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Grande J, Jones TL, Sun Z, Chanana P, Jaiswal I, Leontovich A, Carapanceanu N, Carapanceanu V, Saadalla A, Osman A, Famuyide AO, Daftary GS, Khan Z, Khazaie K. Host immunity and KLF 11 deficiency together promote fibrosis in a mouse model of endometriosis. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166784. [PMID: 37321514 DOI: 10.1016/j.bbadis.2023.166784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Endometriosis is a debilitating disease typically characterized by prolific fibrotic scarring. Earlier we reported downregulation of two transcription factors belonging TGF-βR signaling pathway Sp/Krüppel-like factor 11 (KLF11) and 10 (KLF10) in human endometriosis lesions. Here we investigated the role of these nuclear factors and immunity in the scaring fibrosis associated with endometriosis. METHODS We used a well characterized experimental mouse model of endometriosis. WT, KLF10 or KLF11 deficient mice were compared. The lesions were evaluated histologically, fibrosis was quantified with Masons' Trichome staining, immune-infiltrates were quantified by immunohistochemistry, peritoneal adhesions were score, gene expression was evaluated by bulk RNA sequencing. RESULTS Intense fibrotic reactions and large changes in gene expression were detected in KLF11 deficient implants associated with squamous metaplasia of the ectopic endometrium, as compared to KLF10 deficient or WT implants. Fibrosis was mitigated with pharmacologic agents that blocked histone acetylation or TGF-βR signaling or with genetic deficiency for SMAD3. The lesions were richly infiltrated with T-cells, regulatory T-cells, and innate immune cells. Fibrosis was exacerbated when implants expressed ectopic genes implicating autoimmunity as a major factor contributing to the scaring fibrosis. CONCLUSIONS Our findings identify KLF11 and TGF-βR signaling as cell intrinsic mechanisms and autoimmune responses as cell extrinsic mechanisms of scaring fibrosis in ectopic endometrium lesions. GENERAL SIGNIFICANCE Immunological factors associated with inflammation and tissue repair drive scaring fibrosis in experimental endometriosis, providing the rationale for immune therapy of endometriosis.
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Affiliation(s)
- Joseph Grande
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Tiffanny L Jones
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Zhifu Sun
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Pritha Chanana
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Indu Jaiswal
- Department of Immunology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Alexey Leontovich
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Nicoletta Carapanceanu
- Department of Immunology, Mayo Clinic, CRB, 2-221, 13400 E. Shea Blvd., Scottsdale, AZ 85259, United States of America
| | - Valentin Carapanceanu
- Department of Immunology, Mayo Clinic, CRB, 2-221, 13400 E. Shea Blvd., Scottsdale, AZ 85259, United States of America
| | - Abdulrahman Saadalla
- Department of Immunology, Mayo Clinic, CRB, 2-221, 13400 E. Shea Blvd., Scottsdale, AZ 85259, United States of America
| | - Abu Osman
- Department of Immunology, Mayo Clinic, CRB, 2-221, 13400 E. Shea Blvd., Scottsdale, AZ 85259, United States of America
| | - Abimbola O Famuyide
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Gaurang S Daftary
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Zaraq Khan
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Khashayarsha Khazaie
- Department of Immunology, Mayo Clinic, CRB, 2-221, 13400 E. Shea Blvd., Scottsdale, AZ 85259, United States of America.
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Environmental Factors and Endometriosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111025. [PMID: 34769544 PMCID: PMC8582818 DOI: 10.3390/ijerph182111025] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022]
Abstract
Endometriosis is a common disease, affecting up to 60-80% of women, with pelvic pain or/and infertility. Despite years of studies, its pathogenesis still remains enigmatic. Genetic, hormonal, environmental, and lifestyle-related factors may be involved in its pathogenesis. Thus, the design of the review was to discuss the possible role of environmental factors in the development of endometriosis. The results of individual studies greatly differ, making it very difficult to draw any definite conclusions. There is no reasonable consistency in the role of environmental factors in endometriosis etiopathogenesis.
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Matta K, Koual M, Ploteau S, Coumoul X, Audouze K, Le Bizec B, Antignac JP, Cano-Sancho G. Associations between Exposure to Organochlorine Chemicals and Endometriosis: A Systematic Review of Experimental Studies and Integration of Epidemiological Evidence. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:76003. [PMID: 34310196 PMCID: PMC8312885 DOI: 10.1289/ehp8421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 05/04/2021] [Accepted: 06/21/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Growing epidemiological evidence suggests that organochlorine chemicals (OCCs), including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), may play a role in the pathogenesis of endometriosis. OBJECTIVES We aimed to systematically review the experimental evidence (in vivo and in vitro) on the associations between exposure to OCCs and endometriosis-related end points. METHODS A systematic review protocol was developed following the National Toxicology Program /Office of Health Assessment and Translation (NTP/OHAT) framework and managed within a web-based interface. In vivo studies designed to evaluate the impact of OCCs on the onset or progression of endometriosis and proliferation of induced endometriotic lesions were eligible. Eligible in vitro studies included single-cell and co-culture models to evaluate the proliferation, migration, and/or invasion of endometrial cells. We applied the search strings to PubMed, Web of Science, and Scopus®. A final search was performed on 24 June 2020. Assessment of risk of bias and the level of evidence and integration of preevaluated epidemiological evidence was conducted using NTP/OHAT framework Results: Out of 812 total studies, 39 met the predetermined eligibility criteria (15 in vivo, 23 in vitro, and 1 both). Most studies (n=27) tested TCDD and other dioxin-like chemicals. In vivo evidence supported TCDD's promotion of endometriosis onset and lesion growth. In vitro evidence supported TCDD's promotion of cell migration and invasion, but there was insufficient evidence for cell proliferation. In vitro evidence further supported the roles of the aryl hydrocarbon receptor and matrix metalloproteinases in mediating steroidogenic disruption and inflammatory responses. Estrogen interactions were found across studies and end points. CONCLUSION Based on the integration of a high level of animal evidence with a moderate level of epidemiological evidence, we concluded that TCDD was a known hazard for endometriosis in humans and the conclusion is supported by mechanistic in vitro evidence. Nonetheless, there is need for further research to fill in our gaps in understanding of the relationship between OCCs and their mixtures and endometriosis, beyond the prototypical TCDD. https://doi.org/10.1289/EHP8421.
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Affiliation(s)
- Komodo Matta
- Oniris, INRAE, UMR 1329 Laboratoire d’Étude des Résidus et Contaminants dans les Aliments (LABERCA), Nantes, France
| | - Meriem Koual
- Université de Paris, T3S, Institut national de la santé et de la recherche médicale (Inserm) UMR S-1124, Paris, France
- Service de Chirurgie Cancérologique Gynécologique et du Sein, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Stéphane Ploteau
- Service de gynécologie-obstétrique, Centre d’investigation clinique–Femme Enfant Adolescent, Hôpital Mère Enfant, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Xavier Coumoul
- Université de Paris, T3S, Institut national de la santé et de la recherche médicale (Inserm) UMR S-1124, Paris, France
| | - Karine Audouze
- Université de Paris, T3S, Institut national de la santé et de la recherche médicale (Inserm) UMR S-1124, Paris, France
| | - Bruno Le Bizec
- Oniris, INRAE, UMR 1329 Laboratoire d’Étude des Résidus et Contaminants dans les Aliments (LABERCA), Nantes, France
| | - Jean-Philippe Antignac
- Oniris, INRAE, UMR 1329 Laboratoire d’Étude des Résidus et Contaminants dans les Aliments (LABERCA), Nantes, France
| | - German Cano-Sancho
- Oniris, INRAE, UMR 1329 Laboratoire d’Étude des Résidus et Contaminants dans les Aliments (LABERCA), Nantes, France
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Giampaolino P, Della Corte L, Foreste V, Barra F, Ferrero S, Bifulco G. Dioxin and endometriosis: a new possible relation based on epigenetic theory. Gynecol Endocrinol 2020; 36:279-284. [PMID: 31805795 DOI: 10.1080/09513590.2019.1698024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Endometriosis is a chronic disease characterized by the growth of endometrial-like glands and stroma outside the uterine cavity. Nowadays, the exact etiology of endometriosis is unclear and the interaction between a variety of environmental physical and chemical compounds may potentially promote the disease in women with an individual susceptibility. The first demonstration of a relation between an environmental factor and endometriosis was obtained with the chronic dietary exposure of a primate colony to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Besides the well-known dioxin's pathway of action, several papers are focusing on the role of epigenetic mechanisms, a way through which the genome responds to the environment and can lead to permanent changes in gene expression until affecting the phenotypes or cause disease. In this review, we focus on the possible role of dioxin epigenetics modification in endometriosis.
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Affiliation(s)
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Virginia Foreste
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Giuseppe Bifulco
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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