2,3,7,8-Tetrachlorodibenzo-p-dioxin increases glycodelin gene and protein expression in human endometrium

Pain Symptoms and Peritoneal Fluid Cytokine and Marker Concentrations in Women with and without Endometriosis

Purpose

Endometriosis is not only associated with infertility, it is also a common cause of pain in women, leading to work absenteeism and a reduced quality of life. The objective of this study was to confirm the increased peritoneal fluid (PF) concentration of several cytokines in endometriosis patients, to investigate their association with pain levels, and to identify new biological markers in the PF which are neurostimulatory and thus responsible for the appearance and severity of different types of pain.

Methods

Our sample group included 111 patients with histologically confirmed endometriosis and 47 controls undergoing laparoscopy for reasons of abdominal pain or infertility. They rated their pain during menstruation, during sexual intercourse and general lower abdominal pain prior to undergoing surgery in our clinic using a visual analogue scale. During laparoscopy, PF was aspirated. Marker cytokine concentrations were measured by immunoassay and correlated to the Revised American Fertility Society (rAFS) stage of endometriosis and to the pain level using non-parametric methods.

Results

Differences were found between the correlations of the peritoneal fluid levels of many cytokines with dysmenorrhea or lower abdominal pain, and with the presence of severe endometriosis (rAFS III+IV). Glycodelin and osteoprotegerin (OPG) show the strongest associations with menstrual pain, while IL-8, MCP-1 and OPG were correlated to the stage of endometriosis. Low density cytokine protein arrays did not contribute to finding new markers for endometriosis and pain.

Conclusions

These findings illustrate the large variation of cytokine levels between patients. Glycodelin, IL-8 and OPG are the most likely targets for further investigations towards their future clinical use.

Aryl hydrocarbon receptor and unexplained miscarriage

AIM

The aim of this study was to carry out a preliminary investigation of the expression of aryl hydrocarbon receptor (AhR) in decidua and villus and the relationship between AhR and unexplained miscarriage.

METHODS

The expression of AhR mRNA and protein from decidua and villus were measured using real-time reverse transcription-polymerase chain reaction, western blot and immunohistochemistry in 34 patients with unexplained miscarriage (miscarriage group) and 38 women with normal early pregnancy (control group).

RESULTS

The AhR mRNA and protein expression was increased significantly in the villus in both groups compared with decidua (P < 0.05, P < 0.05). In decidua, AhR mRNA and protein expression in the miscarriage group was increased significantly compared with the control group (P < 0.05, P < 0.05). In villus, AhR mRNA and protein expression in the miscarriage group was increased significantly compared with the control group (P < 0.05, P < 0.05). AhR is expressed mostly in the cytoplasm of syncytiotrophoblasts in villus, and also in the cytoplasm of decidual cells.

CONCLUSIONS

AhR was expressed more in the villus than in the decidua, and the upregulation of AhR mRNA and protein expression is associated with the pathogenesis of unexplained miscarriage.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) inhibits human ovarian cancer cell proliferation

PURPOSE

The aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor, mediates a broad spectrum of biological processes, including ovarian growth and ovulation. Recently, we found that an endogenous AhR ligand (ITE) can inhibit ovarian cancer proliferation and migration via the AhR. Here, we tested whether 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, an exogenous AhR ligand) may exert similar anti-ovarian cancer activities using human ovarian cancer and non-cancerous human ovarian surface epithelial cells.

METHODS

Two human ovarian cancer cell lines (SKOV-3 and OVCAR-3) and one human ovarian surface epithelial cell line (IOSE-385) were used. Cell proliferation and migration activities were determined using crystal violet and FluoroBlok insert system assays, respectively. AhR protein expression was assessed by Western blotting. Expression of cytochrome P450, family 1, member A1 (CYP1A1) and member B1 (CYP1B1) mRNA was assessed by qPCR. Small interfering RNAs (siRNAs) were used to knock down AhR expression.

RESULTS

We found that TCDD dose-dependently suppressed OVCAR-3 cell proliferation, with a maximum effect (~70% reduction) at 100 nM. However, TCDD did not affect SKOV-3 and IOSE-385 cell proliferation and migration. The estimated IC50 of TCDD for inhibiting OVCAR-3 cell proliferation was 4.6 nM. At 10 nM, TCDD time-dependently decreased AhR protein levels, while it significantly increased CYP1A1 and CYP1B1 mRNA levels in SKOV-3, OVCAR-3 and IOSE-385 cells, indicating activation of AhR signaling. siRNA-mediated AhR knockdown readily blocked TCDD-mediated suppression of OVCAR-3 cell proliferation.

CONCLUSION

Our data indicate that TCDD can suppress human ovarian cancer cell proliferation via the AhR signaling pathway and that TCDD exhibits an anti-proliferative activity in at least a subset of human ovarian cancer cells.

Reproductive medicine and inheritance of infertility by offspring: the role of fetal programming

OBJECTIVE

To summarize the molecular processes involved in fetal programming, to describe how assisted reproduction technologies (ART) may affect the epigenetic pattern of the embryo, and to highlight the current knowledge of the role of perinatal events in the subsequent development of reproductive pathology affecting infertile patients.

DESIGN

A literature review of fetal programming of adulthood gynecologic diseases and ART. A Medline search was performed with the following keywords: (fetal programming OR epigenetics OR methylation OR acetylation) AND (IVF OR ART) AND (gynecology). Articles up to October 2010 were selected. Articles and recent reviews were classified by human and animals studies and also according to their experimental or observational design.

SETTING

University hospital research center.

PATIENT(S)

None.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

None.

RESULT(S)

Data from experimental animal models and case-control studies support the potential effect of ART in changing methylation patterns in gametes and embryos. However, these findings are not supported by population studies or experimental studies performed in human gametes/embryos. Experimental and epidemiologic studies support the hypothesis that some adult gynecologic diseases causing infertility may have a fetal origin.

CONCLUSION(S)

Although it seems clear that some adult gynecologic diseases causing infertility may have a fetal origin, there is insufficient evidence to confirm that ART is the origin of later onset, adulthood diseases. Further research in this field must be conducted.

The expression of the aryl hydrocarbon receptor in reproductive and neuroendocrine tissues during the estrous cycle in the pig

The aryl hydrocarbon receptor (AhR) has been recognized as a mediator of xenobiotic-induced toxicity. In addition, it was demonstrated that the AhR is able to influence the regulation of reproductive processes in females. The aim of this study was to examine AhR mRNA (real-time PCR) and protein (Western-blot) expression in ovarian follicles and stroma, corpora lutea (CL), oviducts, endometrium, myometrium as well as in medial basal hypothalami (MBH), and anterior (AP) and posterior (PP) pituitaries harvested during the follicular (days 17-19) and luteal (days 8-10) phase of the porcine estrous cycle. The AhR transcript and protein were found in all structures collected during both phases. AhR mRNA expression tended (p=0.06) to be higher in the CL than in follicles. The AhR protein expression in ovarian stroma was higher (p≤0.01) during the follicular than in the luteal phase. Endometrial expression of AhR mRNA was higher (p≤0.01), while AhR protein was lower (p≤0.01) during the follicular phase in comparison to the luteal phase. Within neuroendocrine tissues, AhR mRNA and protein content in hypothalamus were relatively low and did not differ (p>0.05) between phases. In contrast, higher AhR mRNA expression in AP (p≤0.001) and protein expression in PP (p≤0.01) were found during the luteal phase compared to the follicular phase. Differences in AhR expression observed in reproductive and neuroendocrine tissues during the follicular and luteal phase of the estrous cycle indicate the involvement of AhR in the regulation of reproductive function in pigs.

Estrogen-independent actions of environmentally relevant AhR-agonists in human endometrial epithelial cells

The human endometrium is a cyclically regenerating organ under the influence of ovarian steroid hormones. Disturbances in this highly coordinated regulation of endometrial proliferation and differentiation may result in infertility and diseases such as endometriosis and endometrial cancer. Environmental toxins belonging to the group of polyhalogenated aromatic hydrocarbons (PAHs) are lipophilic xenobiotics, which accumulate in biological systems. PAHs have been implicated in the etiology of uterine pathologies, including infertility, endometriosis and endometrial cancer. However, suitable cellular models of the endometrium are lacking and the molecular mechanism of PAH action in the endometrium is not fully understood. In this study, we have characterized a previously established immortalized human telomerase reverse transcriptase (hTERT) endometrial epithelial cell (hTERT-EEC) model as a responsive in vitro cell model to investigate the cellular and molecular mechanisms of selected environmentally relevant PAH in human EECs. We show that dioxin-type PAHs activate the endogenous arylhydrocarbon receptor (AhR) signaling pathway in hTERT-EEC in a time-, concentration- and congener-specific manner and that the induction of AhR target genes is modulated by estrogen. Strikingly, AhR activation did not interfere with estrogenic actions in these EECs. Independent of their ability to bind to AhR, the PAHs investigated here increased cell migration by hTERT-EEC. Furthermore, we have identified several candidates by proteomic analysis, which are involved in heat shock responses and protein modification and turnover. Our data suggest that AhR-activating environmental pollutants directly alter endometrial cell stress responses and metabolism independent of estrogenic actions.

Correlation between symptoms of pain and peritoneal fluid inflammatory cytokine concentrations in endometriosis

Endometriosis affects 10-20% of women during reproductive age and is a common cause of infertility and pain leading to work absenteeism and reduced quality of life.The objective of this study was to investigate the association between the presence and concentration of interleukin-8 (IL-8), RANTES, osteoprotegerin (OPG), pregnancy-associated plasma protein A (PAPP-A), tumour necrosis factor-alpha (TNF-alpha), midkine and glycodelin in the peritoneal fluid (PF) and the intensity of pain reported by patients undergoing laparoscopy in our clinic. They rated their pain during menstruation, intercourse and lower abdominal using a visual analogue scale. During laparoscopy, PF was aspirated. Pain scores were correlated to the concentration of the above substances in the PF and to the stage of endometriosis. Endometriosis was histologically confirmed in 41 of 68 participating women; 27 without such evidence were considered as controls. TNF-alpha and glycodelin correlated positively with the level of menstrual pain. For IL-8, RANTES, OPG and PAPP-A no correlation between their PF concentration and the menstrual pain scores was observed. Patients with severe dysmenorrhoea had increased PF cytokine and marker levels; the difference was significant for TNF-alpha and glycodelin when compared with the other patients (no or moderate pain). TNF-alpha and glycodelin may thus play a role in endometriosis and the severity of menstrual pain.

The role of the aryl hydrocarbon receptor in the female reproductive system

In recent years, many studies have emphasized how changes in aryl hydrocarbon receptor (AHR)-mediated gene expression result in biological effects, raising interest in this receptor as a regulator of normal biological function. This review focuses on what is known about the role of the AHR in the female reproductive system, which includes the ovaries, Fallopian tubes or oviduct, uterus and vagina. This review also focuses on the role of the AHR in reproductive outcomes such as cyclicity, senescence, and fertility. Specifically, studies using potent AHR ligands, as well as transgenic mice lacking the AHR-signaling pathway are discussed from a viewpoint of understanding the endogenous role of this ligand-activated transcription factor in the female reproductive lifespan. Based on findings highlighted in this paper, it is proposed that the AHR has a role in physiological functions including ovarian function, establishment of an optimum environment for fertilization, nourishing the embryo and maintaining pregnancy, as well as in regulating reproductive lifespan and fertility. The mechanisms by which the AHR regulates female reproduction are poorly understood, but it is anticipated that new models and the ability to generate specific gene deletions will provide powerful experimental tools for better understanding how alterations in AHR pathways result in functional changes in the female reproductive system.

Mechanistic and therapeutic implications of angiogenesis in endometriosis

Like tumor metastases, endometriotic implants require neovascularization to proliferate and invade into ectopic sites within the host. Endometrial tissue, with its robust stem cell populations and remarkable regenerative capabilities, is a rich source of proangiogenic factors. Among the most potent and extensively studied of these proteins, vascular endothelial growth factor has emerged as a critical vasculogenic regulator in endometriosis. Accordingly, angiogenesis of the nascent endometriotic lesion has become an attractive target for novel medical therapeutics and strategies to inhibit vascular endothelial growth factor action. Vascular endothelial growth factor gene regulation in endometrial and endometriosis cells by nuclear receptors, other transcription factors, and also by infiltrating immune cells is emphasized. New data showing that oxidative and endoplasmic reticulum stress increase vascular endothelial growth factor expression are provided. Finally, we review the clinical implications of angiogenesis in this condition and propose potential antiangiogenic therapies that may become useful in the control or eradication of endometriotic lesions.

Female reproductive disorders: the roles of endocrine-disrupting compounds and developmental timing

OBJECTIVE

To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive disruptions warrant evaluation of the impact of EDCs on female reproductive health.

DESIGN

Publications related to the contribution of EDCs to disorders of the ovary (aneuploidy, polycystic ovary syndrome, and altered cyclicity), uterus (endometriosis, uterine fibroids, fetal growth restriction, and pregnancy loss), breast (breast cancer, reduced duration of lactation), and pubertal timing were identified, reviewed, and summarized at a workshop.

CONCLUSION(S)

The data reviewed illustrate that EDCs contribute to numerous human female reproductive disorders and emphasize the sensitivity of early life-stage exposures. Many research gaps are identified that limit full understanding of the contribution of EDCs to female reproductive problems. Moreover, there is an urgent need to reduce the incidence of these reproductive disorders, which can be addressed by correlative studies on early life exposure and adult reproductive dysfunction together with tools to assess the specific exposures and methods to block their effects. This review of the EDC literature as it relates to female health provides an important platform on which women's health can be improved.

[New insights into the pathophysiology of endometriosis]

Endometriosis is a fascinating and complex disease resulting from a dysregulation between exfoliated menstrual endometrium and the intra-abdominal environment. Increased concentrations of activated pelvic macrophages and lymphocytes and elevated levels of specific cytokines and growth factors in the peritoneal fluid support this hypothesis. The precise roles of these soluble factors are currently unknown, but we propose that a complex interplay of these locally produced cytokines, growth factors, steroids and eicosanoids modulates the growth and inflammatory behavior of ectopic endometrial implants via neovascularization. The enhanced secretion of local proangiogenic proteins by endometriosis lesions and associated immune cells (and the concomitant reduction of antiangiogenic principles) promotes the recruitment of capillaries toward the growing lesions. Ultimately, a cascade of effects on the peritoneal microenvironment results in implant proliferation and invasion. Future therapeutic strategies to target these angiogenic stimuli have the potential to block the vascular pathogenesis of endometriosis. This article gives an overview of the different factors involved in the development, growth and progression of endometriosis.