Differentially expressed genes in eutopic and ectopic endometrium of women with endometriosis

OBJECTIVE

To elucidate the potential mechanisms involved in the physiopathology of endometriosis. We analyzed the differential gene expression profiles of eutopic and ectopic tissues from women with endometriosis.

DESIGN

Prospective laboratory study.

SETTING

University hospital.

PATIENT(S)

Seventeen patients in whom endometriosis was diagnosed and 11 healthy fertile women.

INTERVENTION(S)

Endometrial biopsy specimens from the endometrium of healthy women without endometriosis and from the eutopic and ectopic endometrium tissues of patients with endometriosis were obtained in the early proliferative phase of the menstrual cycle.

MAIN OUTCOME MEASURE(S)

Six paired samples of eutopic and ectopic tissue were analyzed by subtractive hybridization. To evaluate the expression of genes found by rapid subtraction hybridization methods, we measured CTGF, SPARC, MYC, MMP, and IGFBP1 genes by real-time polymerase chain reaction in all samples.

RESULT(S)

This study identified 291 deregulated genes in the endometriotic lesions. Significant expression differences were obtained for SPARC, MYC, and IGFBP1 in the peritoneal lesions and for MMP3 in the ovarian endometriomas. Additionally, significant differences were obtained for SPARC and IGFBP1 between the peritoneal and ovarian lesions. No significant differences were found for the studied genes between the control and the eutopic endometrium.

CONCLUSION(S)

This study identified 291 genes with differential expression in endometriotic lesions. The deregulation of the SPARC, MYC, MMP3, and IGFBPI genes may be responsible for the loss of cellular homeostasis in endometriotic lesions.

Steroids and protein markers in the follicular fluid as indicators of oocyte quality in patients with and without endometriosis

PURPOSE

To investigate the concentrations of steroid hormones (estradiol, progesterone), pregnancy-associated protein-A, IGF-binding protein-4 and leptin in the follicular fluid of infertile patients with and without endometriosis.

METHODS

Follicular fluid of IVF patients with and without endometriosis was aspirated, centrifuged and stored to analyze the above mentioned hormones and to compare their concentrations between women with and without endometriosis.

RESULTS

Follicular fluid estradiol levels were significantly higher in controls than in affected women. The concentrations of the other markers did not differ between the two groups.

CONCLUSIONS

Since not only the follicular fluid concentration of estradiol, but also the oocyte quality is decreased in women with endometriosis, we suggest that estradiol can be considered as a marker not only of oocyte maturity but also of oocyte quality.

Insulin-like growth factor-1 and insulin-like growth factor binding protein-1 and 3 in the follicular fluid of infertile patients submitted to in vitro fertilization

PURPOSE

In the present article we propose to evaluate IGF-1, IGFBP-1 and 3 in the follicular fluid of infertile patients submitted to in vitro fertilization.

METHODS

We performed a case-control study with 53 infertile patients submitted to the first in vitro fertilization attempt. We compared their follicular fluid concentration of IGF-1, IGFBP-1 and IGFBP-3 between the patients who became pregnant (n = 11) versus those nonpregnant (n = 42).

RESULTS

The clinical characteristics of patients from the two groups were similar in terms of age and body mass index. Data related to the analysis of ovulation induction was not different regarding length of induction in days, number of retrieved oocytes, fertilization rate, and number of transferred embryos. Furthermore, the number of FSH units required for ovarian induction was also similar between the studied groups. IGF-1 and IGFBP-1 were not significantly different between the groups (p > 0.05). However, those patients that became pregnant presented a lower follicular fluid concentration of IGFBP-3, 2237.10 +/- 582.73 pg/ml and 2657.64 +/- 584.15 ng/ml, respectively (p = 0.038).

CONCLUSIONS

We demonstrated an association of a lower follicular fluid IGFBP-3 in individuals that became pregnant compared to subjects that did not after in vitro fertilization.

Localization and cellular distribution of pregnancy-associated plasma protein-a and major basic protein in human ovary and corpora lutea throughout the menstrual cycle

OBJECTIVE

To assess the expression and cellular distribution of pregnancy-associated plasma protein-A (PAPP-A) and major basic protein (MBP) in human ovarian tissue during the menstrual cycle.

DESIGN

Ovarian tissues (n = 50) and corpora lutea (n = 18) were obtained from patients undergoing hysterectomy/oophorectomy for benign conditions and tissue sections were immunostained for MBP and PAPP-A.

SETTING

University medical center.

INTERVENTION(S)

Immunostaining of tissue sections using antibodies to PAPP-A and MBP.

MAIN OUTCOME MEASURE(S)

Microscopic evaluation to assess the presence, distribution, and cellular co-localization of MBP and PAPP-A and to describe any variations in their expression during the menstrual cycle.

RESULT(S)

Major basic protein (MBP) is found in several ovarian cell types throughout the menstrual cycle. The MBP immunostaining of ovarian follicles varied depending on the size, with primordial follicles staining in the ooplasm with a lack of staining in the granulosa and theca cells. In the intermediate/mature follicles, MBP was immunolocalized in theca, but not in granulosa cells except in the mature follicles. Pregnancy-associated plasma protein-A (PAPP-A) was immunolocalized in primordial follicle ooplasm, theca externa of intermediate/mature follicles, and in granulosa cells with increased intensity as luteinization progressed. The luteal tissue is the major site of MBP and PAPP-A with highest intensity found during the midluteal phase associated with both small and large luteal cells.

CONCLUSION(S)

The expression and distinct pattern of MBP and PAPP-A cellular localization in human ovarian tissue during folliculogenesis and in luteal tissue suggest that their individual and combined actions in a cell specific fashion may play a role in growth and differentiation of theca, granulosa, and luteal cells.

The regulated expression of the pregnancy-associated plasma protein-A in the rodent ovary: a proposed role in the development of dominant follicles and of corpora lutea

Compelling evidence exists displaying that the intrafollicular IGF-I system constitutes an obligatory mediator of FSH action in the murine ovary. Within this system, the ovarian IGF binding protein-4-directed protease (IGFBP-4ase) may have a critical role. Human IGFBP-4ase has been proved identical to the previously well-characterized pregnancy-associated plasma protein-A (PAPP-A). This communication reports the cloning and sequencing of the mouse PAPP-A cDNA as well as its expression and cellular localization in the mouse ovary. PAPP-A mRNA was undetectable in ovaries of untreated immature 25-d-old mice. Treatment with PMSG led to a marked time-dependent increase in PAPP-A expression in well-defined subsets of granulosa cells and follicles. Specifically, PAPP-A expression was detectable exclusively in centrifugally residing membrana granulosa cells of antral follicles during a 3- to 36-h period post PMSG. PAPP-A expression then fell to nondetectable levels in dominant preovulatory follicles at 48 h post PMSG. Treatment of PMSG-primed mice with human CG caused a rapid reinduction of PAPP-A expression in granulosa cells of dominant follicles and was sustained at relatively high levels throughout the ovulation and luteinization. These results suggest a role for gonadotropin-stimulated PAPP-A gene expression in the physiologic processes of dominant follicle development, ovulation, and luteogenesis in the mammalian ovary. The early onset and extended duration of gonadotropin-dependent PAPP-A expression in granulosa cells may serve to degrade the antigonadotropin IGFBP-4. Accordingly, successful antral follicle development, ovulation, and corpus luteum formation may be contingent on an IGFBP-4-deplete/PAPP-A-replete circumstance, hence resulting in an IGF-I-replete intrafollicular microenvironment.

The physiology of folliculogenesis: the role of novel growth factors

OBJECTIVE

To assess major physiological events underlying folliculogenesis, including FSH-dependent dominant follicle (DF) formation, LH/hCG signaling, and the role of novel regulatory molecules in these developmental processes.

DESIGN

Review of some of the past and recent advances in ovarian biology, focusing attention on [1] two novel oocyte-derived growth factors, growth differentiation factor-9 (GDF-9) and bone morphogenetic protein (BMP-15); and [2] a recently discovered follicular insulin-like growth factor binding protein-4 (IGFBP-4) protease, pregnancy-associated plasma protein-A (PAPP-A), that can degrade the FSH antagonist IGFBP-4.

RESULT(S)

Oocyte-derived GDF-9 and BMP-15 are obligatory for folliculogenesis and female fertility in laboratory animals through their ability to stimulate granulosa cell proliferation and modulate FSH-dependent cytodifferentiation. The expression of these growth factors in human primary oocytes supports the hypothesis that GDF-9 and BMP-15 could be involved in ovary function in women. Pregnancy-associated plasma protein-A is a marker for the human dominant follicle and its product the corpus luteum, raising the possibility that this putative FSH antagonist might regulate FSH bioactivity during folliculogenesis and luteogenesis.

CONCLUSION(S)

Oocyte-derived and granulosa-derived regulatory proteins perform very important functions in FSH-dependent folliculogenesis. The current challenges are to understand the role of these novel proteins in ovary physiology and pathophysiology in women.

Developmental regulation of mitogen-activated protein kinase-activated kinases-2 and -3 (MAPKAPK-2/-3) in vivo during corpus luteum formation in the rat

The current study investigates the activation in vivo and regulation of the expression of components of the p38 mitogen-activated protein kinase (MAPK) pathway during gonadotropin-induced formation and development of the rat corpus luteum, employing a sequential PMSG/human CG (hCG) treatment paradigm. We postulated that the p38 MAPK pathway could serve to promote phosphorylation of key substrates during luteal maturation, since maturing luteal cells, thought to be cAMP-nonresponsive, nevertheless maintain critical phosphoproteins. Both p38 MAPK and its upstream activator MAPK kinase-6 (MKK6) were found to be chronically activated during the luteal maturation phase, with activation detected by 24 h post hCG and maintained through 4 days post hCG. The p38 MAPK downstream protein kinase target termed MAPK-activated protein kinase-3 (MAPKAPK-3) was newly induced at both mRNA and protein levels during luteal formation and maturation, while mRNA and protein expression of the closely related MAPKAPK-2 diminished. Two potential substrates for MAPKAPKs, the small heat shock protein HSP-27 and the cAMP regulatory element binding protein CREB, were monitored in vivo for phosphorylation. HSP-27 phosphorylation was not modulated during luteal maturation. In contrast, we observed sustained luteal-phase CREB phosphorylation in vivo, consistent with upstream MKK6/p38 MAPK activation and MAPKAPK-3 induction. MAPKAPK-3-specific immune complex kinase assays provided direct evidence that MAPKAPK-3 was in an activated state during luteal maturation in vivo. Cellular inhibitor studies indicated that an intact p38 MAPK path was required for CREB phosphorylation in a cellular model of luteinization, as treatment of luteinized granulosa cells with the p38 MAPK inhibitor SB 203580 strongly inhibited CREB phosphorylation. Transient transfection studies provided direct evidence that MAPKAPK-3 was capable of signaling to activate CREB transcriptional activity, as assessed by means of GAL4-CREB fusion protein construct coexpressed with GAL4-luciferase reporter construct. Introduction of wild-type, but not kinase-dead mutant, MAPKAPK-3 cDNA, into a mouse ovarian cell line stimulated GAL4-CREB- dependent transcriptional activity approximately 3-fold. Thus MAPKAPK-3 is indeed uniquely poised to support luteal maturation through the phosphorylation and activation of the nuclear transcription factor CREB.

Cloning of two novel mammalian paralogs of relaxin/insulin family proteins and their expression in testis and kidney

Based on sequence homology to insulin and relaxin, we have isolated two novel genes of the insulin superfamily from mouse tissues. Because these proteins show a high similarity to relaxin and relaxin-like factor (RLF or Ley I-L), they were named as RIF1 (relaxin/insulin-like factor 1) and RIF2 (relaxin/insulin-like factor 2). After RT-PCR, full-length cDNAs of RIF1 and RIF2 were obtained from mouse testis and ovary, respectively. In addition, a putative human ortholog of RIF1 was isolated from human testis. The deduced coding regions of mRIF1, mRIF2, and hRIF1 were 191, 145, and 213 amino acids, respectively, and all three proteins contain a typical signal sequence for secretion at their amino terminus. Sequence comparison indicated that RIFs encode proteins consisting of B and A subunits connected by a long C domain peptide, and the deduced mature proteins of these putative ligands are most closely related to relaxin, RLF, and insulin from different species. Northern blot analysis showed that RIF1 transcripts are approximately 1.2 kb in size and are expressed mainly in testis of mouse and human. In contrast, RIF2 message of 2.0 and 1.2 kb are preferentially expressed in mouse kidney and are lower in testis, heart, and brain. In addition, immunohistochemical analysis showed that testis expression of RIF1 is restricted to interstitial cells surrounding seminiferous tubules. In kidney, the RIF2 message is localized to selected epithelial cells of loop of Henle. The exclusive expression pattern of RIF1 and related RLF in testis interstitial cells suggested potential physiological roles of these two distinct insulin/relaxin family ligands in testis function. Additionally, the spatial expression pattern of RIF2 suggests a novel role of RIF2 in nephrophysiology. Identification of RIF polypeptides expands the family of relaxin- and insulin-like hormones and allows future elucidation of the physiological role and hormonal mechanisms for these tissue-specific factors.