a three-dimensional coculture model is augmented by the presence of myocytes from affected uteri

OBJECTIVE

To compare endometrial stromal cell invasion from women with and without adenomyosis and the effect of myometrial cells using a three-dimensional coculture.

DESIGN

Case-controlled blinded comparison.

SETTING

University department.

PATIENT(S)

Premenopausal women with and without uterine adenomyosis.

INTERVENTION(S)

Human endometrial stromal and myometrial cells were grown in a three-dimensional coculture with crossover between cells from uteri with and without adenomyosis. Surface-enhanced laser desorption/ionization-time of flight-mass spectrometry proteomic analysis was performed on culture supernatants.

MAIN OUTCOME MEASURE(S)

Depth of stromal cell invasion into collagen matrix and protein expression profiles.

RESULT(S)

The depth of invasion for adenomyosis stromal cells (AS) was statistically significantly higher than controls (CS) whether grown on plain collagen, control muscle (CM), or adenomyosis muscle (AM). Coculture with AM enhanced invasion of both CS and AS. Enhanced invasion by AS was more marked in cocultures with AM than CM. Proteomic analysis identified differences that may account for the invasiveness and also many similarities between secretory products related to the disease status.

CONCLUSION(S)

Enhanced stromal invasion in adenomyosis is influenced by the myometrium in the in vitro coculture model. This suggests that adenomyosis may be a disease of both the endometrial stroma and myometrium.

Current state of hormone replacement therapy: the case for using trimegestone

Estrogen deficiency has a negative impact on the quality of life of postmenopausal women and is associated with vasomotor symptoms, insomnia and emotional lability. Other manifestations of estrogen deficiency include dry skin, dry vagina and dyspareunia, in addition to bone loss. Estrogen replacement effectively reverses these changes. The only indication for the administration of a progestogen is to protect the postmenopausal uterus against the potential development of endometrial hyperplasia and carcinoma.